P16.06.A INCIDENCE, FOLLOW UP AND OUTCOME IN INCIDENTAL MENINGIOMA IN THE GOTHENBURG REGION - WHAT HAS HAPPENED IN 10 YEARS?

Abstract

Abstract BACKGROUND Meningiomas constitute a large portion of brain tumors, with an often indolent natural course of disease. There a now more asymptomatic meningiomas diagnosed each year as compared to their symptomatic counterparts. With brain imaging widely available, increased findings of incidental meningiomas have emerged. There are many unique challenges to the management of incidental meningioma, where if no symptoms are present, there is a lack of evidence-based guidelines for follow-up and treatment. The aim of this study was to map the use of brain scanning, and the subsequent findings of presumed incidental meningioma between the years 2008-2009 and 2018-2019, and to study differences in follow-up, treatment, and outcome among these patients. MATERIAL AND METHODS Records of performed CT and MRI of the brain at the radiological departments at three hospital sites were retrospectively reviewed in search for patients with presumed incidental meningioma. Their medical health records were the used to study the natural course and clinical handling of these patients. RESULTS An almost identical number of patients underwent brain scanning at our three hospital sites during the two time periods (n=22 259 vs. 22 013). In 2018-2019, 25% more incidental meningiomas were diagnosed as compared to 2008-2009 (n=161 vs. 129). In the later years, patients had a higher median age (79 years vs. 73 years, p=0.03) and more often underwent brain imaging due to non-metastatic cancer (n=38 vs. 15, p=0.009). There were no differences in the indication for diagnostic scanning, nor management decision at time of diagnosis. CONCLUSION We could not show an increase in patients undergoing scanning of the brain between the two time periods studied, but with passing time it has become more common to frequently scan the brain of elder individuals, and individuals with cancer without metastases, perhaps due to improved treatment options for patients if metastatic disease was found. When an incidental meningioma was subsequently found, no differences could be seen in the clinical handling of the patients in terms of treatment or follow-up.