Incidental Meningiomas

European Association of NeuroOncology Magazine 2013; 3 (3): 97-99

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Keywords: incidental meningioma,  natural history,  neurosurgery,  radiological finding,  treatment

Background: The growing use of magnetic resonance and computed tomography imaging has facilitated the diagnosis of brain tumours even before the presence of clinical signs. A significant proportion of incidental lesions identified will be meningiomas, at a point for consideration that > 40 % of the diagnosed meningiomas are not associated with clinical signs. The natural history of incidental, asymptomatic, intracranial meningiomas is to be better understood for the development of the treatment strategy: what is the tumour growth rate? How many asymptomatic tumours do eventually become symptomatic? Method: We performed a literature review trying to answer the questions. Results: In case of incidental meningioma, the elements to consider are its location, size, and radiological aspect, the patient’s age and the risk of complications from eventual surgery, any unknown symptoms, multiplicity of lesions, the possibility of malignancy, and other pathological conditions that mimic meningiomas. Radiological characteristics associated with low tumoural growth rate are the presence of calcifications and hypointense regions on T2-weighted MR images. On the radiological aspect, it seems that > 60 % of asymptomatic meningiomas will not grow in size. However, some of them grow rapidly and some meningiomas even of small size will be treated with regard to their location or due to the risk that they might produce neurological deficits. Conclusion: We are in favour of careful follow- up and neurosurgical consultation for all patients with an incidental meningioma.