Background
To investigate the natural history and the growth rate of spheno-orbital meningiomas (SOMs).
Methods
Ninety patients with a diagnosis of SOM were included, and patient charts and imaging were evaluated. In a subset of 32 patients, volumetric studies were performed.
Results
The median follow-up for the entire group was 4Β years (range, 1β15); the mean age was 47.8 (range, 26β93) years; 94% of the patients were female. The most common clinical signs and symptoms were proptosis (93%), visual deterioration (65%), retro-bulbar pain (23%) and diplopia (6%). In 35% of patients in this series, no visual deterioration occurred, and in 30% only mild proptosis was present. The median annual growth rate of the SOMs in the subset of 32 patients was 0.3Β cm^3^/year (range, 0.03β1.8Β cm^3^/year). We assessed a trend for more rapid tumour growth in younger patients and found the initial volume of the tumour (rhoβ=β0.63) and of the soft tissue component (rhoβ=β074) to be significantly related to the growth rate.
Conclusion
SOMs are slow-growing tumours that cause primarily proptosis and visual deterioration. In a significant number of patients, these tumours cause minimal discomfort and symptomatology. Therefore, in the absence of risk factors, we advocate a βwait and seeβ policy. For patients with large SOMs or with a large soft tissue component at first visit or with fast growing SOMs (>1cm^3^/year), a follow-up examination every 6Β months is indicated.