It’s hard to be dogmatic about this without knowing more about the patient’s individual circumstances. A meningioma that small is unlikely to cause symptoms but I suppose that a tumour near the cavernous sinus, for example, could potentially involve cranial nerves. It seems unlikely, however, that a small calcified meningioma over the cerebral convexity would cause symptoms, and it’s not unusual to discover an asymptomatic meningioma on an imaging study.

Herscovici et al (Neurology 2004;63(6):1133-4) conservatively followed 43 patients with 51 meningiomas. CT was repeated after six to nine months and then annually. Mean follow-up exceeded five years. They found a mean growth rate of 4 mm per year but 63% of tumours didn’t change. Younger age and location on the sphenoid ridge were associated with greater growth rate. Smaller and calcified meningiomas were less likely to grow.

Management of meningiomas is highly individual and it’s worth having a neurologist or neurosurgeon review the patient. Since the morbidity of surgery for large meningiomas can be high, it’s important that patients, especially younger ones, aren’t lost to follow-up.

ENTER KEYWORD(S)

To search a phrase, use quotation marks (e.g. "back pain")