Recent research reveals that meningeal tumours are more prevalent in older women than previously recognised.
In a group of 70-year-olds, 2.7% of women were diagnosed with meningiomas, compared to 1.8% in the general population sampled. This highlights the importance of vigilance in surgical and diagnostic procedures.
The study, conducted at the University of Gothenburg and led by neuroscientist and radiologist Erik Thurin, highlights that many incidental meningiomas are benign and asymptomatic, often discovered during MRI scans performed for unrelated reasons.
While malignant variants remain rare, awareness of these tumours’ prevalence is crucial for timely intervention.
For surgeons managing elderly patients, these findings call for a nuanced approach – balancing watchful waiting with the need for intervention when appropriate – to optimise patient outcomes in this demographic.
Thurin, a neuroscientist at the University of Gothenburg and a radiologist at Sahlgrenska University Hospital, said: ‘We sometimes detect meningiomas in older people as incidental findings on MRI scans when looking for other things. They are often benign, causing no problems in most cases and growing very slowly. Malignant variants are found but very rarely.’
The study was carried out in collaboration with Professor Ingmar Skoog – senior researcher at the university’s department of psychiatry and neurochemistry – and his research team. It was based on the extensive H70 population study, in which 70-year-olds were randomly chosen to attend examinations, including brain MRIs.
Thurin added: ‘We’d seen indications from other countries of many undetected meningiomas among older people, and so we wanted to investigate whether this was the case among Swedish 70-year-olds.’
Most meningioma patients are entirely cured if the tumour is surgically removed. However, surgery can often be avoided as long as the tumour is not growing too rapidly.
In this case, simply monitoring the tumour with regular MRI scans is sufficient to ensure it is not growing. If it appears benign, no immediate action is required.
Thurin said: ‘It’s important not to overreact if the tumour is small. I’ve previously researched how meningioma patients fare after surgery, and I’ve seen that, in some cases, surgery can have unfortunate consequences.
‘One pitfall is if the tumour is found when investigating another problem, such as during an MRI scan to rule out more serious causes following a doctor’s appointment for dizziness. If a small tumour crops up as an incidental finding, it may be mistakenly associated with the original problem, putting the patient at risk of unnecessary surgery. Naturally, there are also situations where surgery is necessary. Patients should always have a thorough consultation with their doctor.’
Thurin concluded: ‘We need to strike a balance between diligence and unnecessary worry. It’s a matter of taking care of our older populations based on both science and common sense.’
