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Acoustic tumor growth: implications for treatment choices
M J Fucci1, C A Buchman, D E Brackmann
1House Ear Clinic, Los Angeles, California, USA.
Background:
Knowledge of acoustic neuroma (AN) growth is essential for treatment planning.
Methods:
A retrospective analysis of 119 patients with AN (mean age, 65 years; range, 37-84 years) followed with interval magnetic resonance imagings (MRIs) was performed. Change in maximum tumor dimension as a function of follow-up period was analyzed.
Results:
Overall, maximum tumor dimension increased >2 mm in only 30% of patients. Of those that grew, the mean growth rate was 3.8 mm/year (maximum, 25 mm/year). Age, gender, and laterality did not predict growth. Most tumors that grew (86.1 %) were <20 mm at presentation. However, tumors >20 mm were statistically more likely to grow (71%, p =0.028).
Conclusions:
Most ANs followed with periodic MRIs do not grow. Available clinical information usually cannot predict growth. Serial MRIs are advocated for all patients treated with observation.
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