[A case of rapidly growing dumbbell-shaped convexity meningioma]

We have had more opportunities to treat incidental meningiomas owing to the recent development of neuroradiological imaging. Generally, most of them are treated conservatively unless they grow rapidly or change to symptomatic. Rapidly growing meningiomas are unusual because meningiomas are generally benign and slow-growing tumors. Particularly, the indication of surgery in elderly patients with asymptomatic meningiomas must be considered very carefully because of the higher risks of complications or postoperative neurological deficits. The author describes a rare case of a rapidly growing dumbbell-shaped convexity meningioma in an elderly patient. The tumor was removed completely (Simpson grade II), and the pathological diagnosis was atypical meningioma. There was a difference of MIB-1 LI within the tumor, which suggests that the difference of proliferation within the meningioma may have changed it into "dumbbell-shaped". The only factor we could identify to explain the rapid growth was the high MIB-1LI. This represents an interesting example of a rapidly growing meningiomas. Although the indication of aggresive surgery in elderly patients with symptomatic meningiomas should be considered, the postoperative deterioration of quality of life must be avoided. And earlier postoperative rehabilitation can be regarded as indispensable for elderly patients.