Suprasellar meningiomas: analysis of 32 cases

Suprasellar meningiomas originating from the tuberculum sellae, diaphragma sellae and planum sphenoidale are uncommon. Tumors of these regions can cause insidious visual loss and often remain undiagnosed until they have enlarged substantially or the symptoms have become aggravated. Previous reports have identified tumor size and duration of symptoms as the major factors determining the patient outcome.

Between 1984 and 1995, at the Department of Neurosurgery, Neurological Institute of Veterans General Hospital-Taipei, 32 patients with histopathologically identified meningiomas originating from the suprasellar region received surgical tumor removal. In this study, the records and clinical data of these patients are retrospectively analyzed.

Tumor sizes ranged from 1.4 to 6.4 cm (average 3.4 cm) in diameter. The age of the patients ranged from 15 to 70 years (average 49 years), with the highest number of patients in their 50s. The male to female ratio was 7:25, with female predominance in all age groups. The presenting symptoms were mostly visual loss (87.5%) and the duration of symptoms ranged from 2 months to 35 years (average 4.25 years). Prognosis was evaluated according to the tumor size and duration of symptoms. Results showed that prognosis was favorably affected by a tumor size of 3.0 cm or less, and symptom duration of one year or less.

In this series, patients with a tumor size of 3 cm or less and patients with a duration of symptoms for one year or less had a better visual outcome, higher total removal rates, lower mortality rates and lower recurrence rates.