The Natural History of Vestibular Schwannoma

  title={The Natural History of Vestibular Schwannoma},
  author={Sven Eric Stangerup and Per Cay{\'e}-Thomasen and Mirko Tos and Jens Christian Thomsen},
  journal={Otology \& Neurotology},
Objective: The incidence of vestibular schwannomas (VSs) approaches 20 per million/yr. As treatment may depend on tumor growth, there is a demand of a treatment strategy based on hard data on the growth pattern of these tumors. This article reports growth data registered prospectively in 552 patients. Study Design: Of the 1,818 consecutive patients, diagnosed with VS during the period from 1975 to 2005, 729 patients were allocated to observation by repetitive magnetic resonance imaging. At… 
The Natural History of Small Vestibular Schwannomas
Overall, the findings in this study suggest that vestibular schwannomas measuring ≤ 4 mm are unlikely to grow and ever require treatment.
Conservative management of 386 cases of unilateral vestibular schwannoma: tumor growth and consequences for treatment.
The results of this study support the role of a conservative "wait-and-scan" policy of management for small-sized vestibular schwannomas because most have a slow growth rate.
Delayed Tumor Growth in Vestibular Schwannoma: An Argument for Lifelong Surveillance.
  • Robert J. Macielak, Neil S. Patel, M. Carlson
  • Medicine
    Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
  • 2019
The findings support the need for lifelong surveillance of untreated VSs given the possibility of clinically significant delayed growth and increasing the time interval between MRI studies after 5 years is a reasonable concession to balance cost and convenience with risk of delayed of tumor growth.
Growth dynamics of the vestibular schwannoma
This thesis empirically evaluates different means of reporting tumor size and growth that can be found in the literature concerning vestibular schwannoma, and presents its own findings of the growth dynamics and predictors of untreated VS, as well as evaluating the treatment outcome and complication rates for tumors treated by gamma knife radiosurgery (GKRS).
Growth of untreated vestibular schwannoma: a prospective study.
Based on the actual measurements, VDT was the most correct way to describe VS growth, and none of the investigated baseline predictors were usable as predictors of growth.
Volumetric growth rates of untreated vestibular schwannomas.
This study comprehensively assessed VS volumetric growth rates using high-resolution images and was conducted in a large and diverse patient sample, finding that larger tumors were associated with increased absolute growth, but there was no relationship between tumor size and proportional growth rate.
Paradoxical trends in the management of vestibular schwannoma in the United States.
Study data demonstrated a shift in the management of small VSs in the US between 2004 and 2007, with microsurgical removal giving way to radiation treatment and the overall rate for observation remaining low and stable.
Management of growing vestibular schwannomas
Most of the tumours affected by unilateral vestibular schwannomas do not grow; in case of tumour growth, a surgical procedure may be suggested and the outcomes are not negatively influenced by the delay of the procedure.


Conservative management of acoustic neuroma.
Few patients with small tumors will come to surgery in the short term, so long-term follow-up studies of 20 years or more are required to be come more confident about the natural history of these tumors.
Incidence and growth pattern of vestibular schwannomas in a Danish county, 1977-98.
The observation of 64 tumours over periods between 5 months and 15 years provided useful information on the natural history of sporadic VS and showed that all VS with positive growth had regular growth patterns.
Conservative management of unilateral acoustic neuromas.
Watchful expectation can be regarded as a safe approach for selected cases of acoustic neuromas as well as an initial conservative approach in patients with proven growth of their tumors.
Conservative management of vestibular schwannomas - second review of a prospective longitudinal study.
Tumours in this study confined to the IAC typically demonstrated minimal or no growth on serial MRI scanning and the role of conservative management in selected cases of vestibular schwannomas was emphasized.
Effectiveness of conservative management of acoustic neuromas.
Conservative management of acoustic neuromas carries difficulties: long-term follow-up of the patients and unpredictability of the tumor growth pattern; a reliable and reproducible radiologic method for evaluating tumor size is of great importance.
Comparison of two radiologic methods for measuring the size and growth rate of extracanalicular vestibular schwannomas.
There was a strong positive correlation between the two methods for assessing both the tumor size and the growth rate of extracanalicular vestibular schwannomas, suggesting that the AAO-HNS method is preferable.
Acoustic tumor growth: implications for treatment choices.
Most ANs followed with periodic MRIs do not grow, and Serial MRIs are advocated for all patients treated with observation.
Conservative treatment of patients with acoustic tumors.
The high incidence of acoustic tumors with no detectable growth or apparent spontaneous regression must be taken into account when evaluating the indications for surgery and the efficacy of radiotherapy.
Conservative management of acoustic neuroma: an outcome study.
Observation is a reasonable management strategy in carefully selected patients with acoustic neuromas and Diligent follow-up with serial magnetic resonance imaging is recommended, because some tumors will enlarge to the point at which active treatment is required.
Size and Growth Rate of Sporadic Vestibular Schwannoma: Predictive Value of Information Available at Presentation
The clinical features available at presentation and diagnosis have no power to predict the expected behavior of sporadic vestibular schwannoma, and the study represents a typical spectrum of patient ages and is of sufficient size in view of the distribution pattern of the variables to give a calculated statistical power in excess of 90% for each variable.