This case involves the missed diagnosis of a meningioma that was approximately 2.3 x 1.5 cm. The mass was not identified by a radiologist on his initial interpretation of an MRI of the head. Two years after the initial screening, the diagnosis was made due to a major seizure episode that warranted more imaging studies of the patient’s brain. Because of the invasive state of the mass, the neurosurgeon was only able to remove 90% of the tumor, and could not use stereotactic brain surgery. There was no way for the surgeon to remove or treat the entire tumor, as it had wrapped around the optic nerve. Following the procedure, and delayed diagnosis, the patient suffered from persistent diplopia and blurry vision, among other complications.
Question(s) For Expert Witness
1. What is the survival rate for this condition if caught at an early stage?
Expert Witness Response E-000572
Most meningiomas grow slowly and have a low mitotic rate, initially. Clinical benefit has been reported in many case series with tumor regression after nuclear medicine. Radiotherapy is mainly used as adjuvant therapy for incompletely resected, high-grade and/or recurrent tumors. It can also be used as primary treatment in some cases (optic nerve meningiomas and some unresectable tumors). Patients whose meningiomas are completely resected usually have an excellent prognosis. The following types of meningiomas are most likely to recur: incompletely excised, malignant, or multiple tumors.
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