Accidentally detected brain tumors: clinical analysis of a series of 110 patients

The clinical records of 1,155 patients with 1,159 brain tumors who drained on Keio University Hospital between 1983 and 1994 were reviewed. Apparently a symptomatic patients and those whose complaints or neurological deficits were not caused by the brain tumors were defined as accidental cases. For example, patients with a headache which was considered to be unrelated to the presence of a tumor were included in this series. One hundred and ten (9.5%) of the 1,155 cases were found to be accidental. Since three accidental cases had multiple meningiomas, there were 113 accidental brain tumors which involved 63 meningiomas, 22 pituitary adenomas, 9 gliomas, 7 metastatic carcinomas, 5 acoustic neurinomas and 7 miscellaneous. Meningiomas occurred significantly more frequent than other types of accidentally identified tumors. Convexity meningiomas and falx meningiomas accounted for 53.9% of the accidental meningiomas, whereas parasagittal meningiomas were less frequent. It is of note that three out of four cases with multiple meningiomas were accidental. Comparison between the present results and the previously reported incidence of asymptomatic brain tumors in postmortem studies suggest that a substantial number of pituitary adenomas, acoustic neurinomas and small parasagittal meningiomas without suggestive symptoms are likely to be missed by routine neuroradiological examinations.