Effects of Age and Gender on the Presentation and Clinical Course of Vestibular Schwannomas: The Birmingham Experience

Objective: Historically, it has been reported that women are more likely to present with vestibular schwannomas (VSs) than men, and it has also been theorized that female sex hormones have an effect on the growth rate of these tumors, although the published data are conflicting. We present our experience of VS patients over the last 15 years with respect to the effect of gender and age on the natural history of VS.

Method: Retrospective case note review of VS patients managed between 1997 and 2012 at University Hospital, Birmingham, UK. Outcome measures recorded were: age, sex, size of tumor at presentation, growth rate, and management. Results were further analyzed for patients older and younger than 50 years, which is the mean age of onset of the menopause in UK women.

Results: Of 896 records reviewed, 49% were male and 51% were female. Women younger than 50 years were significantly more likely to present with larger tumors, to be treated actively following their first presentation, and had a higher annual growth rate than older women and men of the same age.

Conclusion: Our results show that although the sex distribution of VS is nearly equal, younger women tend to have more aggressive tumors, supporting the theory that VS may be sensitive to female sex hormones.