Hello @linnyg, I am sorry to hear about the outcome of you recent MRI. Unfortunately, I do not believe that your results are unusual, which is why you are being monitored annually, as you will continue to do if you have the surgery. While you should ask your neurosurgeon about the necessity for the surgery, I can share what I have learned after having had surgery to remove a large meningioma 4.5 yr ago. If feasible, surgical removal of the growth is a very good option because the larger it gets, the more potential it has for causing problems for you, including potential vision and/or hearing impairment, speech and/or mobility impairment, and a whole host of other undesirable effects. The surgery itself is not without risks, but in many cases the benefits outweigh the risks, a good discussion topic to have with your neurosurgeon. I wish you well at your upcoming appointment and on what ever path forward you choose. Best to you!