Meningioma

What is a meningioma?

 

A meningioma is a type of tumour that is typically benign (non-cancerous). They arise from membranes covering and indenting the brain (and rarely the spinal cord).

Most meningiomas are solitary and sporadic, that arise for no clear reason. Rarely meningiomas can develop as part of other tumour syndromes such as NF2. A known cause can be radiation treatment in childhood. Meningiomas tend to occur more commonly in women (around 2/3) than men (1/3).

Typically, they grow very slowly, but with growth may cause focal neurological symptoms.

There are generally 3 different grades of meningioma:

Grade I – tumour grows very slowly (majority of meningiomas are grade 1)

Grade II – tumour grows more quickly and is often called atypical meningioma

Grade III – tumour grows and spreads very quickly and is often called anaplastic or malignant meningioma (very rare and only account for 1-4% of all meningiomas).

 

 

 

 

What are the symptoms?

 

With increased scanning, meningiomas are often found by chance before causing any symptoms. With growth they can cause headaches from raised pressure in the head. If the meningioma affects the underlying brain, symptoms will relate to the area of the brain that is affected by the tumour and what that area controls.

Symptoms of a meningioma may include:

Headaches Seizures Drowsiness Changes in personality or behaviour Weakness, especially in arms and legs Problems with speech, vision or hearing Memory loss

 

How is a meningioma diagnosed?

 

In a lot of cases, meningiomas are asymptomatic. They can often be found incidentally during investigations for other conditions.

If there is suspicion of a meningioma, your doctor will conduct a full neurological evaluation followed by an imaging test, like an MRI or a CT scan, to get an image of your brain and locate the tumour.

The only definitive way of confirming a meningioma and its grade is by a biopsy (examination of a tumour sample). The tissue obtained will outline the appropriate treatment plan or whether to ‘watch and wait’ to observe any changes.

 

How is a meningioma treated?

 

Treatment depends on the location, grade, characteristics, and behaviour of the meningioma. Small, asymptomatic meningiomas may not require immediate treatment. Their development can be carefully monitored with regular scans to detect growth or changes - in which case intervention may be required.

For some meningiomas, the main treatment is surgery. During this intervention, a surgeon will perform a craniotomy (the temporary removal of the bone flap) to extract the tumour.

However, complete removal may not be possible for everyone - for example, if the tumour has invaded surrounding veins. In these cases, the surgeon will extract as much of the meningioma as possible to improve neurological functions.

Your doctor will then recommend alternative treatment, such as Radiotherapy or Stereotactic Radiosurgery, or you may have radiation treatment as the main treatment.

 

What is the prognosis?

 

Tumour location, its size and grade as well as patient factors (such as age) can determine the success rate of treatment. Careful follow up will monitor the treatment success and any further interventions or treatment that may be required.

 

Which specialist treats meningiomas?

 

You will be referred to a neurosurgeon who will confirm your diagnosis and recommend the best treatment for you.