Meningiomas represent about 15 percent of all primary brain tumors and 12 percent of all spinal cord tumors. They can occur in children, but most often occur in adults between the ages of 40 and 60 years. Most meningiomas are benign, as less than 10percent of meningiomas are malignant.
What is a meningioma?
A meningioma is a brain tumor that grows in the meninges, a thin layer of tissue covering the brain and spinal cord. Some meningiomas contain cysts or calcified mineral deposits, and others contain hundreds of tiny blood vessels. Because meningiomas tend to grow inward, they commonly cause pressure on the brain or spinal cord. Although less common, meningiomas can grow outward, causing the skull to thicken. Meningiomas grow very slowly, and it is often many years before they become symptomatic.
What are the symptoms?
Symptoms vary by location and size of the tumor. They often first appear as headaches and seizures, primarily due to increased pressure of the growing tumor. Weakness in the arms or legs, or loss of sensation, may occur with spinal cord meningiomas.
How do I know if I have a meningioma?
Your specialist will conduct a neurological examination, followed by CT scans and/or an MRI. This will help determine the size, location and type of tumor, if one exists. Skull x-rays may be obtained if the tumor is believed to involve the bone. For spinal cord tumors, a myelogram may be done, and in some cases, arteriograms, or x-rays of the blood vessels, are necessary. The diagnosis can be confirmed by a biopsy.
What treatments are available?
Surgical removal of the tumor is the treatment most often used in patients with meningioma. Aggressive surgery may include removal of part of the meninges and any abnormality in the bone as well as the tumor. Options include:
- Skull base neurosurgery
- Image-guided neurosurgery
- Interventional MRI
- Partial removal. Sometimes, only part of the tumor will be removed because of its location near sensitive areas of the brain. This partial removal can still relieve symptoms, and further surgery may not be needed because of the availability of other effective treatments. Radiation therapy may be used on the remaining tumor cells.
- Growth monitoring. Because of the slow growth of meningiomas, elderly patients with this tumor may be monitored instead of undergoing surgical removal of the tumor. The physician will monitor the growth of the tumor with frequent MRI scans. Patients should report any symptomatic change immediately.
- High-precision radiotherapy, including three-dimensional conformal radiotherapy and stereotactic radiosurgery