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Meningioma

CT brain scan with acute subdural hematomaMeningiomas, also called meningioma tumors, are the most common type of primary brain tumors. A meningioma grows in the meninges, which are the layers of tissue that cover both the brain and spinal cord.

As these tumors grow, they compress tissue in the surrounding areas, which can have an adverse effect on the cranial nerves, leading to a wide range of neurological symptoms.

There are three different grades of meningiomas — grade I, grade II and grade III — identifying the severity of the tumor and its characteristics.

Grade I is the lowest grade of meningioma and the most common type, with tumor cells that grow slowly. Grade II meningiomas are considered midgrade tumors, meaning they could come back after they’re removed. Grade III meningiomas are the only grade that’s cancerous, and this grade of tumor is fast-growing.

While most cases of meningioma are benign, these tumors can grow steadily over time, eventually becoming very large and disabling.

Meningioma is typically diagnosed more often among older adults, and it is also more common among African Americans. Other risk factors for meningioma include excess exposure to ionizing radiation and a genetic disorder called neurofibromatosis type 2.

Symptoms of Meningioma

In most cases, a meningioma will be slow-growing and cause few noticeable symptoms. As the tumor progresses in size over time, though, patients with a meningioma may begin to experience symptoms.

The individual symptoms a person might experience will vary depending on the location of the meningioma. For example, someone with a spinal meningioma might experience back pain or pain in the limbs, while someone who has a meningioma of the olfactory groove (the nerves between the brain and the nose) may experience a loss of smell or vision problems. Meningioma symptoms may include:

  • Behavioral or cognitive changes
  • Confusion
  • Drowsiness
  • Headaches
  • Hearing loss
  • Muscle weakness
  • Nausea and vomiting
  • Seizures
  • Vision changes

How Meningioma Is Diagnosed

Meningiomas can be difficult to diagnose in some cases because the symptoms are often subtle and mimic those associated with normal aging. But if a person is experiencing symptoms associated with meningioma, a doctor can take several steps to conclusively determine whether this type of tumor is to blame.

A doctor will first carefully review the person’s symptoms being experienced as well as his or her personal and family medical history. From there, the doctor will conduct a thorough medical exam that will likely also include a neurological evaluation. Imaging tests, such as CT and MRI, will also be ordered to help visualize the brain and spinal cord.

If a meningioma is identified through an imaging scan, biopsy will be used to determine whether the tumor is benign or malignant. A type of imaging called magnetic resonance spectroscopy may also be used to examine the meningioma’s chemical makeup.

Treatment for Meningioma

For patients with grade I meningiomas or meningiomas that cause no symptoms, a doctor may recommend observation rather than an active treatment plan. This would include regular checkups and imaging scans to identify whether the tumor has gotten bigger or worsened.

For symptomatic meningiomas and those that are grade II and grade III, surgery is the recommended treatment standard. Surgery is used to remove as much of the tumor as possible without resulting in additional symptoms. Because meningiomas typically have a defined border, complete surgical removal is possible in many cases.

Radiation therapy may be used in conjunction with surgery to delay the return of grade II and grade III tumors, which can recur. In the case of aggressive tumors or those that cannot be resected, chemotherapy may also be recommended.

 

Sources:

https://www.cancer.gov/rare-brain-spine-tumor/tumors/meningioma

https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Meningiomas

https://braintumor.org/brain-tumor-information/meningioma/