Meningioma

Meningiomas account for 40% of primary brain tumors in the United States; most are benign. Statistics show an estimated 42,260 people will receive a meningioma diagnosis in 2023, with most cases among adults 65 and older.

What Is Meningioma?

The central nervous system consists of the brain and spinal column, which controls many vital functions, such as emotions, thinking, behavior and other activities. Meningioma is the most common benign primary brain tumor, with 96% occurring within the skull and 4% in the spinal column.

A tumor is a mass that forms when healthy cells change and grow out of control. It can be malignant (cancerous) or benign (noncancerous). A malignant tumor can spread or grow into other body organs, while a benign tumor can grow but will usually not spread.

Meningioma is a slow-growing tumor on the meninges, the delicate membrane covering the brain and spinal cord. If left undetected, they can grow until they are very large and press on the brain or spinal cord over time, which can be severely disabling and life-threatening.

What Causes Meningiomas?

Usually, when cells grow old or become damaged and die, human cells grow and multiply to form new ones. Cancer develops when abnormal cells grow uncontrollably, spread to other parts of the body and create new, abnormal cells that may become tumors.

The cause of meningioma is unknown. However, certain risk factors increase a person's chance of developing meningioma. If you have any of the following conditions associated with meningioma, consult a healthcare provider to help point you in the right direction and help you make more informed lifestyle choices and treatment plan options.

• Age – The risk of meningioma increases among adults aged 65 or older but is rare among children aged 0-14.
• Gender – Incidences of benign meningioma are higher in women during reproductive years and disappear with increasing age. However, incidences of malignant meningioma are equally likely among men and women.
• Radiation exposure – Evidence indicates a connection between meningioma and exposure to radiation, especially high doses to the head. Common sources of radiation that can cause meningioma include full-mouth dental radiographs, accidental exposure to radiation and radiat1ion therapy as a treatment for ringworm on the scalp.
• Genetics – Neurofibromatosis type 2, a hereditary disorder, puts a person at a higher risk of developing malignant or multiple meningiomas.
• Race/ethnicity – Meningioma is more common among African Americans than other ethnic groups in the United States and Africa than in North America or Europe.

What Are Meningioma Symptoms?

Slow-growing tumors like meningioma often do not cause signs and symptoms until they reach a large size. The disease is often discovered through a brain scan for an unrelated condition. Symptoms of meningioma may include the following:

• Headaches
• Seizures
• Change in personality or behavior
• Progressive focal neurologic deficit
• Confusion
• Drowsiness
• Hearing loss or ringing in the ears
• Muscle weakness
• Nausea or vomiting
• Visual disorders

How To Diagnose Meningioma?

Diagnosing meningiomas can be difficult. Meningioma symptoms are so subtle that the doctor may attribute them to normal signs of aging or associate them with other medical conditions. Getting a correct diagnosis may take several years.

Generally, meningioma is only diagnosed until symptoms begin. If you have signs of mental dysfunction, new seizures and persistent headaches, consult your doctor for a thorough neurological evaluation and radiological studies. Diagnostic tools include:

• Computed tomography (CT or CAT scan)
• Magnetic resonance imaging (MRI)
• Magnetic resonance spectroscopy (MRS)
• Biopsy

What Are Meningioma Treatments?

The first and most common treatment for a malignant meningioma is surgery to obtain tissue samples to determine the tumor type and remove as many tumors as possible without causing more symptoms. Radiation is often the next step to help delay the meningioma from returning. Other meningioma treatment options may include clinical trials with new chemotherapy and targeted therapy or immunotherapy drugs.

The type of meningioma treatment will depend on the patient's age, remaining tumor after surgery, tumor type and location. The disease may be advanced or terminal if all treatments fail to treat or control the symptoms.

What To Expect After Meningioma Surgery?

Surgery is often the only treatment option for a person with a benign meningioma that can be removed entirely with surgery. However, the treatment plan for patients with a cancerous tumor or a tumor that cannot be removed through surgery may include radiation or chemotherapy after surgery. Talk with your provider about the techniques available, including the possible side effects and what you can expect after surgery.

Recommendations

A patient's age upon diagnosis plays a significant role in predicting the outcome. In general, younger patients have better results. According to the Central Brain Tumor Registry of the United States Statistical Report, 84% of people with benign meningiomas have a life expectancy of at least 10 years after their prognosis, while patients with malignant meningiomas have an overall 10-year survival rate of 62%. If you have meningioma symptoms, consult your provider to help you map a treatment plan and cope with other complications. Please don't delay care.