A meningioma is a tumor of the protective lining of the brain and spinal cord. This lining is called the meninges. Most meningiomas are benign, though some may be malignant. Benign meningiomas are generally slow growing. They usually don't cause problems unless they are surrounding the structures that cause sight.
Malignant meningiomas (also called aggressive or anaplastic) are less common. These tumors are faster growing. They often cause problems and can cause some swelling in the brain. Often both benign and malignant meningiomas require some form of therapy, surgery, and/or radiotherapy depending upon location.
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The exact cause of meningiomas is unknown. However, there are a few theories under study. These include:
- Certain hormones may increase the growth of meningiomas.
- Radiation exposure, especially to the face, can increase the risk of developing meningiomas.
- Sex: twice as common in women than men
- Age: 40-70
- History of breast cancer or sarcoma, as part of the Li-Fraumeni syndrome
- A diagnosis of neurofibromatosis type 2
- Having received radiation to the face as a child (for acne, warts, or fungal infections)
Symptoms of meningioma are usually related to the area of the brain that is affected. Often the symptoms are caused by increased pressure within the skull, from blockage or inflammation. Symptoms may include:
- Visual problems
- Changes in behavior
- Loss of sensation or weakness in the arms and legs
- Loss of bladder or bowel control
- Slurred speech (if tumor is on the left side of the brain)
- Loss of coordination and memory loss (if tumor is in the temporal lobe)
- Difficulty writing (if tumor is in the parietal lobe)
Your doctor will ask about your symptoms and medical history and perform a physical exam. You will also be given a neurologic test to assess your motor skills. Other tests may include:
- CT scan -a type of x-ray that uses a computer to make pictures of the inside of the body, in this case the head
- MRI scan -a test that uses magnetic waves to make pictures of the inside of the body, in this case the head
- Angiogram -the injection of a special dye to highlight blood vessels in the brain
- Electroencephalogram (EEG) -a test that records the brain's activity by measuring electrical currents through the brain
- Blood tests-Recently, a blood test has been reported to be available that may assist in the detection of meningiomas.
Treatment will depend on whether the tumor is malignant or benign, the size and position of the tumor, as well as your general health. The main types of treatment for meningiomas are:
Surgery may be recommended if the tumor is located in an area of the brain that is accessible to surgery. Most surgeries can be performed without causing neurologic damage.
In some instances, prior to surgery, a catheter may be inserted into blood vessels supplying the meningioma in order to disrupt the flow of blood to the tumor, causing it to shrink and making it easier to remove surgically.
Radiation therapy is used either on its own or after surgery has been performed. If the tumor is not located in an area of the brain where surgery can be safely done, and the tumor is causing problems, radiation therapy is an effective way of treating the tumor and stopping its growth. If the tumor is malignant, radiation is generally always offered. In this case, radiation may be given either on its own or after surgery to help prevent the tumor from coming back.
Your radiation oncologist will describe how the therapy is delivered and how many treatments are needed. You may receive 25-40 treatments on a daily basis, or far fewer treatments if you are having stereotactic radiotherapy (surgery)
Chemotherapy is used only in the treatment of malignant meningiomas. Different medications are available and are generally used in conjunction with surgery and radiation therapy. Your oncologist will discuss the options and choice of medications.
There are no guidelines for the prevention of meningiomas.
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