Meningiomas account for more than 25 percent of primary brain tumors. A meningioma tumor is a tumor that has grown from the protective meninges that surround the brain and spinal cord. Meningioma tumors typically grow to the inside therefore they can apply pressure on the spinal cord or brain. Most meningiomas are benign, though some may be cancerous.
Meningioma tumors vary in symptoms and cannot be treated properly until their location is determined. Meningioma symptoms may include headaches, problems with vision, changes in behavior, vomiting, and pain. The symptoms of a meningioma tumor will vary depending on the size and location of the tumor.
Meningiomas are readily visualized with contrast CT, MRI with gadolinium, and arteriography, all attributed to the fact that meningiomas are extra-axial and vascularized.
Observation with close imaging follow-up can be used in select cases if a meningioma is small and asymptomatic.
Meningiomas can usually be surgically resected (show video) (partially removed) and result in a permanent cure if the tumor is superficial on the dural surface and easily accessible. Transarterial embolization has become a standard preoperative procedure in the preoperative management.
Radiation therapy may include photon-beam or proton-beam treatment, or fractionated external beam radiation. Radiosurgery can be used in lieu of surgery in small tumors located away from critical structures.
Fractionated external-beam radiation can also be used as primary treatment for tumors that are surgically unresectable, or for patients who are inoperable for medical reasons.
Radiation therapy is often considered for WHO grade I meningiomas after subtotal (incomplete) tumor resections.
In the case of a grade III meningioma, the current standard of care involves postoperative radiation treatment regardless of the degree of surgical resection.
Grade II tumors can behave variably and there is no standard of whether to give radiotherapy following a gross total resection. Subtotally resected grade II tumors should be radiated.
Current chemotherapies are likely not effective.