Posted by Brigham and Women's Hospital April 30, 2014
Contributor: Ian Dunn, MD, is a neurosurgeon in the Department of Neurosurgery at Brigham and Women’s Hospital and an Associate Professor of Neurosurgery at Harvard Medical School. Dr. Dunn’s interests include surgery for meningiomas, chordomas, and other skull base tumors.
A meningioma is a type of tumor that develops from the meninges, the membrane that surrounds the brain and spinal cord. Most meningiomas (90 percent) are categorized as benign tumors, with the remaining 10 percent being atypical or malignant. In many cases, benign meningiomas grow slowly. This means that depending upon where it is located, a meningioma may reach a relatively large size before it causes symptoms.
Meningiomas account for about 27 percent of primary brain tumors, making them the most common tumor of that type. Here are some common questions about meningiomas, with answers from our neurosurgeons at Brigham and Women’s Hospital (BWH):
What are the risk factors of meningiomas?
Meningiomas are most common in people between the ages of 40 and 70, and are more common in women than in men. Meningiomas are very rare in children, with pediatric cases accounting for only 1.5 percent of the total. There are not many predisposing factors associated with the development of meningiomas, but a few include:
- Previous trauma – Meningiomas have been found at the site of previous trauma (such as near a previous skull fracture, scarred dura, or around foreign bodies), but the relationship between trauma and meningioma risk isn’t fully understood.
- Radiation – Exposure to radiation has been associated with a higher incidence of meningiomas.
- Genetic predisposition – People with a genetic disorder known as neurofibromatosis type 2 (Nf2) are more likely to develop meningiomas.
What are the common symptoms of meningiomas?
Not all meningiomas are symptomatic, particularly if they are small or developed relatively recently. Patients with symptomatic meningiomas may experience:
- Blurred vision
- Weakness in the arms or legs
- Speech difficulty
What are the treatment options for meningiomas?
There are generally three treatment options for meningiomas:
- Observation – If a meningioma is small and asymptomatic in a person over 65, it may just be observed. Observation requires annual CT or MRI scans with contrast. Typically, asymptomatic meningiomas can be observed for a period of 3 to 12 months before a definitive treatment decision is made.
- Surgery – Surgery is the primary treatment for meningiomas, and is tailored to the size and location of the tumor. Complete removal is the ideal result.
- Radiotherapy – Several recent studies have shown radiotherapy to control tumor growth by 50 to 90 percent. Newer forms of focal radiotherapy (such as radiosurgery, stereotactic radiotherapy, or intensity modulated radiotherapy) also are effective and minimize effects of radiation on the surrounding brain tissue.
How successful is meningioma treatment?
Eighty percent of patients reported satisfaction with the quality of their lives after undergoing treatment. The location of a patient’s tumor within the brain is the most important factor in determining the success of treatment. Due to their location, certain types of meningiomas (convexity, parasagittal, and lateral sphenoid wing) usually are completely removable through surgery, yielding excellent results. Optic sheath and skull-based meningiomas can be more difficult to remove surgically. Older patients or those or in poor health prior to surgery may face additional challenges during treatment and recovery.
Where can I find support for myself or a family member diagnosed with a meningioma?
Your physician can answer questions about meningioma diagnosis and help you select appropriate treatment options. Additionally, there are many groups that provide ongoing support to patients and families living with meningiomas. The National Brain Tumor Society and the Brain Science Foundation provide a list of support groups on their websites.