Meningioma

What is a meningioma?

A meningioma is a type of tumor that grows in the meninges, which are layers of tissue that cover the brain and spinal cord. Technically, a meningioma is not a brain tumor because it does not arise from brain tissue. But, it's often referred to as a brain tumor.

These tumors are usually non-cancerous (benign). This means that unlike cancerous tumors, they don't tend to spread to distant parts of the body. Because of their location, though, meningiomas can still cause neurological problems. As these tumors grow, they can compress the brain and spinal cord, leading to serious symptoms.

Meningiomas are the most common type of brain tumors in adults and occur more often than cancerous brain tumors. They're more common in women and usually develop in the 40s or 50s. Children rarely get meningiomas.

What causes meningiomas?

The underlying cause of meningiomas is not clear. Hormonal fluctuations may encourage the growth of these tumors, but more research is needed to confirm this.

Researchers have found a chromosome defect in a significant percentage of meningiomas. This suggests that the tumors may be caused by genetic-related factors. The specific chromosome involved functions to suppress tumor growth.

Who is at risk for meningiomas?

Women are much more likely to get meningiomas than men, which has led experts to suspect that certain hormones might play a role in the development of these tumors. Other people at higher risk include those who have had radiation treatment to the head and people with neurofibromatosis (an inherited nervous system disorder).

What are the symptoms of meningiomas?

These tumors usually grow slowly. You may not have any symptoms until the tumor has become large. The tumor can cause different symptoms, depending on where it's growing. These are possible symptoms:

• Vision or hearing loss
• Seizures
• Trouble thinking clearly
• Trouble walking
• Loss of smell
• Weakness in an arm or leg
• Headache
• Nausea

How are meningiomas diagnosed?

Meningiomas often come to light because of symptoms a person is having. To diagnose meningiomas, these tests may be done:

• Neurological exam. Your healthcare provider will ask about your symptoms and may do a neurological exam to look for changes in motor and sensory function, vision, coordination, balance, mental status, and in mood or behavior.
• Imaging. Your healthcare provider may diagnose a meningioma using an MRI or CT scan to get a picture of the brain and nearby structures.
• Biopsy. In addition, your provider may want to remove a sample of the tumor to examine it under a microscope before making the diagnosis.

How are meningiomas treated?

Not all meningiomas need to be treated right away.

Surgery

If your meningioma is causing symptoms or is growing, your healthcare provider will likely want to remove it with surgery. In some cases, though, trying to remove the tumor may be too risky. For example, the tumor may be too close to a vital brain structure or blood vessel.

If you do have surgery, the surgeon will try to take out as much of the tumor as possible. The surgeon may use MRI images of your brain to help guide the surgery. The surgeon may also use a special microscope during the surgery to get a better view of the tumor and the surrounding parts of your brain.

Radiation therapy

If the surgeon can't remove the tumor — or can only remove part of it — you may need radiation therapy. Depending on the areas of the brain or spinal cord that are involved, radiation therapy may help shrink any remaining tumor and can also help prevent it from spreading to the tissues around it. Even if the tumor is completely removed during surgery, some health care providers may still recommend radiation therapy to help prevent another meningioma from developing in the future. Meningiomas have a tendency to grow back after surgery.

Medication

Your provider may also recommend medicine to treat the tumor. Experts are studying several drugs to see if they work against meningiomas. You may need to take part in a study to use these drugs.

You may also be able to use other drugs to treat symptoms caused by the meningioma, such as seizures, excessive vomiting, weakness, and vision disturbances.

Living with a meningioma

In many people, meningiomas don’t cause any symptoms and grow quite slowly. For this reason, experts might recommend watchful waiting. This means you will report any new symptoms to your healthcare provider, and he or she will order scans on a regular basis to track even minor changes in the tumor. This may be a reasonable option for managing small tumors that aren't causing symptoms, especially in older adults who may not be able to have surgery or radiation therapy because of other medical conditions.

Key points

• A meningioma is a type of tumor grows in the meninges, which are layers of tissue that cover the brain and spinal cord. These tumors are usually not cancerous (benign), but they can still grow and press on the brain, which can lead to serious symptoms.
• Symptoms depend on where the tumor is and can include headache, nausea, vision or hearing loss, seizures, trouble thinking, loss of coordination, or weakness in an arm or leg.
• Not all meningiomas need to be treated right away. If treatment is needed, surgery is usually the first option if it can be done. Radiation therapy can also be used, either alone or along with surgery.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.