A meningioma is a tumor that forms in your meninges, which are the layers of tissue that cover your brain and spinal cord. They’re usually not cancerous (benign), but can sometimes be cancerous (malignant). Meningiomas are treatable.
A meningioma is a tumor that forms in your meninges, which are three layers of tissue that cover and protect your brain and spinal cord. Meningiomas originate from arachnoid cells in particular, which are cells within the thin, spiderweb-like membrane that covers your brain and spinal cord. This is one of three layers that make up the meninges.
Most meningiomas aren’t cancerous (benign), though they can sometimes be cancerous (malignant). In general, if a tumor is cancerous, it means it’s aggressive, can invade other tissues and potentially spread to other parts of your body. A benign tumor won’t spread to other parts of your body.
Meningiomas are most often found near the top and the outer curve of your brain. They may also form at the base of your skull. Spinal meningiomas are rare.
Meningiomas tend to grow slowly and inward. Often, they’ll have grown quite large before they’re diagnosed. Even benign meningiomas can grow large enough to be life-threatening if they compress and affect nearby areas of your brain.
There are three types of meningioma by grade:
There are several different types of meningiomas based on their location and tissue type. Some location examples include:
There are also 15 variations of meningiomas according to their cell type as viewed under a microscope.
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In most cases, meningiomas are benign (noncancerous), but they can sometimes be cancerous (malignant). Even if a meningioma is benign, if it grows large enough, it can press on important nerves and structures of your brain, which can cause harm and even be life-threatening.
Meningiomas much more commonly affect adults than children, although children can still develop them. The average age at diagnosis is 66 years. Black people tend to have higher rates of meningioma than other ethnic groups in the United States.
People assigned female at birth (AFAB) are more likely to have a meningioma than people assigned male at birth (AMAB). This is likely due to hormonal factors that contribute to the development of meningiomas.
However, malignant (cancerous) meningiomas are found more often in people AMAB.
Meningiomas are somewhat common. Approximately 97 out of every 100,000 people are diagnosed with meningioma. In other words, more than 170,000 people are diagnosed with meningioma each year in the United States.
Meningiomas are the most common type of brain tumor.
Because meningiomas are typically slow-growing tumors, they may not cause noticeable symptoms until they grow large enough to push on important structures around them. The symptoms of meningioma can vary greatly depending on which part of your brain is affected by it.
Certain meningioma locations are associated with certain neurologic symptoms. For example:
More common symptoms of brain meningiomas include:
The most common symptoms of spinal meningiomas include:
If you’re experiencing any of these symptoms, it’s important to tell your healthcare provider as soon as possible.
Scientists don’t yet know the exact cause of meningiomas. Research has shown that 40% to 80% of all meningiomas have an abnormality in chromosome 22, which is involved in the suppression of the growth of tumors. This overwhelmingly occurs spontaneously (randomly) or rarely as part of certain genetic (inherited) conditions.
So far, scientists have identified certain environmental, hormonal and genetic risk factors for meningiomas.
A meningioma can be difficult to diagnose because it often grows slowly and often doesn’t cause symptoms until it’s big enough to affect neighboring areas of your brain. In addition, the majority of meningiomas are slow growing and mainly affect adults. The symptoms may be so mild that the affected person and/or their healthcare provider may attribute them to the normal signs of aging.
If your healthcare provider suspects you may have a meningioma, they’ll likely refer you to a neurologist.
To diagnose a meningioma, your healthcare provider will perform a physical examination and a neurological examination. They’ll also recommend imaging tests, such as:
Sometimes, if the diagnosis is in doubt, a biopsy may be needed to confirm the diagnosis of meningioma and exclude other possible diagnoses. Your neurosurgeon will perform the biopsy to obtain a small tissue sample. The tissue sample will be examined to establish a diagnosis, determine whether the tumor is benign or malignant, and decide on a tumor grade.
Treatment for meningiomas is highly individualized and will likely involve a combination of the following therapies:
Together, you and your healthcare team will determine the best treatment plan for you.
Healthcare providers often use the “wait-and-see” observation approach for several reasons, including:
Your healthcare provider will suggest follow-up MRI scans and appointments to monitor the size of the tumor and your symptoms. Some tumors won’t grow any larger.
Surgical resection, which is the surgical removal of a tumor, is the primary choice for symptomatic meningiomas or large tumors that are anticipated to cause symptoms soon.
A total removal (also called gross total resection, or GTR) can cure the majority (about 70% to 80%) of people with meningiomas. The goal of surgery is maximum, safe removal. The ability to achieve this may be limited by various factors, including:
The extent of resection largely impacts the rates of recurrence (of the tumor returning) for surgically treated meningiomas of all grades.
Radiation therapy is a form of cancer treatment that uses radiation (strong beams of energy) to kill cancer cells or keep them from growing and dividing. Radiation therapy is also useful in treating some benign tumors, including benign meningiomas.
Radiation therapy is the first-line treatment for meningiomas that can’t be fully removed or when the risk of surgery outweighs the potential benefit. These include certain deeply located meningiomas and those that are encasing neurovascular structures.
Types of radiation therapy to treat meningiomas include:
Adjuvant radiotherapy for atypical and cancerous meningiomas improves control of the tumor’s growth with longer progression-free survival and overall survival. Adjuvant therapy, sometimes called helper therapy, targets cancer cells that primary treatment didn’t destroy. Adjuvant radiotherapy after total surgical removal of atypical meningiomas may decrease the risk for recurrence (when the tumor comes back).
Meningioma and its treatment cause physical symptoms and side effects, as well as emotional and social issues. Managing all of these effects is called palliative care. It’s an important part of your care that’s included along with treatments intended to slow down, stop or eliminate the tumor.
Palliative care focuses on improving how you feel during treatment by managing symptoms and supporting you and your family. Palliative treatments vary widely and often include:
Chemotherapy is one of several cancer treatments that use drugs against various types of cancer. Although the use of chemotherapy is rare in treating meningiomas, healthcare providers generally recommend chemotherapy for people who develop recurrent or progressive meningiomas that no longer respond to surgery or radiation therapy.
The use of bevacizumab, a type of chemotherapy, for people with anaplastic meningiomas after surgical resection and radiation therapy, has shown successful results in tumor regression.
The treatment options for meningiomas come with certain risks and possible complications and side effects. Be sure to ask your healthcare team questions about the risks involved with your treatment plan.
Surgery to partially or fully remove a meningioma is a complex procedure that’s not without certain risks and complications. As with any type of surgery, there’s a risk of infection and bleeding. Other possible complications include:
While the radiation treatment process for meningioma treatment itself isn’t painful, it can cause certain side effects when healthy tissues are exposed to radiation. The most common side effects of radiation therapy for meningioma include:
Aside from the cognitive symptoms, which can be permanent, most of these side effects are temporary and usually go away within several weeks of treatment.
The side effects of chemotherapy for meningioma depend vary based on each person and the type and dose of the chemotherapy. Side effects can include:
The risk factors for meningioma include:
There are also genetic risk factors for meningioma. If you have any of the following conditions or have a first-degree biological relative (sibling or parent) who’s had a meningioma, you’re at an increased risk of developing a meningioma:
If you’re concerned about your risk of developing a meningioma, be sure to talk to your healthcare provider.
It’s important to remember that no two people with meningioma are affected in the same way. It’s difficult to predict how you’ll be affected. The best way you can find out is to talk to healthcare providers who specialize in researching and treating meningioma. They can give you a more accurate explanation of what to expect given your unique situation.
The prognosis (outlook) for meningioma depends on several factors, including:
For adults, your age at the time of diagnosis is one of the strongest predictors of outcome. In general, the younger you are, the better your prognosis tends to be. Better outcomes are associated with surgical removal of the entire tumor; though, this isn’t always possible due to the location of the tumor.
Meningiomas can come back after treatment (recur). The recurrence rate of meningioma is associated with the extent of surgical removal. Complete surgical removal is associated with lower recurrence rates.
A meningioma and its treatment can cause long-term complications, including:
The five-year survival rates for meningioma are as follows:
The 10-year survival rates for meningioma are as follows:
The 10-year survival rate for malignant (cancerous) meningiomas has been increasing due to the new treatments available.
It’s important to remember that statistics on the survival rates for people with meningioma are an estimate. Your healthcare provider can provide a more informed prognosis based on your unique situation.
If you’ve been diagnosed with meningioma and notice new and different symptoms, you should report the changes to your healthcare provider as soon as possible.
If you’ve been treated for meningioma, your care doesn’t end when active treatment has finished. Your healthcare team will continue to check that the tumor hasn’t come back (recurred), manage any long-term side effects and monitor your overall health.
If you’ve been diagnosed with meningioma, it may be helpful to ask your healthcare provider the following questions:
A note from Cleveland Clinic
Receiving a brain tumor diagnosis is unsettling, regardless if it’s benign or cancerous. The good news is that meningiomas are treatable and generally have a good prognosis. Know that your healthcare team is there to provide you with robust, individualized treatment options and support. If you have any questions or concerns, don’t be afraid to ask your healthcare team. They’re available to help you.
Last reviewed by a Cleveland Clinic medical professional on 05/09/2022.
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