Meningioma

A meningioma is a tumor that grows in the tissue that surrounds your brain, called the meninges. These are three layers of tissue that cover and protect your brain and spinal cord.

Tumors are most often found near the top and the outer curve of your brain. They may also form at the base of your skull. Tumors that form around your spine are possible but rare.

These tumors tend to grow slowly. You might not notice you have this tumor until it becomes large. Symptoms usually happen because the tumor presses against your brain and affects how those areas function.

Meningiomas are the most common type of brain tumor. Most meningiomas aren’t cancerous (they’re benign). But some can be cancerous (malignant).

Types of meningioma

There are several different types based on their location, including:

• Convexity meningiomas: These grow on the outer surface of your brain.
• Intraventricular meningiomas: These grow within the ventricles of your brain. Your ventricles carry cerebrospinal fluid (CSF).
• Olfactory groove meningiomas: These are between your brain and nose at the base of your skull. They grow near your olfactory nerve. This nerve gives you your sense of smell.
• Sphenoid wing meningiomas: These form along a ridge of bone behind your eyes.

Grades of meningioma

There are three grades. Grades tell how severe the tumor is:

• Grade I (typical): This is a noncancerous meningioma that grows slowly. These are the most common.
• Grade II (atypical): This is a noncancerous meningioma that grows more quickly and can be more resistant to treatment. These are less common.
• Grade III (anaplastic): This is a malignant (cancerous) meningioma that grows and spreads quickly. These are rare.

Symptoms of meningioma

Because meningiomas are typically slow-growing, they may not cause noticeable symptoms until they grow large enough to push on important structures around them. Symptoms can vary depending on which part of your brain it affects.

Common meningioma symptoms may include:

• Headaches
• Hearing loss
• Loss of smell
• Memory problems
• Muscle weakness
• Seizures
• Vision changes (like bulging eyes, double vision or blurriness)

Meningioma causes

Most tumors happen because of a chromosomal deletion. This is a genetic mutation where part of a chromosome is missing. These mutations happen randomly (sporadically). Or you may inherit them as part of certain genetic conditions, like:

• Cowden syndrome
• Li-Fraumeni syndrome
• Multiple endocrine neoplasia type 1
• Neurofibromatosis type 2
• Von Hippel-Lindau disease

Risk factors for meningioma

Meningiomas can affect anyone. You may be more at risk for a meningioma if you:

• Are over age 65
• Are Black
• Are female
• Are using hormone replacement therapy and/or birth control pills
• Had or have breast cancer
• Underwent radiation therapy (on your head)
• Have a biological relative with meningiomas

Cancerous tumors are more common in males.

Complications of meningioma

If the tumor is large and untreated, you may have the following complications:

• Memory loss
• Paralysis
• Personality or behavioral changes
• Speech difficulty
• Vision loss

How doctors diagnose meningioma

To diagnose a meningioma, a healthcare provider will perform a physical and neurological exam. They’ll confirm with imaging tests like a CT scan or an MRI.

A meningioma can be difficult to diagnose. This is because it grows slowly and doesn’t cause symptoms until it’s bigger. Also, symptoms may resemble normal signs of aging in adults over 65.

How is meningioma treated?

Treatment for meningiomas varies from person to person. It’ll likely involve a combination of the following therapies:

• Observation: Your provider may use the “wait-and-see” approach if you have a small tumor with few or slow-progressing symptoms. You’ll see your provider often for follow-up visits so they can do imaging tests and monitor tumor size and symptoms.
• Surgery: Surgical resection is the removal of a tumor. A total removal (gross total resection) can cure meningiomas if it’s a safe option.
• Radiation therapy: This uses strong beams of energy to kill cancer cells or keep them from growing and dividing. It’s also useful in treating some noncancerous meningiomas.
• Radiosurgery (Gamma Knife): This delivers a blast of radiation to help stop tumors from growing. It’s typically used for small, benign meningiomas.
• Palliative care: This focuses on improving how you feel during treatment by managing symptoms and supporting you and your family.
• Chemotherapy (rare): Your provider may recommend this if you develop recurrent or progressive tumors that don’t respond to surgery or radiation therapy. Bevacizumab may help treat anaplastic tumors after surgery and radiation therapy.
• In-depth molecular analysis: An in-depth analysis of meningioma tissue may help find chemotherapeutic drugs that may be effective in your case. This can help better predict the likelihood of it coming back after treatment.

Meningiomas may come back after treatment (recur). Tumors are less likely to come back if your surgeon can safely remove all of them during surgery.

When should I see my healthcare provider?

If you have meningioma and notice new or different symptoms, report the changes to your provider as soon as possible.

If you’ve completed treatment for meningioma, your care doesn’t stop there. Your provider will keep monitoring your health, checking for tumor recurrence and managing any long-term side effects during follow-up visits.

What is the life expectancy for meningiomas?

Your life expectancy depends on several factors, including:

• Your age and overall health
• The size of the tumor
• The location of the tumor
• If the tumor is cancerous
• If surgery partially or fully removed the tumor

It varies from person to person. You should talk to your provider to learn more about what your life expectancy looks like.

What is the survival rate for meningiomas?

A survival rate is a statistic that estimates the likelihood of surviving for a set period. It’s usually five years after a cancer diagnosis. For grade II and grade III tumors, the five-year survival rate is 63.5%.

It’s important to remember that survival rates are an estimate. Your provider can give you the most accurate information based on your situation.