From the Guidelines
A meningioma is a type of brain tumor that develops from the meninges, the protective membranes covering the brain and spinal cord, and is typically slow-growing and benign (non-cancerous), accounting for about 30% of all primary brain tumors. Meningiomas often cause symptoms by pressing on adjacent brain tissue, nerves, or blood vessels, leading to headaches, seizures, vision problems, or weakness in limbs depending on their location. Many meningiomas are discovered incidentally during brain imaging for other conditions.
Key Characteristics of Meningiomas
- Typically slow-growing and benign (non-cancerous)
- Account for about 30% of all primary brain tumors
- Often cause symptoms by pressing on adjacent brain tissue, nerves, or blood vessels
- Can lead to headaches, seizures, vision problems, or weakness in limbs depending on their location
- Many are discovered incidentally during brain imaging for other conditions
Treatment Options
- Observation with regular MRI monitoring for small, asymptomatic tumors
- Surgical removal for accessible tumors causing symptoms
- Radiation therapy when surgery isn't possible
Underlying Cause and Prognosis
- The underlying cause of meningiomas isn't fully understood, though genetic factors, previous radiation exposure to the head, and female hormones may play roles in their development
- Most meningiomas have excellent outcomes after treatment, with a low recurrence rate for completely removed tumors, as noted in studies such as 1.
Recent Guidelines and Recommendations
Recent studies, including 1 and 1, have provided updates on the molecular risk parameters and recommendations for WHO grading of meningiomas, highlighting the importance of considering copy-number alterations and other genetic factors in the diagnosis and treatment of meningiomas.
From the Research
Definition and Overview of Meningioma
- Meningiomas are the most common primary intracranial brain tumor, accounting for more than a third of all primary central nervous system (CNS) tumors 2.
- They are mostly benign tumors that can be observed or preferentially treated with gross total resection, which provides good outcomes 2.
- Meningiomas have a heterogeneous biology and an unmet need for targeted treatment options, with existing treatments limited to surgery, radiotherapy, or a combination of these depending on clinical and histopathological features 3.
Treatment Options for Meningioma
- Radiation therapy is an option as a primary treatment for small meningiomas and for treatment of recurrences after surgery 4.
- Radiotherapy is a critical component of meningioma treatment, either as a definitive intervention using stereotactic radiosurgery or external beam radiotherapy, or in the adjuvant setting for residual disease or for adverse pathologic factors, such as high WHO grade 3.
- Surgery and radiotherapy are the two longstanding primary therapeutic modalities for meningioma management, with data from prior and ongoing investigations of other treatment modalities, including systemic and targeted therapies, also being explored 5.
Diagnosis and Prognosis of Meningioma
- Advances in genomics and molecular characteristics of meningiomas have uncovered potential use for more accurate grading and prediction of prognosis and recurrence 2.
- Anatomical location and adjacent vital structures are crucial for decision-making in meningioma management, with outcomes dictated by extent of resection and histopathologic factors, such as World Health Organization (WHO) grade and proliferation index 3, 6.
- Radiosurgical intervention has resulted in high tumor control rates and acceptably low adverse radiation events for meningiomas in various anatomical subregions 6.