Meningioma tumors

Meningioma tumors are often included in lists of brain tumors even though they don’t grow inside the brain. Most of these tumors form just inside the skull, in the meninges. The meninges are thin layers of tissue that surround and protect the brain and spine. When a meningioma of the brain starts to grow, it spreads through these layers making a thin, flat tumor that fits between the skull and the brain.

Meningiomas that form around the brain can cause symptoms if they put too much pressure on an area of the brain or skull.

Some meningiomas form in the meninges around the spine. They can also cause symptoms when they grow and put pressure on the spine, organs or other tissues.

About 80% of meningiomas are benign (noncancerous) and fewer than 2% are malignant (cancerous). The rest are considered atypical, which means they could develop into cancerous meningioma tumors.

Our trusted Advocate Health Care team offers the latest treatments for meningioma tumors including targeted therapy and immunotherapy.

Meningioma risk factors

Meningiomas are more frequent in people older than 65 and rare in children. They’re also more common in Black people and in women. Other risk factors for meningioma tumors are:

• Exposure to radiation
• Neurofibromatosis type 2 (NF2), a genetic disorder
• Schwannomatosis, a genetic disorder
• Relation to female hormones
• Meningioma symptoms

Most meningiomas of the brain are slow-growing and may not cause symptoms until they become very large. Some are only discovered when a person has a brain scan for symptoms unrelated to the meningioma tumor.

When you do experience meningioma symptoms, they’ll depend on the size of the tumor and what part of the brain or spine is near the tumor. Common symptoms are:

• Headaches that are often worse in the morning
• Seizures
• Personality or behavior changes
• Progressive neurologic deficits
• Confusion
• Drowsiness
• Hearing loss
• Nausea or vomiting
• Problems with sight

Both benign and cancerous meningioma tumors can be disabling if they grow near areas of the brain that control your hearing, sight or movement. Either type can also be life-threatening.

Meningioma types

Your doctor may describe a meningioma based on its location inside the skull. They may also describe it based on its classification, which comes from the appearance of groups of cancer cells under a microscope, and any mutations or changes to genes or chromosomes inside individual cancer cells. Some of those classifications are:

• Grade 1: Benign slow-growing tumors. Most common type.
• Grade 2: Has cells that look atypical and tumors have a higher chance of coming back after removal.
• Grade 3: Malignant fast-growing tumors. Most likely to invade the brain.

Meningioma diagnosis

When you have a potential meningioma tumor, you’re likely to be referred to a neuro-oncologist or a neurosurgeon for care. They have the expertise needed to accurately diagnose such tumors and work with a multidisciplinary team to develop a personalized plan of care for you.

Initially, your specialist will perform a physical and gather information about the duration of your potential meningioma symptoms. They’ll also perform a neurological exam to test reflexes and functions related to your symptoms.

Your doctor will either evaluate any imaging tests (MRI, CT or others) that have already been done or order testing. These tests can’t always diagnose a meningioma. They can give your doctor a good idea about the size and location of the tumor, which helps them predict what parts of the brain might be affected.

A meningioma diagnosis often relies on examination of a biopsy (sample of tumor tissue), which requires a surgical procedure. Biopsy tissues will be evaluated under a microscope by a neuropathologist, who’ll provide a classification based on the appearance of the cells.

Part of the biopsy tissues will be used for biomarker testing to identify mutations or changes inside genes of the cancer cells. Such changes affect both the diagnosis and planning for meningioma treatment.

Meningioma treatments

For small meningioma tumors that aren’t causing many symptoms or swelling in the brain, your doctor may recommend observation over a period of time. You’ll be scheduled for periodic imaging tests and appointments to talk with your doctor about any symptoms or growth of the tumor shown by imaging.

Surgery is often the first meningioma treatment offered. The goal of meningioma surgery is to gather a biopsy to confirm the type of tumor and to remove as much of the tumor as possible without causing more symptoms. If the meningioma tumor is hard to access or too close to important areas of the brain, it may not be possible to remove the whole tumor.

Meningioma surgery might be followed by radiation therapy to remove any remaining tumor and delay any possible return of the tumor. Radiotherapy, including techniques like intensity-modulated radiation therapy (IMRT), can be very precise about targeting only tumor tissues and minimizing damage to nearby normal tissue.

Meningioma treatments like targeted therapy or immunotherapy may also be recommended for some types of tumors.