What Is a Meningioma?
A meningioma is a common skull base tumor that is a mass of abnormal cells growing in the thin tissue known as the meninges covering the brain and spinal cord.
As the tumor grows inward, it may press on your brain. If it grows outward, the skull can thicken. You may have more than one meningioma, which may be located in a different part of the brain or spinal cord.
Are Meningiomas Cancer?
Rarely. The majority of meningiomas are benign (not cancer).
Who Gets Meningiomas?
This kind of tumor is found in women more commonly than men. Meningiomas appear more frequently in people who are over 35 years old.
An estimated 25,000 meningiomas are diagnosed each year in the United States.
About one-third of all skull base tumors are meningiomas. The type you have depends on the speed of its growth, location, and whether it is benign or, in rare cases, malignant (cancer). A meningioma can appear in a variety of locations.
- Olfactory groove meningioma -- This is located under the frontal lobes (the front part of the brain) and involves the nerves that serve your sense of smell.
- Suprasellar meningioma -- This is located near the pituitary gland and optic nerves. It commonly presents with visual loss.
- Convexity meningioma -- This type of tumor grows on the surface of the brain and may compress the brain causing neurological problems such as weakness or sensory loss.
- Falcine and parasagittal meningiomas -- These grow in the fold between the sides of the brain.
- Foramen magnum meningioma -- This is where the head attaches to the spine.
What Is Considered a Large Meningioma?
Meningiomas can be significant in size. It's not unusual for the tumors to be two inches wide or more.
Many people have meningiomas for years with no apparent symptoms. They grow at a slow rate and are sometimes discovered by accident — during an imaging test such as an MRI (magnetic resonance imaging) performed for a different health reason. These are referred to as incidental meningiomas.
When meningiomas are large enough to compress your brain tissue or nerves, the most common symptoms are:
- weakness in an arm or leg, and
- vision changes.
Other symptoms include:
- personality changes,
- difficulty with eye movements,
- numbness in your face,
- decreased hearing, and
- decreased sense of smell.
No one knows for sure what causes brain tumors. People with a certain genetic disorder called neurofibromatosis type 2 (NF2) or an abnormal chromosome (22) may be more likely to have a meningioma.
Previous radiation to the head or trauma could also be connected to the tumor’s development. Women’s hormones may also play a role.
Why Are Meningiomas More Frequent in Women?
Nobody knows why meningiomas are found more frequently in women than men.
Meningioma Treatment Options
Your doctor will consider the size of the meningioma, its location, your age, and general health when deciding how to treat it. Observation, surgical removal, or radiation therapy are the options. In some cases, surgery is followed by radiation.
For some patients, the best course of treatment may be to monitor the meningioma’s growth over time through imaging tests. If your symptoms change, you should let your doctor know immediately.
Growth Can Stop
For some people, their meningioma may stop growing after they reach about age 50.
The majority of meningiomas are removed through surgery because of the patient’s significant symptoms and tumor size. Doctors often recommend surgery when tumors are too large to be treated with radiation.
What to Expect For Meningioma Surgery
For this procedure, known as a craniotomy, we will cut out a small piece of your skull to access the tumor. During the procedure, we use a large surgical microscope that provides a highly magnified view of the tumor.
Our neurosurgeons remove as much of the meningioma as possible. At the end of the surgery, we replace the skull bone.
Thanks to significant improvements in radiation treatment, you will receive radiation tailored to your specific tumor (or tumors) with the least possible impact on healthy tissue.
At University of Utah Health, we typically use stereotactic radiation therapy, which can stop the growth of your meningioma. Despite the name, no surgery takes place during this method. Instead, patients often receive a single high dose of radiation or a small number of doses.
The focused radiation treatment does not cause you to lose your hair. Many patients return to work the next day.
Your doctor may recommend radiation in place of surgery if your tumor is too difficult to remove, malignant, or recurring. If remnants of tumors remain after surgery, radiation may also be necessary.
What to Expect After Meningioma Surgery
While many meningiomas can be completely removed, there may be long-term impacts from surgery and radiation depending on the tumor location. These may occur for anteriorly-based tumors but rarely occur with laterally-based tumors.
Complications can include:
- memory loss,
- concentration problems, and
- changes to personality.
Is There a Cure?
Depending on the type of meningioma you have, it may be completely removable. Meningiomas do have a high rate of recurrence.
While some symptoms such as dizziness may improve, your hearing loss may not. The tumor may permanently damage nerves in the ear.
What If Meningiomas Recur?
In some cases, meningiomas do recur after surgery or radiation. Your doctor may recommend occasional imaging tests (one to three years in frequency) to check for regrowth.
Even after surgery and radiation, some malignant tumors may require chemotherapy.
Meningioma Survival Rate
The American Society of Clinical Oncology states that cancerous meningiomas make up a little more than one percent of all primary brain tumors (tumors that start in the brain).
Even if your tumor turns out to be cancer, it is estimated that the 10-year survival rate for patients with malignant meningiomas is more than 78 percent for people ages 20 to 44 and 34 percent for people who are 75 years of age and older.
If you believe you need an evaluation for a meningioma, you can make an appointment with one of our skull base tumor specialists.
No doctor referral is necessary to come visit us, but please check with your insurance first as some insurance companies require referrals.