Brain meningioma tumors

A meningioma of the brain is a tumor that develops in the meninges – thin layers of tissue that cover and protect your brain. A meningioma begins as a thin, flat tumor that fits between the brain and the skull.

If a meningioma becomes thicker and grows inward, it may put pressure on brain tissue, nerves and blood vessels. If it grows outward, it can press against the skull. Meningiomas may be noncancerous (benign) or, rarely, cancerous (malignant).

Some meningiomas grow on the spinal cord. These tumors may also cause meningioma symptoms if they grow and put pressure on the spine, organs or other tissues.

About 80% of meningiomas are benign and fewer than 2% are malignant. The rest are considered atypical and have the potential to develop into cancerous meningioma tumors.

Meningioma risk factors

People who are older than 65 are more likely to develop a meningioma. They’re rare in children. They’re more common in women and in Black people. Other risk factors for meningioma tumors are:

• Exposure to radiation
• Female hormones
• Neurofibromatosis type 2 (NF2), a genetic disorder
• Schwannomatosis, a genetic disorder

Meningioma symptoms

You may not notice symptoms of a benign meningioma at first. Most of these tumors are slow-growing and may not cause symptoms until they become larger. If you have meningioma symptoms, they’ll be related to the part of the brain that the tumor is near and the size of the tumor.

If you have a meningioma of the brain, you may experience:

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

Both benign meningiomas and cancerous meningiomas can be disabling if they grow near areas of the brain that control your hearing, sight or movement. Both types of tumors 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. Classifications are assigned based on:

• The microscopic appearance of groups of cancer cells
• Mutations or changes to genes or chromosomes inside individual cancer cells

Some of those classifications for meningioma tumors 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

To diagnose a brain meningioma, you’ll begin by meeting with your doctor for a physical exam. You’ll talk about your symptoms and how long they’ve been happening, and your doctor may test your motor skills and senses.

Your doctor will likely order imaging tests, such as an MRI or a CT scan, which may allow them to diagnose the tumor. MRI and CT scans provide a clear image of the size and location of the meningioma tumor and indicate what parts of your brain may be affected.

A biopsy may be needed to confirm a meningioma diagnosis. Biopsies require a surgical procedure. Once obtained, the biopsied tissue will be evaluated by:

• Microscopic evaluation of a group of cancer cells
• Biomarker testing to identify mutations or changes in genes within the cancer cells

The results of these evaluations are combined to determine a diagnosis.

Meningioma treatment options

You may be referred to a neurosurgeon or neuro-oncologist for treatment for a brain tumor. Seeing an Aurora Health Care specialist ensures you’ll get the most up-to-date meningioma treatment. Our health care team has access to all kinds of clinical trials that may be good options for your treatment. Your expert neurosurgical team will work with you to determine the best treatment for your needs.

Treatment will depend on your age and general health, and your tumor’s size, location, and rate of growth. It may include:

• Ongoing monitoring by your doctor
• Brain surgery (craniotomy) to remove the tumor and obtain a biopsy for testing
• The Expanded Endonasal Approach (EEA), a minimally invasive procedure in which the tumor is removed through the nasal passages, resulting in no incisions, a shorter hospital stay and faster recovery.

If necessary, your doctor may recommend additional meningioma treatments, including:

• Radiation therapy, a process that destroys cancer cells and prevents more from growing.
• CyberKnife® radiosurgery, a non-invasive, robotic system that delivers high radiation doses to tumors with pinpoint accuracy.
• Targeted therapy that targets cancer cells and doesn’t harm healthy cells
• Immunotherapy which helps your immune system detect and destroy cancer cells