April 13, 2017 by Dr. Joung H. Lee, M.D.0
- Meningiomas are mostly (92%) benign tumors arising from the brain covering (“the meninges”).
- Meningiomas are the most common “primary” brain tumors with the annual incidence approaching 80/million (when including “incidental” tumors).
- Meningiomas are more common in the female sex by 2-2.5:1.
- Meningiomas most commonly affect the middle aged population, with the average age at the time of initial diagnosis being 54 years.
- Meningiomas are most likely caused by alterations or damages that have occurred in the patient’s genes. Unfortunately, however, exactly which gene(s) lead to meningioma formation, other than the NF2 gene in select patients, and why those genetic changes occurred are unknown as of today.
- Meningiomas grow slowly, with 44% of observed tumors showing growth within 4 years.
- Not all meningiomas require treatment at the time of initial diagnosis.
- Management options include observation, surgery and radiation/radiosurgery.
- Surgery is the treatment of choice for most patients with meningiomas.
- Surgery is recommended for young, healthy, symptomatic patients and those with large tumors.
- The factors determining long term survival include the tumor histology (graded according to the WHO classification of Grades I (“benign”) vs. II (“aggressive”) vs. III (“malignant”)) and the extent of resection, which commonly is, in turn, influenced by the surgeon’s experience.
- Gross tumor removal along with removal of the surrounding/involved dura and bone may lead to surgical “cure” in benign meningiomas.
- The factors determining patient’s outcome following surgery include the patient’s co-morbidity (C), tumor location (L), patient’s age (A), tumor size (S), symptoms (S), in addition to history of any prior surgery or radiation, as well as the surgeon’s experience.
- Young, healthy patients with small and/or asymptomatic meningiomas undergoing surgery by an experienced surgeon do very well following their surgery.