Predominantly benign tumour of the meninges occurring at both cranial and spinal sites.
Produces symptoms from local mass effect due to compression of neural structures or may present with seizure.
Diagnosis confirmed by the characteristic appearance on magnetic resonance imaging (MRI) with and without contrast enhancement.
Asymptomatic lesions may be followed up with serial observation.
Treatment of symptomatic meningioma is usually surgical resection, although, in some cases, local radiotherapy is used as primary treatment.
Radiation therapy considered as adjuvant treatment for grade III meningiomas and in some cases grade II lesions.
Meningiomas are one of the most common primary tumours of the cranial and spinal compartments. Estimates indicate that they represent over 36% of primary brain tumours and 53.5% of all non-malignant tumours. They are more frequent in women and are usually benign. They are sometimes atypical or malignant in nature.
History and exam
Key diagnostic factors
- family history of brain tumour
Other diagnostic factors
- neurological deficit
- family history of NF2
- history of breast cancer
- history of radiation
- genetic predisposition
- hormones: endogenous and exogenous
- head trauma
1st investigations to order
- MRI head or spine without and with contrast
- CT head or spine
Investigations to consider
- histopathology of surgical resection
age ≤65 years and good surgical candidate
age >65 years or poor surgical candidate
recurrent tumour following surgical resection
- Dural metastasis
- Pituitary adenoma (in appropriate parasellar location)
- Brain tumours (primary) and brain metastases in adults
- Suspected cancer: recognition and referral
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