Predominantly benign tumor 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 radiation therapy 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 tumors of the cranial and spinal compartments. Estimates indicate they represent over 36% of primary brain tumors and 53.5% of all nonmalignant tumors. 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 tumor
Other diagnostic factors
- neurologic deficit
- family history of NF2
- history of breast cancer
- history of radiation
- radiation therapy
- 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 tumor following surgical resection
William T. Couldwell, MD, PhD, FACS
Professor and Chairman
Department of Neurosurgery
University of Utah School of Medicine
Salt Lake City
WTC is an author of several references cited in this topic.
Professor William T. Couldwell would like to gratefully acknowledge Dr Jayson A. Neil, a previous contributor to this topic. JAN declares that he has no competing interests.
Marc Chamberlain, MD
Professor of Neurology
Moffitt Cancer Center and Research Institute
University of Washington
MC is an author of several references cited in this topic.
Ian McCutcheon, MD
Professor of Neurosurgery
The University of Texas M. D. Anderson Cancer Center
IM declares that he has no competing interests.
- Dural metastasis
- Pituitary adenoma (in appropriate parasellar location)
- EANO guidelines for the diagnosis and treatment of meningiomas
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