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Meningioma

Almost a quarter of all brain tumours in adults are meningiomas. They are most common in older people (aged 50+) and women. They're very rare in children.

What is a meningioma?

A meningioma (pronounced men-in-gee-oh-ma) is a tumours that grows in the set of 3 membranes just inside the skull, called the meninges. The function of these membranes is to cover and protect the brain and spinal cord. 

The individual membranes are called the dura mater, the arachnoid mater and the pia mater.

Types of meningioma brain tumour

Brain tumours are generally graded from 1-4, according to what they look like under the microscope and their behaviour, such as how quickly they’re growing. 

Meningiomas can be graded 1, 2 or 3, but there are no grade 4 meningiomas. Although most meningiomas are low grade and slow growing, some don’t behave as expected and can grow quicker than others.

Grade 1 meningiomas are the most common and are slow growing tumours that're less likely to return after treatment (also called a recurrence). They may not cause symptoms for many years after your diagnosis and may not need immediate treatment.

Grade 2 meningiomas are slow growing, but may be more likely to come back after treatment, possibly as a higher grade.

Grade 3 meningiomas are very rare. They’re faster growing and have a higher chance of recurring after treatment.

Within these grades, there are also different types of meningioma, which you may hear at your diagnosis or during consultations with your healthcare team.

What are the different types of meningioma?

Grade 1

  • meningothelial meningioma
  • fibrous (fibroblastic) meningioma
  • transitional (mixed) meningioma
  • psammomatous meningioma
  • angiomatous meningioma
  • microcystic meningioma
  • secretory meningioma
  • lymphoplasmacyte-rich meningioma
  • metaplastic meningioma.

Grade 2

  • chordoid meningioma
  • clear cell meningioma
  • atypical meningioma.

Grade 3

  • papilliary meningioma
  • rhabdoid meningioma
  • anaplastic meningioma.

What are the symptoms and side-effects of a meningioma?

Meningiomas can often be present in the brain without causing any symptoms or side-effects for many years. Symptoms usually begin gradually, as they gently push and compress brain tissue, rather than invading it.

Symptoms may include:

    • headaches
    • nausea and vomiting
    • weakness in an arm or leg
    • loss of hearing
    • loss of eyesight
    • personality changes
    • being confused
    • seizures (sometimes called fits).

    However, as with other brain tumours, the symptoms will depend on which part of the brain is affected.

    How are meningiomas diagnosed?

    Meningiomas can usually be diagnosed using MRI and CT scans. This means that a biopsy (an operation to remove a small piece of the tumour) is rarely needed to get a diagnosis.

    Usually you’ll be given an MRI scan, as these can provide detailed images of the brain and the tumour from which the grade of tumour can usually be diagnosed.

    You may also be given a CT scan to see if the tumour has affected the bone of the skull or whether the tumour has calcified. Calcified meningiomas tend to grow very slowly, if at all.

    Usually CT and MRI scans can now provide enough information for a surgeon to also plan an operation to remove the tumour, if this is the recommended treatment.

    Questions you may want to ask your doctor

    To help you better understand your diagnosis and understand what to expect, we've put together a list of questions that you may want to ask your medical team.

    Find out more

    What causes meningiomas?

    As with most brain tumours, it’s still not known exactly why meningiomas begin to grow.

    How do meningiomas develop?

    Meningiomas, like all brain tumours, are the result of uncontrolled growth of brain cells.

    Normal cells grow, divide and die in a controlled way, in response to signals from the genes present in all your cells. These signals, along with checkpoint proteins, work together to tell a cell when to grow and when to stop growing.

    When a cell divides, mistakes can sometimes be made when copying the genes into the new cell. Mistakes (known as mutations) in specific genes of a cell can make the cell behave as if it’s receiving a growth signal, even if it’s not, or can deactivate the checkpoints that would normally stop the cell from dividing.

    As a result, any cells affected will continue to divide and can develop into a tumour.

    A great deal of meningioma research into its possible causes focuses on our genes and the molecular changes that can occur in our cells.

    Meningioma risk factors

    A risk factor is something that increases your chance of developing a tumour, but most do not directly cause the tumour.

    This means that some people with several risk factors may never develop a tumour, while others with no known risk factors do develop a tumour.

    Age

    Meningiomas are more common in people aged over 50, and particularly in people over 65 years.

    Gender

    Grade 1 meningiomas are more common in women and it’s thought this may be linked to female hormones. Grade 2 and 3 meningiomas are equally common in men and women.

    Hormones

    As well as meningiomas being more common in women, it‘s also been noted that occasionally meningiomas can grow faster during pregnancy. Some studies have also suggested a link between breast cancer and meningioma risk.

    In addition, it’s been found that some meningiomas have specialised cells (called receptors) that interact with the female hormones, progesterone and oestrogen. This has led doctors to believe that female hormones may play a role in increasing your risk of developing a meningioma

    Research is looking at the role of hormones in the growth of meningiomas to understand the significance of this.

    Radiation treatment

    Exposure to radiation, particularly to the head and particularly in childhood, may increase the risk of developing a meningioma later in life. This could include accidental exposure to radiation or radiation therapy as a treatment for various medical conditions.

    Obesity

    Women who have a body mass index (BMI) of 30 or more have a 60% higher risk of developing a meningioma than women who have a BMI of between 18.5-24.9.

    This is thought to be due to the fact that fatty tissue produces hormones such as oestrogen because the risk of meningioma in men is not linked to their BMI.

    Genetics

    A small number of meningioma brain tumours occur as a result of rare genetic conditions. 

    For example, the rare condition neurofibromatosis type 2 (NF2) causes (usually low grade) tumours to grow along the nerves, including those in the brain and spinal cord. As a result, it’s known to increase the risk of developing brain tumours, including meningiomas.

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