Almost a quarter of all brain tumours in adults are meningiomas. They are most common in older people and in women; they are very rare in children. The majority of meningiomas are low grade and slow growing, however, some do not behave as expected and can be more aggressive.
Meningioma brain tumours develop in the meninges. The meninges are a set of three membranes that cover and protect the brain and spinal cord. They are called the dura mater, the arachnoid mater, and the pia mater.
As with most brain tumours, the cause of meingiomas is not known. Exposure to radiation is the only known environmental risk. A small number of brain tumours are caused by rare genetic conditions - the rare condition neurofibromatosis type 2 is known to increase the risk of meningioma and other brain tumours.
Some meningiomas have specialised cells (receptors) that interact with hormones, including progesterone, androgen, and oestrogen. It has been observed that occasionally meningiomas can grow faster during pregnancy. Research is looking at the role of hormones in the growth of meningiomas to understand the significance of this.
Brain tumours are graded from 1 - 4, according to what they look like under the microscope as well as their behaviour, such as the speed at which they are growing. Meningiomas can be graded 1, 2 or 3.
Grade 1 Meningioma – the most common type, slow growing and less likely to return after treatment.
Grade 2 Meningioma – slow growing but may be more likely to recur after treatment.
Grade 3 Meningioma – very rare type, faster growing and has a higher chance of returning after treatment.
The most appropriate treatment for you can depend on a number of factors. Things that your medical team will consider when deciding what treatment is right for you can include:
Due to all of these considerations, treatment can vary from patient to patient.
Chemotherapy is rarely used in the treatment of meningiomas. The blood-brain-barrier (BBB) is a membrane of cells which helps to protect the brain from harmful substances in the blood, such as bacteria or viruses, that could cause infections. Meningiomas occur outside of the BBB, therefore some drugs can reach them. However, meningiomas are very resistant to currently available chemotherapies. Chemotherapy may still be used in some circumstances, such as a high grade meningioma recurring after surgery or radiotherapy.
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