What is meningioma?

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.

What causes meningiomas?

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.

Meningiomas and hormones

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.

Types of Meningioma brain tumour

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.

How are meningiomas treated?

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:

  • Location of tumour
  • Size of tumour
  • Grade of tumour
  • Your general health
  • Symptoms

Due to all of these considerations, treatment can vary from patient to patient.

Watch and wait

Some meningiomas may not need immediate treatment. This is usually when they are small, slow growing and not causing symptoms. You will see your specialist for regular check ups/MRI scans every three, six or 12 months.

Surgery

Surgery is the main treatment for meningiomas and in many cases meningiomas can be fully removed by surgery with no requirement for further treatment. Patients will still have regular scans for a period of time to ensure that there is no recurrence.

Radiotherapy

Radiotherapy may be used on its own when surgery is not possible, or following surgery where the tumour is unable to be completely removed, or to reduce the chance of the tumour returning. Sometimes a type of radiotherapy called stereotactic radiotherapy (SRT) is used.

Chemotherapy

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.

Know what to expect

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