Meningioma Overview

The most common type of primary brain tumor, meningioma forms in the meninges, the outer three layers of protective tissue between the brain and the skull. More specifically, the tumors grow out of the middle layer of the meninges (arachnoid), a web-like sheet of connective tissue that does not contain any nerves or blood vessels.

Most meningiomas are benign, grow slowly and can go undetected for up to several years. However, even a noncancerous meningioma can grow large enough to pressure sensitive neural tissues, such as the brain, spinal cord and spinal nerve roots, which can lead to disruptive neurological symptoms.

What causes meningioma?

Meningioma develops when cells in the meninges undergo harmful genetic mutations. Up to 80% of meningiomas involve an abnormality in chromosome 22, which carries a gene responsible for regulating cell growth in the meninges. A mutation or deletion in chromosome 22 can interfere with its tumor-suppressive function, causing uncontrolled cell growth and leading to tumor formation.

What are the risk factors for meningioma?

Known risk factors for meningioma include:

• Advanced age – Although it can occur at any age, meningioma primarily affects adults 60 and older.
• Inherited cancer predisposition syndromes – Individuals with certain genetic conditions, such as neurofibromatosis type 2 (NF2), schwannomatosis and multiple endocrine neoplasia type 1 (MEN1), are at heightened risk of developing benign central nervous system tumors, including meningiomas.
• Exposure to ionizing radiation – Previous radiation therapy delivered to the head or neck for medical treatment, especially during childhood, can increase the risk of brain tumors, including meningiomas.
• Hormonal factors – Fluctuating hormone levels, such as those that occur during a woman’s menstrual cycle, pregnancy and long-term hormone replacement therapy, can promote tumor growth because meningioma cells often have female hormone receptors.
• Gender – Studies suggest that women are three times more likely than men to develop meningioma, possibly due to hormonal factors.

What are the symptoms of meningioma?

Meningioma symptoms can vary based on the size and location of the tumor. Possible signs include:

• Persistent or worsening headaches
• Blurred or double vision
• Vision loss
• Seizures
• Hearing loss, especially in one ear
• Numbness or weakness in the face, arms or legs
• Dizziness
• Difficulty concentrating
• Memory loss
• Personality changes

These symptoms may be vague and subtle initially and gradually worsen over time.

How is meningioma diagnosed?

Meningioma is usually diagnosed through a combination of tests, which may include:

• Clinical evaluation – The physician will discuss the patient’s symptoms, review their personal and family health history and perform a physical examination.
• Neurological exam – The physician will assess the patient’s vision, hearing, balance, coordination, reflexes and cognitive ability.
• Brain scan – The physician may order computed tomography (CT) or magnetic resonance imaging (MRI) to obtain detailed images of the brain, which may reveal distinctive radiological characteristics of a meningioma, such as attachment to the meninges (dural tail) or an indentation in the brain tissue.
• Biopsy – A pathologist will examine the tumor tissue under a microscope to determine its cellular characteristics and grade.

How is meningioma treated?

Meningioma treatment is highly individualized and usually involves a combination of therapies, such as:

• Observation – The physician may suggest a “wait and watch” approach for a small tumor that is asymptomatic or causing only mild symptoms.
• Surgery – Surgical resection is often the primary treatment for a small tumor that is causing disruptive symptoms or a large tumor that is likely to cause symptoms in the near future.
• Radiation therapy – The first-line treatment for meningiomas that cannot be fully removed, radiation therapy involves the delivery of high-energy beams to destroy cancer cells, which can be effective for a tumor that is deeply located in the brain or encases neurovascular structures.
• Supportive care – Medications, dietary changes, relaxation techniques, physical therapy and counseling can help the patient manage the symptoms and side effects of meningioma and its treatment.
• Chemotherapy – Although chemo is rarely used for meningioma treatment, it may be considered to address an advanced or recurrent tumor that does not respond to other therapies.

Frequently asked questions (FAQs) about meningioma

The following FAQs-related articles provide additional information about meningioma:

• What is meningioma?
• Are meningiomas hereditary?
• What are the meningioma treatment options?
• When should a meningioma be removed?
• Can meningioma grow back?
• What are the side effects of radiation therapy for meningioma?

Benefit from world-class care at Moffitt Cancer Center

The multispecialty team in Moffitt’s high-volume Neuro-Oncology Program has extensive expertise in treating rare and complex brain tumors, including meningiomas. Working together, we use the latest techniques and technologies—including state-of-the-art imaging modalities and minimally invasive, robotic-assisted surgical procedures—to ensure precise diagnostics and effective treatment. Additionally, Moffitt has earned a national reputation as a leader in brain tumor research, and we offer our patients unique opportunities to be among the first to benefit from promising new therapies available only through our robust portfolio of clinical trials.

If you would like to learn more about meningioma, you can request an appointment with a brain tumor specialist at Moffitt by calling 1-888-663-3488  or submitting a new patient registration form online. We do not require referrals.