Meningioma: Can it be treated? (Prognosis and treatment)

meningioma

Article reviewed and approved by Dr. Ibtissama Boukas, physician specializing in family medicine

The brain are tissues that cover the brain and spinal cord. Sometimes they are the seat of a tumor called meningioma. Let's take a closer look at this disease.

What is a meningioma? (Definition)

 

Meningiomas are tumors that form next to the brain. They come from the meninges: a set of tissue layers that covers the brain and the spinal cord, the outermost layer being called the dura mater. They are most often located within the arachnoid cells.

This type of tumor tends to grow slowly. They move inward. Unfortunately, they may even only be discovered at an already very advanced stage.

In terms of statistics, meningiomas can both affect men and women. While two-thirds of cases of meningiomas concern women, malignant meningiomas are more common in men. Also, this tumor is found mainly in adults between 30 and 70 years old.

Although it is generally benign, the tumor of the meninges can also become bulky enough to endanger the patient's life.

Some patients may have more than one meningioma. Meningiomas account for about a third of all primary brain tumors.

Common types of meningiomas

There are three types of meningiomas classified according to their grade.

  • Grade I (benign meningioma) which grows slowly.
  • Grade II (atypical meningioma) which grows faster.
  • Grade III (meningioma malin) which grows and spreads very rapidly.

The main causes of meningioma

La true cause of a meningioma still remains unknown. The frequent cases of meningiomas lead us to deduce that something is altering certain meninge cells : they multiply uncontrollably. This leads to a meningioma tumor. We then speak of risk factors. They are numerous.

Radiation therapy 

Radiation therapy that involves radiation to the head may increase the meningioma risk.

female hormone treatments

Hormone treatments based on Luteran, Luthenyl and Androcur are known to increase the risk of developing a meningioma. The same is true for some birth control pills and hormone replacement therapy.

An inherited disorder of the nervous system

There are also hereditary disorders of the nervous system which prove to be notable risk factors for this type of tumour. This is the case of the neurofibromatosis 2 : a rare disease. It increases the risk of meningioma and other brain tumors in the patient.

How is a meningioma diagnosed?

Le diagnosis of a meningioma can be difficult as it usually grows slowly.

Many associate the symptoms with those of aging: This is why we often need to make neurological examinations thorough to confirm the diagnosis. These mainly concern the radiological examinations.

In addition, it is also possible that the doctor carries out other tests such as hearing and visual tests (or other neurological examination). They help determine how a meningioma affects the brain.

La computed tomography (CT) and magnetic resonance imaging (MRI) also come into play in the diagnosis of a meningioma.

Un complete diagnosis can claim a biopsy, however, the diagnostic can sometimes be laid only with a CT or MRI.

On rare occasions, the doctor may prescribe a cerebral angiography. This helps assess the vascularity of the tumor and how it affects the blood flow in the brain.

What are the symptoms of a tumor in the meninges?

The most common signs of a meningioma are the headache and weakness in a hand or foot. Some symptoms are specifically related to the area of ​​the brain where the tumor is located.

Other symptoms include:

  • confusion and disorientation;
  • drowsiness;
  • sight or hearing problems;
  • personality changes;
  • nausea and vomiting;
  • jerks and convulsions;
  • numbness or pain in the face.

The prognosis and life expectancy with a meningioma

As regards the healing prognosis and life expectancy with meningioma, we observe better results with a surgical removal of the entire tumor or a radiosurgery. Also, the younger the patient is at the time of diagnosis, the better the long-term prognosis.

Despite this, although many meningiomas can be completely removed, surgery and radiation therapy can have long term effects depending on thetumor location. These can occur for anterior based tumors. It is rarer with lateral base tumors.

The cancerous meningiomas represent just over 1% of all primary brain tumors (tumors that start in the brain).

Even if it is cancer, it is estimated 10-year survival rate of a patient with a malignant meningioma to:

  • 78% and more for seniors 20 to 44 year-olds ;
  • 34% approximately for the elderly 75 years and older.

What treatments are available for a meningioma?

To treat a tumor in the meninges, it is important to take into account the meningioma size, these are emplacement,age and l'health general of the patient. There are three treatment options for this type of brain tumor:observation,surgical removal and radiotherapy. In some cases, surgery is followed by radiation therapy.

L'observation

For some patients, the best treatment may be monitor meningioma growth over time through imaging tests. Indeed, there are cases where the meningioma can stop growing after the age of about 50 years.

The surgical operation to remove the meningioma

In the majority of cases, a meningioma is treated with surgery.. It is particularly indicated when the symptoms seriously affect the health of the patient. Surgery by specialists is also necessary if the size of the tumor is large and can no longer be treated with radiotherapy.

For this procedure, known as craniotomy, we start by cutting out a small piece of the bone of the skull to access the tumor. During the operation, neurosurgeons use a large surgical microscope that provides a greatly magnified view of the tumor.

Then they remove as many meningiomas as possible. At the end of the operation, they replace the skull bone with synthetic material.

Radiation to treat this brain tumor

Thanks to significant improvements in the radiotherapy, it is possible to treat a tumor with the least possible effect on surrounding healthy tissue.

The most common is the stereotactic radiotherapy. This can stop the growth of a meningioma. Despite the name, no surgery takes place during this method. Typically, the patient receives a single high dose of radiation or a small number of doses.

Radiation therapy may be an alternative to surgery if the tumor is malignant or recurrent, or if it is too difficult to remove. If remnants of tumors remain after surgery, radiation therapy may also be needed.

Recovery: life after meningioma surgery

Depending on the type of meningioma, life after the procedure can vary. In addition, meningiomas have a high recurrence rate.

Also, although some symptoms such as dizziness may improve, hearing loss quite often persists. This is because the tumor can permanently damage the nerves in the ear.

What if the meningiomas recur?

A recurrence after surgery or radiation therapy is common for this meningeal tumour. Faced with this risk, the doctor may recommend occasional imaging tests with a frequency of one to three years to check regrowth.

Even after surgery and radiation therapy, some malignancies may require chemotherapy.

Treatment complications

Here are some complications that can arise during the meningioma treatment :

  • seizures;
  • memory loss;
  • concentration problems;
  • personality changes.

References

https://www.passeportsante.net/fr/Maux/Problemes/Fiche.aspx?doc=meningiome_pm

https://www.femmeactuelle.fr/sante/sante-pratique/meningiome-tout-ce-quil-faut-savoir-sur-cette-tumeur-cerebrale-2094540

https://www.topsante.com/medecine/cancers/cancer-du-cerveau/meningiome-symptomes-traitements-tumeur-cerveau-628602

https://sante.journaldesfemmes.fr/fiches-maladies/2674667-meningiome-definition-symptomes-biopsie-operation-traitements/

https://commons.wikimedia.org/wiki/File:MRIMeningioma.png

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