Meningioma symptoms develop slowly but account for one-third of all brain tumors.

Slow-growing tumors called meningioma can be hard to detect because of their subtlety. They occur in the “meninges,” the thin membranes that cover and protect the brain and spinal cord.

Meningiomas grow gradually, compressing nerves and blood vessels. In many cases, they are not diagnosed until you have symptoms seemingly unrelated to a tumor.

Symptoms for meningioma include:

  • Headaches that become more severe and worsen with activity or in the early morning
  • Seizures
  • Loss of consciousness
  • Loss of control of body functions
  • Changes in sensory functions
  • Personality or memory changes
  • Weakness or pain in the arms and legs

The good news is that about 98 percent of all meningiomas are benign. According to the American Brain Tumor Association, most occur in adults older than 50 and twice as often in women as men. Meningiomas account for one-third of all brain tumors.

What causes meningioma?

A meningioma tumor forms when healthy cells change and begin to multiply out of control. Why this occurs is unclear, but doctors believe that inherited genes, environmental causes, hormones, or a combination of these could be factors.

How is meningioma diagnosed?

Because they are hard to detect, meningioma tumors often are discovered when doctors are exploring the cause of seemingly unrelated symptoms. An imaging test that provides a detailed picture of the brain, such as a CT scan or MRI, will confirm whether meningioma is present.

How is meningioma treated?

Treatment is based on the size, location and whether the meningioma is aggressive. Your health and goals for treatment also are considered. In cases where the meningioma is slow-growing, small and without symptoms, your doctor may not recommend treatment but choose to monitor the tumor over time.

If the meningioma is growing, there are several treatment options.

Surgery:

Removing as much of the tumor as possible is the most common form of treatment. If the entire tumor can be removed, no further treatment may be needed.

A minimally invasive approach to meningioma surgery involves inserting an endoscope into the nose, through which surgeons can remove tumors near the base of the skull, reducing recovery time. Another technique removes tumors through a tiny incision in the eyebrow.

“We are a leading center in California for minimally-invasive brain surgery,” said Gabriel Zada, MD, associate professor of neurological surgery at Keck School of Medicine of USC and director of the USC Minimally Invasive Neurosurgery and Endoscopic Skull Base Center

at USC Neurosciences of Keck Medicine of USC. “There are only a couple of academic medical centers that can do these types of surgery.”

Radiation therapy:

If surgery can’t remove all of the tumor, the remaining tumor may be treated with radiation. This involves using fractionated stereotactic radiotherapy (SRT) and intensity-modulated radiation therapy (IMRT) to destroy malignant meningioma cells and reduce the chance of occurrence.

Radiosurgery:

Performed on an outpatient basis, radiosurgery involves pinpointing radiation therapy at a precise point on the tumor. This option may be considered when the meningioma can’t be removed with conventional surgery or when it recurs after treatment.

Medication:

When surgery and radiation are not effective, doctors may try chemotherapy. Chemotherapy can be difficult for brain cancer patients because high doses are needed to reach the brain, which can cause toxicity in the body, although research being done at the USC Norris Comprehensive Cancer Center is looking at an inhaled drug for brain cancer chemotherapy.

“We are putting all our effort into looking for the next big breakthrough for brain cancer,” said Thomas Chen, MD, PhD, professor of neurosurgery at the Keck School of Medicine of USC and a neurosurgeon at Keck Medicine of USC.

By Heidi Tyline King

As one of the eight original National Cancer Institute (NCI)-designated comprehensive cancer centers in the United States, USC Norris Comprehensive Cancer Center at Keck Medicine of USC is one of the preeminent academic medical institutions in the country. If you are in the Los Angeles area, make an appointment by calling (800) USC-CARE (800-872-2273) or visiting https://cancer.keckmedicine.org/request-an-appointment/.