Meningioma
Meningiomas are tumours arising from the meninges, the membranous layers surrounding the central nervous system. These tumours are usually benign, many of them are producing no symptoms throughout a patient's life, so that they require no treatment.
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Different Types of Meningioma
- meningothelial meningioma (WHO grade I)
- fibroblastic meningioma (WHO grade I)
- transitional (mixed) meningioma (WHO grade I)
- psammomatous meningioma (WHO grade I)
- angiomatous meningioma (WHO grade I
- microcystic meningioma (WHO grade I)
- secretory meningioma (WHO grade I)
- lymphoplasmacyte-rich meningioma (WHO grade I)
- metaplastic meningioma (WHO grade I)
- chordoid meningioma (WHO grade II)
- clear cell meningioma (WHO grade II)
- atypical meningioma (WHO grade II)
- papillary meningioma (WHO grade II, III)
- rhabdoid meningioma (WHO grade III)
- anaplastic meningioma (WHO grade III)
Histology of Meningeoma
- slowly growing, benign meningeoma (WHO-grade I)
- atypical meningeoma, tending to relapses (WHO-grade II)
- fast growing, anaplastic meningeoma (WHO-grade III)
Epidemiology of Meningeoma
- 85% of all meningeoma are benign, 8-10% are atypical and 2-5% anaplastic
- average age between 50 and 60
- women are a little more often affected
Symptoms of Meningeoma
- depending on location and the compression which is connected to it
- signs of cerebral pressure (e.g. headache)
- neurological deficits (e.g. impaired vision, uncertain gait)
- epilepsy
- often patients don´t feel any symptoms
Diagnosing Meningeoma
- diagnosis with CT and MRI
- if necessary MR-angiography, functional MRI, MR-spectroscopy, PET
- clearly defined lesion with perifocal edema
- intensive, homogenous enhancement of contrast agent
- tends to calcification
- 9% oft he patients have more than one meningeoma
- 27% of meningeoma feature genetic modifications (monosomy 22)
- occurs more often in patients with neurofibromatosis type II and preceding radiotherapy
- possibly faster growth in pregnancy
Therapy of Meningeoma
- if possible, complete surgical removal of brain tumour
- preoperative embolisation possible in vascular-rich tumours
- treatment of anaplastic menigeoma with additional radiotherapy
- small, asymptomatic meningeomas therapy is not always necessary
Therapy of Recurrent Meningeoma
- re-operation
- (second) irradiation
- chemotherapy, e.g. with hydroxyurea
- experimental therapy, e.g. with antiangiogenic approaches
Aftercare of Meningeoma
- check-up every 6 to 12 months
- if necessary ophthalmological, neurological and endocrinological examinations
Course of Meningeoma
- slow, extrusive growth with branches in dura mater
Prognosis of Menigeoma
- complete surgical removal of benign meningeoma i soften equivalent to a cure
- frequency of recurrences of WHO-grade I: 7-20%
- frequency of recurrences of WHO-grade II: 30-40%
- frequency of recurrences of WHO-grade III: 50-80%
