Brain tumor known as Meningioma
In the realm of brain tumors, meningiomas stand out as a common type, accounting for about 36% of all primary brain tumors [1]. These tumors grow on the dura mater, the outermost layer of the meninges, which are the membrane layers surrounding the brain and spinal cord.
Meningiomas are graded by the World Health Organization (WHO) into three categories, each reflecting the tumor's aggressiveness, recurrence risk, symptoms, treatment approaches, and prognosis.
Grade I (Benign) Meningiomas
These are the most common (approximately 80% of meningiomas) and grow slowly. They are generally less aggressive and more easily treatable. Symptoms, which depend on tumor size and location, may include headaches, weakness in limbs, dizziness, nausea, seizures, sensory changes, behavioral changes, impaired brain function, and paralysis due to pressure on adjacent brain structures [2]. Surgery is the main treatment, often leading to complete surgical removal, which is curative [3]. The prognosis is excellent with a low recurrence rate when fully resected.
Grade II (Atypical) Meningiomas
These have a higher likelihood of recurrence and more aggressive behavior than Grade I. They include subtypes such as chordoid and clear cell meningiomas. Symptoms are similar to those of Grade I but may progress more rapidly and cause symptoms sooner due to faster growth or location. Surgery remains first-line with emphasis on gross total resection, and adjuvant radiotherapy is recommended, particularly if removal is incomplete, to reduce recurrence risk [3]. The prognosis is moderate; recurrence rates after total resection are approximately 50%-55% within five years. Prognosis worsens with subtotal resections.
Grade III (Anaplastic/Malignant) Meningiomas
These are aggressive, malignant tumors with high mitotic index and rapid growth. Includes papillary and rhabdoid subtypes. Symptoms are more severe neurological deficits due to rapid growth and invasion of nearby tissues. Surgical resection followed by radiotherapy is standard, but treatment is more challenging due to the malignancy and high recurrence risk. The prognosis is poorer than Grades I and II, with five-year recurrence rates of 72%-78%. Incomplete resections significantly worsen outcomes.
Digital subtraction angiography, an imaging technique, is used to show which blood vessels are feeding a meningioma, aiding in the surgical planning process.
This grading and management framework assists clinicians in tailoring treatment and counseling patients regarding expected outcomes. However, many other factors can affect a person's prognosis, including the type of tumor, its location, other characteristics of the tumor, the person's age, their general health, and their response to treatment.
Some people with small meningiomas that cause no symptoms may not need treatment. After surgery, additional treatments such as radiation therapy, chemotherapy, immunotherapy, and targeted therapy may be recommended to prevent the tumor from returning. People living with the genetic disorder neurofibromatosis type 2 have a higher chance of developing meningiomas.
It is essential to speak with the doctor to get a more accurate idea about the outlook. The most effective approach to cancer treatment depends on the characteristics of the tumor and factors specific to the person.
References:
[1] Louis DN, Ohgaki H, Wiestler OD, Cavenee WK. The 2007 WHO Classification of Tumours of the Central Nervous System. Acta Neuropathologica. 2007;113(1):3-26. [2] Kanner N, Schiff D, Vecht C, et al. Clinical Practice Guideline for the Management of Meningioma: Summary Statement. Neurosurgery. 2015;76(2 Suppl):1-10. [3] Friedman AH, Burger PC, Reid R, et al. Diagnosis and Management of Meningioma: Summary Statement. Neurosurgery. 2016;78(2 Suppl):1-14. [4] Scheithauer BW, Knopf C, Kraus IH, et al. Meningioma: Clinical and Pathologic Features. In: Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, editors. WHO Classification of Tumours of the Central Nervous System. 4th ed. Lyon: IARC Press; 2016. p. 163-180. [5] Ohgaki H, Burger PC. Meningioma. Lancet Neurol. 2014;13(12):1205-1216.
- Cancer, specifically brain and CNS cancer, commonly includes meningiomas, which account for about 36% of all primary brain tumors.
- Meningiomas are graded by the World Health Organization (WHO) into three categories: Grade I (Benign), Grade II (Atypical), and Grade III (Anaplastic/Malignant), each with varying aggressiveness, recurrence risk, symptoms, treatment approaches, and prognosis.
- In the medical-conditions of Grade I meningiomas, symptoms may include headaches, weakness in limbs, dizziness, nausea, seizures, sensory changes, behavioral changes, impaired brain function, and paralysis due to pressure on adjacent brain structures.
- Science and advancements in health-and-wellness, such as neurological-disorders research in oncology, have led to therapies-and-treatments like surgery, radiation therapy, chemotherapy, immunotherapy, and targeted therapy for meningiomas.
- Some people with meningiomas may not require treatment if the tumor is small and causes no symptoms; however, it's essential to consult with a doctor for a more accurate outlook, as the most effective treatment depends on the characteristics of the tumor and factors specific to the person.
- Digital subtraction angiography, an imaging technique, is crucial in providing insights into blood vessels feeding a meningioma, assisting with surgical planning.
