The idea of any brain tumor can be frightening, but the word “tumor” just refers to an excessive growth of cells, which does not necessarily mean they are cancerous. In fact, many patients live with a brain tumor and never even realize it if it isn’t causing any noticeable effects.
A meningioma is an excessive growth of the cells of the meninges. The meninges are a protective covering that surrounds your entire central nervous system, or the brain and spinal cord. They are made up of three delicate layers that are distinct from your brain. That means that a meningioma is not actually a tumor of brain cells, though it can impact your brain.
There are three different types, or grades, of meningioma, depending upon the nature of your tumor. These classifications are based on the histology, or what can be seen under the microscope when a pathologist looks at a slide with a small piece of the tumor.
Meningioma (Grade I)
Around 90 percent of meningiomas are classified as Grade I, which means they are completely benign. The term “benign” refers to the fact that your tumor is considered non-cancerous, in that it is not invading the nearby tissue or metastasizing (spreading) to other organs. However, the term can be misleading, because the growth itself could be putting pressure on your brain, blocking cerebrospinal fluid (CSF) and/or blocking blood flow, which can be causing your symptoms.
Atypical Meningioma (Grade II)
If your meningioma is classified as Grade II, or atypical, that means it is somewhere between Grade I and Grade III. The cells appear to be abnormal, or atypical, and your tumor is growing faster than a Grade I. There may be a small degree of invasion of the tumor growing into the brain, but not necessarily. Grade II meningiomas have a greater chance of recurrence after treatment bec Despite the more aggressive nature of Grade II meningiomas, they are not considered to be cancerous/malignant.ause of their nature, and represent 7-8 percent of all meningiomas.
Anaplastic Meningioma (Grade III/Malignant)
The remaining 2-3 percent of meningiomas are classified as Grade III, or malignant. The cells are anaplastic, meaning they are even more irregular than Grade II, and they also grow more quickly. Grade III meningiomas can grow into the brain, as well as metastasize (spread) to other organs. If your meningioma is malignant, your tumor has the greatest chance of recurrence and will likely require more aggressive therapy.
Symptoms of Meningioma
Meningiomas can be difficult to diagnose because the symptoms are shared with other conditions. The problems caused by your meningioma relate to the fact that it is growing within an enclosed space, often with a hard, bony surface on one side (your skull) and the more malleable surface of your brain on the other. That forces the tumor to grow inward, putting pressure on your brain, blocking the flow of CSF and perhaps blocking blood vessels.
If your meningioma is slow-growing, it can take a long time for symptoms to occur, if they ever do. Some common symptoms include:
- Weakness in an arm or leg
- Blurred vision
- Difficulty speaking
- Personality changes
Treatments for Meningioma
Not all meningioma patients will require treatment, and your physician may recommend regular observation and monitoring. However, depending upon your tumor classification, location, symptoms and personal health history, your brain tumor surgeon may recommend a treatment plan that includes surgery and/or radiation therapy.
The goal of surgery is complete removal of your tumor, which can often be accomplished in a single surgery for a Grade I meningioma. If your surgeon can completely remove your tumor, the chances of it returning are low. A complete resection, including removal of the dura, has about only about a 9% recurrence rate. If a small portion of the affected dura remains (which is common) recurrence is generally then around 20% or higher.
To access your tumor, your surgeon will likely perform a craniotomy and remove a small section of your skull. After removing the tumor, he will replace the section of skull and secure it with screws or a plate. You can expect to spend approximately 3 days in a hospital setting so that your care team can monitor your recovery. After being discharged from the hospital, you will likely be put on restricted activity for a while to allow your body to recover.
Sometimes the brain tumor surgeon cannot completely remove the tumor through surgical means, or the tumor may be in a location that is difficult to access. In that case, your surgeon may recommend radiation therapy as either a primary or adjunct therapy. In some cases, if the tumor is small enough, it can be completely eradicated using a method called stereotactic radiosurgery. (Grade II and Grade III meningiomas will always receive some form of post-operative radiation therapy.)
Stereotactic radiosurgery, in spite of the name, does not involve an incision, but rather uses a small, highly focused beam of radiation to destroy the tumor cells. If you are not a good candidate for surgery because of your health conditions or the location of your tumor, your surgeon may recommend this approach.
Why Choose Neurosurgeons of New Jersey?
Because you are an individual, your condition is not going to be the same as anyone else’s. It’s important to find a surgeon experienced in treating meningiomas who can work with you to develop a treatment plan best suited for your needs.
Neurosurgeons of New Jersey is the largest sub-specialized practice in the tri-state area, with a proven track record, cutting-edge technology and a patient-centric philosophy. Each surgeon at Neurosurgeons of New Jersey is a specialist in his specific field, ensuring you receive focused, expert care from a surgeon devoted to your condition.