Meningiomas are brain tumors of the meninges that line the central nervous system (brain and spinal cord). Intracranial tumors are the most common in adults. Meningiomas are most common at the age of 30-70 years.
There are 3 classifications of meningiomas based on their pathology :
Grade I (benign) ️➡️
- Meningiothelial.
- Fibrous (fibroblastic).
- Transitional (mixed).
- Psammomatous.
- Angiomatous.
- Microcystic.
- Secretory.
- Lymphoplasmacyte-rich.
- Metaplastic.
Grade II (atypical) ️➡️
- Choroid.
- Clear lear cells.
- Atypical.
Grade III (malignant) ️➡️
- Papillary.
- Rhabdoid.
- Anaplastic.
Meningiomas etiology.
The cause of meningiomas is still undecided. Gene mutations associated with meningiomas :
- NF2 deletion and inactivation on chromosome 22.
- Other genes (NF1, PTCH, CREBBP, VHL, PTEN and CDKN2A).
Risk factors :
- Radiation (ionizing radiation).
- Hormone.
- Head trauma.
- Cellphone use.
- Family history of meningiomas.
Signs and symptoms :
- Headache.
- Sleepy.
- Seizures.
- Loss of hearing.
- Tinnitus.
- Progressive focal neurologic deficit.
- Muscle weakness.
- Nauseous vomit.
- Confusion.
- Visual disturbances.
Diagnosis.
Diagnosis is difficult because meningiomas are slow growing tumors. Diagnosis is made by :
- CT/CAT scan.
- MRI.
- Positron emission tomography.
- Magnetic resonance spectroscopy: to examine the chemical profile of the tumor.
Treatment.
Surgical therapy and radiation therapy are commonly used for the treatment of meningiomas.
- Grade I : Gross total resection is the treatment of choice.
- Grade II : resection as much as possible. External beam radiation post-surgery can also be performed.
- Grade III : maximum resection + adjuvant radiation.
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