Summary and Further Reading

Chapter 10 - Classification and Treatment Strategies of Meningiomas

Summary

  • Meningiomas are the most common primary intracranial/intraspinal tumours in adults
  • Meningiomas are more common in women than in men
  • Risk factors include higher age, female gender, prior cranial irradiation and hereditary tumour syndromes (e.g. NF2)
  • Patients with germline NF2 Mutations typically present with multiple meningiomas and bilateral vestibular schwannomas
  • Radiological assessment is preferentially done by cranial MRI
  • Common intracranial locations are the cerebral convexities, olfactory grooves, sphenoid wings, tentorium and posterior fossa
  • Histopathologically, approximately 75% of cases correspond to WHO Grade 1 (benign meningioma), 20% to WHO Grade 2 (atypical meningioma) and 5% to WHO Grade 3 (malignant meningioma)
  • Neurosurgical resection is the treatment of choice for newly diagnosed meningiomas
  • Adjuvant RT is commonly applied after resection of WHO Grade 3 meningiomas, and after incomplete resection of WHO Grade 2 meningiomas
  • In the recurrent setting, surgical resection, fractionated RT, radiosurgery or systemic therapy are commonly applied, but evidence from clinical trials is lacking

Further Reading

Domingues P, González-Tablas M, Otero Á, et al. Genetic/molecular alterations of meningiomas and the signaling pathways targeted. Oncotarget 2015; 6:10671–10688.

Kaley T, Barani I, Chamberlain M, et al. Historical benchmarks for medical therapy trials in surgery- and radiation-refractory meningioma: a RANO review. Neuro Oncol 2014; 16:829–840.

Louis DN, Ohgaki H, Wiestler OD, Cavenee WK (Eds). WHO Classification of Tumors of the Central Nervous System, 4th Edition. Lyon: International Agency for Research on Cancer (IARC), 2007.

Mawrin C, Chung C, Preusser M. Biology and clinical management challenges in meningioma. Am Soc Clin Oncol Educ Book 2015: e106–e115.

Rogers L, Barani I, Chamberlain M, et al. Meningiomas: knowledge base, treatment outcomes, and uncertainties. A RANO review. J Neurosurg 2015; 122:4–23.

Wen PY, Quant E, Drappatz J, et al. Medical therapies for meningiomas. J Neurooncol 2010; 99:365–378.

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Last update: 18 September 2017