meningioma

meningioma
Name	Meningioma
Field	Neurosurgery, Neuropathology, Oncology
Symptoms	Headache, focal neurological deficits, seizures
Complications	Neurological deficits, recurrence
Onset	Any age, most common in adults
Types	Benign, atypical, malignant
Causes	Genetic mutations, ionizing radiation exposure
Risks	Female sex, radiation, familial syndromes
Diagnosis	Neuroimaging, histopathology
Treatment	Surgery, radiotherapy, observation
Prognosis	Generally favorable for benign tumors

meningioma Meningioma is a common primary intracranial neoplasm arising from meningothelial cells of the meninges. It often presents with focal neurological signs, seizures, or incidental radiological detection and is managed by neurosurgical, radiation oncology, and neuropathology teams. Clinical decision-making involves input from multidisciplinary centers such as Mayo Clinic, Johns Hopkins Hospital, Cleveland Clinic, and specialist units in tertiary hospitals like Massachusetts General Hospital, UCSF Medical Center, Mount Sinai Health System.

Overview

Meningiomas are historically studied in neuropathology texts and atlases used at institutions such as Harvard Medical School, Stanford University School of Medicine, Columbia University Irving Medical Center and referenced in guidelines by organizations like the American Association of Neurological Surgeons and European Association of Neuro-Oncology. Research incorporating genetics from groups at National Institutes of Health, Wellcome Trust Sanger Institute, and Broad Institute has elucidated molecular drivers that guide contemporary management at academic centers including Memorial Sloan Kettering Cancer Center and Dana-Farber Cancer Institute. Epidemiological data are reported by agencies such as Centers for Disease Control and Prevention and registries like Surveillance, Epidemiology, and End Results Program.

Signs and symptoms

Presentation varies by location and size, producing seizures that bring patients to epilepsy centers such as Mayo Clinic Epilepsy Center, focal deficits managed at stroke units like Massachusetts General Hospital Stroke Service, cognitive changes observed in services at University College Hospital and symptoms attributable to cranial nerve compression seen in neuro-ophthalmology clinics such as Bascom Palmer Eye Institute. Headache patterns prompt referral pathways used by Royal London Hospital and Guy's and St Thomas' NHS Foundation Trust in the UK. Raised intracranial pressure with papilledema is evaluated by teams linked to Johns Hopkins Wilmer Eye Institute.

Causes and risk factors

Established risk factors include prior therapeutic ionizing radiation from radiotherapy programs at institutions such as University of Pennsylvanian Radiation Oncology and exposure incidents overseen historically by bodies like International Atomic Energy Agency. Hormonal associations have been explored in clinical studies at Mayo Clinic and Karolinska Institutet, noting higher incidence in females treated across centers like King's College Hospital. Genetic predisposition arises in familial syndromes managed by genetic services at Guy's and St Thomas' NHS Foundation Trust and NIH Clinical Center, including alterations found by teams at Cold Spring Harbor Laboratory and Sanger Institute affecting genes characterized in consortia involving Cancer Research UK.

Diagnosis

Diagnosis relies on neuroimaging modalities available at radiology departments of Mayo Clinic and UCSF Medical Center including magnetic resonance imaging protocols developed at Massachusetts General Hospital and computed tomography techniques used at Cleveland Clinic. Advanced techniques such as diffusion imaging, perfusion MRI, and functional MRI are applied in centers like Johns Hopkins Hospital and Mount Sinai Health System. Definitive diagnosis requires histopathology and immunohistochemistry performed by neuropathology services at Massachusetts General Hospital Pathology and Karolinska University Hospital with molecular testing increasingly offered by laboratories at Broad Institute and Memorial Sloan Kettering Cancer Center.

Classification and pathology

Histological grading follows systems promulgated by international bodies such as the World Health Organization and is applied in neuropathology practices at Mayo Clinic and Johns Hopkins Hospital. Subtypes are reported in surgical series from Cleveland Clinic and Stanford Health Care, while molecular classifications incorporating chromosomal alterations and mutations are advanced by researchers at Broad Institute and Wellcome Sanger Institute. Pathologists at institutions like Memorial Sloan Kettering Cancer Center and UCSF Medical Center use immunostains and mitotic indices to distinguish benign, atypical, and anaplastic variants.

Treatment and management

Management is tailored by multidisciplinary teams at comprehensive cancer centers such as MD Anderson Cancer Center, Memorial Sloan Kettering Cancer Center, Mayo Clinic, and Johns Hopkins Hospital. First-line therapy for symptomatic lesions usually involves microsurgical resection performed by neurosurgeons trained in programs at Barrow Neurological Institute and Toronto Western Hospital, with skull base approaches taught at Rothman Orthopaedic Institute and NIH Clinical Center. Adjuvant stereotactic radiosurgery is delivered by radiosurgery units at Gamma Knife Center facilities including Karolinska University Hospital and UCSF Medical Center. Systemic therapies and clinical trials are coordinated by oncologists at Dana-Farber Cancer Institute, MD Anderson Cancer Center, and consortia such as EORTC.

Prognosis and epidemiology

Prognosis depends on grade, resection extent, and tumor location; long-term outcomes are reported by registries including SEER Program and cohort studies from Mayo Clinic and Johns Hopkins Hospital. Incidence increases with age and shows a female predominance noted in population studies from Centers for Disease Control and Prevention and national health services like NHS England. Recurrence patterns and survival statistics inform follow-up protocols at specialist centers including Memorial Sloan Kettering Cancer Center and MD Anderson Cancer Center.

Category:Brain tumors