Meningioma

A Meningioma is a mostly benign brain tumor that does not cause any symptoms at the beginning due to its slow growth. Meningiomas are among the most common brain tumors, accounting for around 15 percent of all tumors inside the skull, with women developing meningiomas more often than men.

What is a meningioma?

A Meningioma is a usually benign (benign) and slowly growing brain tumor that originates in the so-called meninges, the cover cells of the arachnoid of the brain and spinal cord, which are spider tissue together with the pia mater as soft meninges (leptomeninx), the cranial cavity below the hard meninges undress.

Meningiomas usually border the hard meninges from the inside and, as they grow, displace the surrounding tissue, which can cause damage to the meninges and neurological disorders. A meningioma can have several tumor foci (meningiomatosis) as well as diffuse (scattered) growth, whereby those affected with more than one tumor foci usually have a genetic disease (neurofibromatosis type 2 or Recklinghausen's disease).

causes

The causes of developing a Meningioma could not be fully clarified so far. What is certain is that a meningioma develops when arachnoid cells or cells of the spider tissue skin degenerate and proliferate, although the trigger for this degeneration process is unclear.

In addition, children who have been exposed to radiation therapy as a result of a tumor disease have an increased risk of developing particularly malignant meningiomas.

Genetic factors are also assumed, as in many cases people affected by meningiomas have lost information on chromosome 22.

A head trauma or a meningeal tumor as well as other skull injuries can be excluded as triggering factors for a meningioma.

Symptoms, ailments & signs

Meningioma often lasts several years before symptoms appear. The first signs of a brain tumor are unspecific and can appear in different parts of the body. For example, smell disorders, visual and speech disorders, fatigue, headaches and paralysis of the limbs can occur. In addition, seizures, deficits in the arms and legs and psychological changes can occur.

If the tumor is located in the spinal canal, paresthesia, back pain and nerve problems occur. Outwardly, a meningioma can be recognized by weight loss, pale skin, and a generally sickly appearance. The meningioma develops very slowly and the brain can adapt well to the tumor, which is why those affected usually do not notice any symptoms themselves.

It is often the relatives who notice noticeable symptoms such as personality changes. Older patients then show signs of dementia or depression, while children and adolescents can experience stunted growth. If the tumor is located in the bony top of the skull, this can lead to increased bone growth. The result is an externally visible bump.

In some patients, the eyeball also protrudes.This so-called exophthalmus is also associated with pain and severe discomfort. The symptoms increase as the tumor grows and only slowly regress after the growth is removed. Long-term damage often remains.

Diagnosis & course

To diagnose a Meningioma Imaging diagnostic methods such as CT (computed tomography) or MRT (magnetic resonance tomography) are primarily used. The tumor is made visible by a contrast agent with which it is enriched.

If a tumor with a smooth border in the area of ​​the meninges as well as the characteristic thickening in the contact area between the tumor and the meninges is detected, a meningioma can be assumed.

As a rule, a meningioma shows a good course, but in rare cases (1.7 percent) it can degenerate into a malignant brain tumor with metastasis. Due to the very slow growth of this type of brain tumor, meningioma often causes no symptoms at the beginning and is diagnosed by chance after years.

If symptoms such as neurological disorders (abnormal sensations, impaired vision or speech ability) occur, surgery is required. In some cases (13 percent), with so-called anaplastic or atypical meningiomas, the prognosis is less favorable.

Complications

In most cases, meningioma is diagnosed late because it does not cause any particular discomfort or complications as it grows in the first few months and years. For this reason, early treatment of this disease is usually not possible. Those affected primarily suffer from severe headaches and sensory disorders.

There are also disorders of sensitivity and paralysis in different regions of the body. Due to the paralysis and restricted mobility, those affected may be dependent on the help of other people in their everyday lives. It is also not uncommon for epileptic seizures and visual disturbances to occur.

Patients also suffer from thinking and speaking disorders, so communicating with other people is also difficult due to the meningioma. The quality of life is significantly reduced by this tumor. The tumor can be removed by surgery.

It cannot be generally predicted whether the symptoms will disappear completely. As a rule, those affected are then also dependent on chemotherapy, which often leads to various side effects. Furthermore, the life expectancy of the patient can also be reduced by the meningioma.

When should you go to the doctor?

Diagnosing meningioma is often difficult because the ulcer grows very slowly. The signs and symptoms can thus be mistaken for other disease states or written off as normal signs of aging. Headaches that are only temporary can be relieved by changing your diet or by consuming larger amounts of water. The conscious avoidance of psychological stress and more sleep can provide a significant relief here.

The workplace in the office should possibly be optimized, as mismatches between screen orientation and sitting position can also have a negative effect on the head joints, which can lead to headaches. A physiotherapist or osteopath can help with this. A visit to the general practitioner is advisable if the headache persists and gets worse over time. If they suspect a meningioma, they may be referred to a neurologist, who will then carry out examinations followed by imaging tests such as CT or MRI.

Meningioma may require emergency care if there are sudden seizures and changes in vision or memory.

Treatment & Therapy

The therapy is aimed at one Meningioma according to the location, size and rate of growth of the tumor. Due to the principally benign character and the very slow growth of a meningioma, its development is initially observed in the course of follow-up examinations.

If neurological disorders manifest themselves, the meningioma is removed as part of a surgical procedure. Angiography is used to visualize the arteries of the meninges that supply the meningioma and that are embolized (obliterated or closed) to minimize blood loss during the procedure. Surgical intervention aims to completely remove the meningioma.

If complete removal of the tumor is not possible or a malignant meningioma is present, additional radiation therapy will be required after the operation to kill the remaining tumor cells. Small tumors (maximum three centimeters in diameter) are irradiated once within the scope of radiosurgery with a gamma knife or linear accelerator with high-dose gamma rays. This form of therapy is also used when the meningioma is in an unfavorable position for operations or the general condition of the person concerned does not allow such an operation.

Chemotherapy is only used in exceptional cases for meningiomas, as only a few clinical or experimental studies have so far existed and its effectiveness in meningiomas has not yet been proven.

Outlook & forecast

Statistically, six out of 100,000 people will develop a meningioma during their lifetime. A noticeably high number of patients are between the ages of 40 and 60 at the time of diagnosis. Women are at greater risk. If you look at the chances of recovery, the picture is mixed. Around nine out of ten diseases are benign. If such a tumor can even be completely removed by surgery, a full recovery is likely. If, on the other hand, tumor cells remain, they will grow again.

In one out of ten other cases, the meningioma is fast-growing or malignant. The prognosis for this tumor is comparatively poor. On the one hand, there is an increased risk of renewed growth. On the other hand, every third patient of the malignant form develops metastases. Almost 80 percent of the last training suffered renewed tumor growth within five years of the prognosis.

When assessing the prospect, the location of the tumor tissue always plays a role. For example, if it is stuck to the underside of the brain, it usually cannot be completely removed. Even in such an unfavorable situation, a surgeon can easily damage the brain. This creates permanent, irreparable neurological disorders.

prevention

As the triggering factors for the manifestation and development of a Meningioma have not yet been clarified, this cannot be prevented. In general, unnecessary radiation (especially in children) and carcinogenic substances such as nicotine or alcohol should be avoided. In addition, a healthy diet and sporting activity strengthen the body's own defense system and help to minimize the risk of cancer and thus also the risk of meningioma.

Aftercare

The diagnosis of meningioma is very often made relatively late, as there are hardly any complaints or complications in the first years or months of growth. It is therefore hardly possible to treat this disease early. The patients mainly suffer from sensory disturbances and severe headaches, and there can also be paralysis in different parts of the body.

As a result, those affected can be restricted in their movement and then also need help to cope with their everyday lives. Visual disturbances or epileptic seizures can also occur. The sick often also suffer from speech or thought disorders, which can lead to communication problems. The patient's quality of life can therefore suffer considerably if a meningioma occurs.

The tumor can be removed by surgery, but it cannot be predicted with certainty whether the symptoms will completely disappear. Usually, the patients also have to undergo chemotherapy, which can cause a wide variety of side effects. In addition, the life expectancy of those affected can be reduced by a meningioma, because the risk that the tumor will grow again is relatively high.

You can do that yourself

In addition to medical treatment, meningioma patients can resort to a number of strategies and self-help measures to make everyday life easier and to support therapy.

First of all, the doctor will recommend rest and protection. Especially in the first time after an operation, those affected have to forego strenuous activities. In addition, a balanced diet is recommended, in which fiber is taken instead of carbohydrates. Since brain tumors need sugar in order to grow, sweet foods, certain types of fruit and sugary drinks such as lemonade or cola should also be avoided. Foods like chickpeas, soybeans, and red clover should be included in the diet because of their high content of biochanin - a fiber that has a healing effect on tumor cells. In addition to a change in diet, general measures such as regular exercise and avoiding stress are recommended.

Affected people are also recommended to visit a self-help group and exchange ideas with other affected people. In general, it is important to understand the disease, because only then can it be overcome mentally in the long term. The Association of German Brain Tumor Aid e.V. offers further information for those affected.