Meningiomas are tumors of the central nervous system (the brain and spinal cord). They are the most common tumor in the head, representing about one-third of all meningioma cases and affecting about 170,000 people in the U.S.
Although most meningiomas are not cancerous, a small percentage can be. Even noncancerous meningiomas can cause life-altering symptoms or be life-threatening.
Meningiomas grow slowly and often do not present symptoms right away.
Learn more about meningiomas, including symptoms, treatment options, and more.
There are no specific causes of meningioma, although people who have had whole-head radiation are at increased risk for them many years later. They come from the meninges, which are the protective layers that surround your brain and spinal cord.
According to the American Brain Tumor Association, meningiomas usually grow inward. This causes pressure on the brain, spinal cord, or eye. When they grow outward, toward the skull, they cause the skull to thicken.
The American Brain Tumor Association says meningiomas most often form near the top or outer curve of the brain. They also can form at the base of the skull.
Types of Meningiomas
The World Health Organization (WHO) classifies three grades of meningioma tumors:
- Grade 1 (benign meningiomas). These are the most common, slowest growing, and least aggressive forms of meningioma. More than 80% of meningioma cases are benign.
- Grade 2 (atypical meningiomas). These are still benign but can be more aggressive and invasive forms of meningioma. They grow more quickly than benign meningiomas and can recur even after removal. Between 15% and 20% of meningioma cases are Grade 2.
- Grade 3 (malignant meningiomas). These account for under 2% of meningiomas but are the most severe. They are the most aggressive, fastest growing, and most invasive forms of meningioma. They cause cancer and are the most likely to recur.
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Meningioma Risk Factors
Risk factors for meningioma include:
- Age. Meningiomas are much more common in adults than children, with older adults at highest risk.
- Sex. Females are more than twice as likely to have meningiomas as males.
- Race. Black people are more at risk of meningioma in the United States than white people.
- Radiation exposure. People with radiation exposure to the head are at higher risk for meningioma.
- Obesity. People with obesity are at higher risk of meningioma.
- Genetics. Certain genetic conditions — including neurofibromatosis type 2, schwannomatosis, and Gorlin syndrome — are risk factors for meningioma.
Are Meningiomas Cancerous?
Although most meningiomas are benign (noncancerous), some can become malignant (cancerous).
But even noncancerous meningiomas can cause life-altering or life-threatening symptoms.
Meningioma symptoms depend on the size and location of the tumor. Because many meningiomas grow slowly, symptoms may not be present right away. Common symptoms include:
- Weakness in arms and legs.
- Visual problems.
- Hearing problems (loss of hearing or ringing in the ears).
- Anosmia (loss of smell).
- Changes in personality.
- Cognitive changes.
- Nausea and vomiting.
Depending on the tumor’s location, it may cause problems with other normal body functions, like walking or using the bathroom.
Meningiomas can be hard to diagnose because they grow slowly and often do not cause symptoms at first. Also, some of their symptoms mirror those of other health conditions. Many times, the diagnosis does not occur until symptoms are present.
You likely will need to see a neurologist for a meningioma diagnosis, but your primary doctor may order a scan if symptoms are consistent with one. The first step to getting a diagnosis often is a medical history and neurological testing. Imaging tests, such as magnetic resonance imaging (MRI) or a computer tomography (CT) scan, can diagnose meningioma.
You also may need a biopsy to determine whether the tumor is cancerous.
Treatment for meningioma depends on the size and location of the tumor, along with the symptoms it’s causing. For example, if the tumor is small and slow-growing and you are not experiencing symptoms, you may not need immediate treatment. But for large tumors that are causing symptoms, you may need treatment right away.
Treatment for meningiomas my include surgery, radiation therapy, radio surgery, and chemotherapy. Whatever treatment you receive, you likely will need follow-up care to make sure the tumor does not come back.
Surgery for meningioma
The most common treatment for meningioma is surgical removal. A neurosurgeon opens the skull with a craniotomy to remove the tumor.
The goal of surgery is to remove the entire tumor. But if removing the tumor could cause neurological complications, the surgeon will remove as much of the tumor as is safely possible.
Radiation therapy for meningioma
If the entire tumor cannot be removed through surgery, radiation therapy may be recommended instead of surgery or as a follow-up to surgery. It also may be an option if surgery is too risky for another reason. Radiation therapy uses high-energy rays, such as x-rays, to shrink or eliminate tumors. Radiosurgery is a very precise, focused form of radiation given in a single or a few doses. However, it can only be used on smaller tumors.
Chemotherapy for meningioma
Doctors may recommend chemotherapy or immunotherapy as a meningioma treatment in combination with other treatments, or if other treatments are not successful. Chemotherapy uses drugs to shrink or eliminate tumors. Immunotherapy uses the body’s own immune system to help stop or slow their growth.
Are Meningiomas Serious?
Meningiomas can cause life-changing or life-threatening symptoms, and a small number are cancerous. But with early diagnosis and treatment, meningiomas are curable. Factors like your tumor’s size and location and your overall health will play a part in your prognosis.
According to the American Association of Neurological Surgeons, the 10-year survival rate for nonmalignant meningiomas is 84%. The 10-year survival rate for malignant meningiomas is 62%.
The UPMC Neurological Institute provides care for a wide range of brain and spinal conditions, from common to complex. To find a neurologist near you, visit the UPMC Department of Neurology online. To find a neurosurgeon near you, visit the UPMC Department of Neurosurgery online.
American Association of Neurological Surgeons, Meningiomas. Link
American Brain Tumor Association, Meningioma. Link
American Society of Clinical Oncology, Meningioma. Link
Genetic and Rare Diseases Information Center, Meningioma. Link
National Brain Tumor Society, Meningioma. Link
National Cancer Institute, Meningioma. Link
The UPMC Department of Neurosurgery is the largest academic neurosurgical provider in the United States. We treat conditions of the brain, skull base, spine, and nerves, including the most complex disorders. We perform more than 11,000 procedures each year, making our team one of the most experienced in the world. Whether your condition requires surgery or not, we strive to provide the most advanced, complete care possible. Our surgeons are developing new techniques and tools, including minimally invasive treatments. Find an expert near you.