Updated: 12/26/2021

Meningioma

0%
Topic
Review Topic
0
0
N/A
N/A
Questions
2
0
0
0%
0%
Videos / Pods
1
Topic
Images
https://upload.medbullets.com/topic/120395/images/mengioma.jpg
https://upload.medbullets.com/topic/120395/images/meningioma_mri.jpg
https://upload.medbullets.com/topic/120395/images/contrast_enhanced_meningioma.jpg
https://upload.medbullets.com/topic/120395/images/meningioma_high_mag_(1).jpg
  • Snapshot
    • A 55-year-old woman presents to the emergency department after an unprovoked seizure. Laboratory testing is unremarkable. CT head without contrast demonstrates an extra-axial mass. An MRI brain with and without contrast demonstrates a homogenous extra-axial gadolinium enhancing mass. Neurosurgery is consulted for surgical resection.
  • Introduction
    • Overview
      • neoplasm arising from the meninges
        • most are benign
  • Epidemiology
    • Incidence
      • most common primary brain tumor
    • Risk factors
      • ionizing radiation
  • etiology
    • Associated conditions
      • neurofibromatosis type 2
      • schwannomatosis
      • multiple endocrine neoplasia type 1
  • Presentation
    • Symptoms/physical exam
      • determined by the location of the meningioma
        • these tumors are slow growing and often are asymptomatic
        • for example, parasagittal meningiomas compressing the motor strip results in bilateral leg weakness
      • seizures
        • seen in ~30% of cases
      • obstructive hydrocephalus
        • if growing in the posterior cranial fossa
  • Imaging
    • MRI brain with and without gadolinium
      • indication
        • imaging study of choice
      • findings
        • extra-axial and dural-based mass that has homogenous signal changes
        • uniformally enhanced with gadolinium
        • may have a dural tear
    • CT head with and without contrast
      • indication
        • initial imaging study of choice in patients with an acute focal neurological deficit
      • findings
        • extra-axial and dural-based mass with smooth contours
        • uniformally enhanced with contrast
  • Studies
    • Histopathology
      • indication
        • required to confirm the dagnosis and determine if the meningioma is benign or malignant
      • classified according to the World Health Organization (WHO) schema
        • WHO grade I is considered benign
        • WHO grade II and III are more likely to result in invasive disease
      • findings include
        • spindle cells arranged in a whorled pattern
        • psammoma bodies
  • Differential
    • Malignant brain neoplasm
      • differentiating factors
        • based on histological findings
          • e.g., glioblastomas will have pleomorphic tumor cells surrounding a central area of necrosis
  • Treatment
    • Medical
      • radiation therapy
        • indication
          • nonaccessible meningiomas that requires intervention
          • in atypical or malignant meningiomas to achieve source control after resection
    • Surgical
      • resection
        • indication
          • if symptomatic, meningioma is infiltrating, or resulting in substantial surrounding edema
            • lesion must be accessible to be removed
  • Complications
    • Hydrocephalus
    • Seizure
  • Prognosis
    • WHO grade I carries a favorable prognosis

Please rate this review topic.

You have never rated this topic.

Thank you. You can rate this topic again in 12 months.

Flashcards (0)
Cards
1 of 0
Questions (2)
Question locked
Sorry, this question is for
PEAK Premium Subscribers only
Upgrade to PEAK
Question locked
Sorry, this question is for
PEAK Premium Subscribers only
Upgrade to PEAK
VIDEOS & PODCASTS (1)
EXPERT COMMENTS (3)
Private Note