What is a Meningioma?

Meningioma is a commonly occurring brain tumour in Singapore and the most common primary central nervous system (CNS) tumour. Meningiomas are formed from the meninges, specifically, the meningothelial (arachnoid) cells.

Meninges protect the CNS by anchoring the brain and preventing excessive movement that will compromise brain stability. When a mutation occurs in these membranes, a meningioma develops.

Meningiomas are tumours that are formed from meninges in the brain.

Whist meningiomas are often benign (non-cancerous) and slow-growing; depending on the location and grade, they can cause significant neurological issues. This ultimately means one’s bodily functions can be severely altered. Below are the types of meningiomas, their grades, and classifications:

Meningiomas GradeDescription
Benign meningiomaINoncancerous tumours with distinct borders. Tend to be slow-growing and may not exhibit any symptoms.  
Atypical meningiomasIIMid-grade tumours with a higher likelihood of recurrence.
Anaplastic meningiomasIIICancerous tumours that are significantly rare, with chances of metastasising to the lungs, bone, liver, lymph nodes, and kidneys.

What causes Meningiomas?

The exact cause of meningioma is unknown. Meningiomas are fundamentally a product of genetic mutations, particularly abnormalities in chromosomes such as the NF2 gene. There are, however, some factors that may increase the risks of meningiomas.

What are the common symptoms of Meningiomas in Singapore?

The symptoms exhibited by meningiomas vary depending on the size, location, and exact region of the brain it impacts. Some of the symptoms may include:

  • Headaches
  • Dizziness
  • Nausea
  • Bodily jerks, spasms, and twitches
  • Changes in sensory capabilities such as smell, sight, and hearing
  • Personality changes and changes in memory
  • Seizures
  • Gait disturbances (abnormal walking patterns)
  • Neurological deficits, such as loss of function in certain areas of the body

Are Meningiomas painful?

In most cases, meningiomas are asymptomatic; thus, patients rarely face discomfort or pain in the early stages. However, as the tumour grows, symptoms of pain are usually derived from headaches at the site of tumour growth.  

Who is at risk of Meningiomas in Singapore?

Certain elements can magnify the risk of meningiomas, which include:

  • Gender: women are twice as likely to develop meningiomas than men. Given that meningiomas harbour hormone receptors, it is hypothesised that female hormones may play a role in the growth and development of meningiomas.
  • Ionising radiation: excessive exposure to ionising radiation from the environment increases the risk of developing meningiomas.
  • Age: meningiomas are common among older adults (age 65 and above).
  • Genetic disorders: conditions such as Neurofibromatosis type 2 predispose one to meningioma growths.
Headaches are common in meningioma development due to pressure from the tumour growth.

How are Meningiomas diagnosed in Singapore?

It is typical for meningiomas to be identified when one is under examination for other health reasons, such as abrupt behavioural changes and worsening vision. With a neurologist, a set of diagnostic tests will be conducted to confirm the meningiomas diagnosis:

  • Medical review: symptoms and risk factors are first established to gauge the likelihood of meningioma development.
  • Neurological tests: a series of examinations will be conducted, particularly if patients are exhibiting symptoms of neurological deficiencies.
  • Imaging tests: if suspected of meningiomas, imaging tests such as computed tomography scans (CT scans) and magnetic resonance imaging (MRIs) will provide definitive identification of meningioma growth.
  • Biopsy: a biopsy may be requested if meningioma is suspected to be malignant (cancerous), typically in larger tumours.
Meningioma CT Scan
CT scan visualising the growth of a meningioma in the brain.

What are the treatment options for Meningiomas in Singapore? 

Depending on the type and size of the tumour, the treatment approach may vary. Some of the treatment options currently available are: 

  • Total resection: microsurgery that completely removes CTA tumours in an operating theatre. 
  • Radiosurgery: utilising a focused beam of radiation known as gamma rays to “arrest” (stunt) the growth of the tumour and to increase chances of preserving the cranial nerves. This is, however, primarily possible when the size of the tumour is relatively small.
  • Radiotherapy: radiation (also known as gamma rays) therapy is administered in multiple sessions to gradually treat the tumour, mainly where tumours are more significant. 
  • Combination of surgery and radiation: a combination of two treatment methods may be utilised first to remove large tumours and then treat any excess tumours with radiation.
A craniotomy is a frequently employed surgical method to remove meningiomas

Frequently asked questions  

What is considered a large meningioma?

A meningioma is classified as “large” when it is 3-5 centimetres in diameter. These are typically grade II meningiomas.

What is the prognosis for meningiomas?

The outlook is generally positive where noncancerous meningiomas are concerned, with an estimated 8 out of 10 being completely cured. The life expectancy of meningioma patients will differ according to age and health status. Where malignant meningiomas are concerned, the 5-year survival rate is over 67%, while the 10-year survival rate is about 61%.
A discussion with your neurosurgeon is pertinent to gauge the exact prognosis for your specific case. Do not be disheartened by a meningioma diagnosis. The prognosis for meningiomas has improved over time due to increasingly new research and techniques for managing the condition. More often than not, you will recover and lead a normal life.

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Copyright © 2023 Chou Neuroscience Clinic. All Rights Reserved