How is Meningioma treated?

Meningiomas vary in their symptoms and treatment options, depending on where they are located and other factors. Treatment is personalized for each patient to ensure the best outcome with lowest risk. Most people with a meningioma will have a tumor at only one site, but it also is possible to have several tumors growing simultaneously in different parts of the brain and spinal cord. When multiple meningiomas occur, more than one type of treatment may be necessary.

Three options may be involved in treating someone with a meningioma:

• Observation, also called “watchful waiting” may be suitable for small tumors that are not causing symptoms. These tumors typically are growing slowly and not affecting the brain, nerves or crucial blood vessels. Patients will undergo MRI (magnetic resonance imaging) scan and/or contrast enhanced CT (computerized tomography) scans at regular intervals to monitor for tumor growth.
• Surgery to remove the tumor is the most common treatment, with the goal of removing the entire tumor and the membranes from which it originates. Complete removal decreases the risk of the tumor returning and can be curative. Ability to remove the tumor completely depends on its location, whether it is adjacent or attached to critical nerves or blood vessels, and patient age. The type and complexity of surgery also depends on the tumor’s location. This procedure (called craniotomy) typically involves removing the tumor through a window-like opening cut into the skull, which is closed after the surgery. This often can be done within the hairline, making it nearly invisible after healing.
• Radiation in combination with surgery may be recommended for aggressive meningiomas, especially malignant (cancerous) ones.

Outcome Indicators

Treatment success depends on the extent of resection at the time of surgery and the biology of the tumor. Benign meningiomas have the highest survival rate, follow by atypical meningiomas and then malignant meningiomas. The molecular signature, specifically chromosomal alterations, found in meningiomas also contributes to the likelihood of recurrence after surgery.

What Meningioma treatment options does Brigham and Women’s Hospital offer?

The Brain Tumor Center and the Skull Base Surgery Program provide leading treatment options for patients with meningiomas. Our neurosurgeons have particular expertise in removing and treating meningiomas, including in areas of the skull base that traditionally are difficult to reach.

Our unique combination of world-leading technology, teamwork, technical skill and compassion brings exceptional, individualized care to patients with meningiomas.

Neuroscience Intensive Care Unit

In the Neuroscience Intensive Care Unit, one of the largest such units in the country, critical care specialists are available 24/7. The medical team includes neuro-radiologists who analyze imaging, neuro-pathologists who diagnose tumor type, and neuro-anesthesiologists who specialize in assisting surgical treatment of brain tumors.

Research

Our Meningioma treatment team is also nationally known for its scientific pursuits surrounding the treatment and research of these tumors. From basic science examining the underlying genetic and molecular profile of these tumors, to surgical techniques, patient outcome and clinical trials, we strive to lay the scientific foundation today that will help guide clinical care in the future.

Contact the Brain Tumor Center

The Department of Neurosurgery includes 24 neurosurgeons – among them world leaders in the diagnosis and treatment of meningiomas. In additional to their exceptional technical skill, our neurosurgeons are known for their clear communication, compassion, and ample time devoted to personalized care and attention.

We have a talented team of neurosurgeons with deep expertise in treating meningiomas of the brain, including:

• Ossama Al-Mefty, MD
• Omar Arnaout, MD
• Mohammad A. Aziz-Sultan, MD
• Wenya Linda Bi, MD, PhD
• John H. Chi, MD, PhD
• Elizabeth B. Claus, MD, PhD
• Garth Rees Cosgrove, MD
• Alexandra Golby, MD
• Nirav J. Patel, MD, MA
• Pier Paolo Peruzzi, MD, PhD
• Timothy R. Smith, MD, PhD, MPH
• Hasan A. Zaidi, MD

To schedule an appointment with a physician in the Brain Tumor Center, please contact our Patient Coordinator at: (617) 732-6600. We see new patients with a brain tumor diagnosis as soon as the next business day.

If you are a physician seeking to refer a patient to the Brain Tumor Center, please call (617) 732-6600 or you can access our physicians’ office phone numbers. To contact one of our physicians with a question, patient referral or second opinion, you may also email: BWHNeurosurgery@partners.org.