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Questions and Answers
What is the primary brain tumor in adults?
What is the primary brain tumor in adults?
What is the incidence of meningioma in the USA?
What is the incidence of meningioma in the USA?
What is the median age at diagnosis for meningioma?
What is the median age at diagnosis for meningioma?
What is the incidence of metastases from all meningiomas?
What is the incidence of metastases from all meningiomas?
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What is the risk differential of grade 1 meningioma in women compared to men before menopause?
What is the risk differential of grade 1 meningioma in women compared to men before menopause?
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What is the percentage of CNS tumors that meningioma accounts for?
What is the percentage of CNS tumors that meningioma accounts for?
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What is the primary established environmental risk factor for meningioma?
What is the primary established environmental risk factor for meningioma?
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What is the incidence of meningioma in Black people compared to White people?
What is the incidence of meningioma in Black people compared to White people?
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What is the association between hormone exposure and meningioma risk?
What is the association between hormone exposure and meningioma risk?
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What is the effect of breastfeeding on meningioma risk?
What is the effect of breastfeeding on meningioma risk?
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What is the association between CT scans in childhood and meningioma risk?
What is the association between CT scans in childhood and meningioma risk?
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What is the genetic aspect of meningioma risk after exposure to ionizing radiation?
What is the genetic aspect of meningioma risk after exposure to ionizing radiation?
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What is the recurrence rate of cases with a proliferation index > 4% similar to?
What is the recurrence rate of cases with a proliferation index > 4% similar to?
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What is the purpose of staining for the mitosis marker phosphohistone H3?
What is the purpose of staining for the mitosis marker phosphohistone H3?
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What is the characteristic arrangement of meningothelial meningioma cells?
What is the characteristic arrangement of meningothelial meningioma cells?
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What are the nuclei of meningothelial meningioma cells like?
What are the nuclei of meningothelial meningioma cells like?
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What is the significance of the similarity between meningothelial meningioma cells and arachnoid cap cells?
What is the significance of the similarity between meningothelial meningioma cells and arachnoid cap cells?
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What is rare in meningothelial meningiomas compared to other subtypes?
What is rare in meningothelial meningiomas compared to other subtypes?
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What do most rhabdoid meningiomas have in common?
What do most rhabdoid meningiomas have in common?
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What percentage of rhabdoid meningiomas have CNS WHO grade 1 features?
What percentage of rhabdoid meningiomas have CNS WHO grade 1 features?
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What is the impact of atypical features on CNS WHO grade 1 meningiomas?
What is the impact of atypical features on CNS WHO grade 1 meningiomas?
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What is a key factor in determining patient outcome for rhabdoid meningiomas?
What is a key factor in determining patient outcome for rhabdoid meningiomas?
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What is a characteristic feature of some rhabdoid meningiomas?
What is a characteristic feature of some rhabdoid meningiomas?
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What is the association between malignant histological features and survival times?
What is the association between malignant histological features and survival times?
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What is a genetic characteristic of some patients with rhabdoid and/or papillary meningiomas?
What is a genetic characteristic of some patients with rhabdoid and/or papillary meningiomas?
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What is the median survival time for anaplastic meningioma?
What is the median survival time for anaplastic meningioma?
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What is a condition associated with some rhabdoid and/or papillary meningiomas?
What is a condition associated with some rhabdoid and/or papillary meningiomas?
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What is the difference in outcome between de novo anaplastic meningiomas and secondary anaplastic meningiomas?
What is the difference in outcome between de novo anaplastic meningiomas and secondary anaplastic meningiomas?
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What is the impact of high mitotic counts on overall survival in meningiomas?
What is the impact of high mitotic counts on overall survival in meningiomas?
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What is the significance of molecular features in meningiomas?
What is the significance of molecular features in meningiomas?
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Study Notes
Neuroimaging Features
- Neuroimaging features are not always specific for the diagnosis of meningioma or for estimating prognosis.
- However, quantitative and qualitative imaging features from gadolinium-enhanced MRI can suggest the histological grade of meningiomas and predict more likely patient outcomes.
Spread
- Meningiomas commonly invade adjacent anatomical structures (especially the dura).
- The rate and extent of local spread are often greater in more aggressive subtypes.
- Extracranial metastases (e.g., to lung, pleura, bone, and/or liver) are rare and most often associated with CNS WHO grade 3 meningiomas.
Epidemiology
- The incidence of meningioma in the USA is 8.58 cases per 100,000 population, accounting for 37.6% of CNS tumors.
- Meningioma is the most common primary brain tumor in adults (estimated to occur in up to 1% of the population).
- The least common in children aged 0-19 years.
Age, Sex, and Race Distribution
- The risk of meningioma increases with age; the median age at diagnosis is 66 years.
- The incidence of grade 1 meningioma is 2.32 times greater in women than in men, with the greatest risk differential (3.28) seen before menopause and decreasing thereafter.
- The incidence is significantly higher in Black people than in White people (9.25 vs 7.88 cases per 100,000 person-years).
Etiology
- Exposure to ionizing radiation is the primary established environmental risk factor for meningioma.
- Lower doses of ionizing radiation also increase the risk of meningioma, including exposure to CT in childhood or adolescence.
- Genetic susceptibility to the development of meningioma after exposure to ionizing radiation is suggested by the Tinea capitis cohort study.
Meningothelial Meningioma
- Epithelioid cells form syncytia-like lobules, with some nuclei appearing to have nuclear holes and pseudoinclusions.
- The cells resemble the morphology of arachnoid cap cells and are largely monomorphic, with abundant eosinophilic cytoplasm, and are arranged in lobules that can be demarcated by fine collagen septa.
Rhabdoid Meningioma
- Rhabdoid meningiomas are highly proliferative and have other histological features of malignancy.
- Most rhabdoid meningiomas have CNS WHO grade 1 or 2 features.
- Patient outcome is strongly correlated with CNS WHO grade, independent of the rhabdoid features.
Molecular Features
- Higher-grade meningiomas are associated with more complex copy-number changes and chromosomal abnormalities.
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Description
Learn about the role of neuroimaging features in diagnosing meningioma and predicting patient outcomes. Discover how MRI scans can help estimate prognosis and suggest histological grades.