Meningioma

Meningioma is a benign tumor of the brain and spinal cord. The tumor arises in one of the meninges – the arachnoid. These membranes are the layer between the brain and the skull. They act as a scaffold for arteries and veins, and are involved in the normal circulation of cerebrospinal fluid. Meningioma increases intracranial pressure and compresses the centers of the brain, leading to disability.

A meningioma needs to be operated in a medical center, where there is a specialized neurosurgical department. Contacting the doctor-coordinator of MedTour will allow you to undergo effective treatment and get a chance for a full recovery.

Reasons for the appearance of meningioma

Scientists have not found reliable reasons for the development of meningioma. It is believed that changes in the work of some genes and hormones can lead to uncontrolled multiplication of meninges cells. Genetic changes can be inherited from relatives or acquired over the course of life.

Doctors have identified risk factors that can lead to the development of the disease:

• Female sex hormones: increased levels of estrogen and progesterone, the female sex hormones, cause women to get sick more often than men. Also, doctors find a definite connection between the detection of breast cancer and the development of meningioma against the background of a general hormonal imbalance.
• Oral contraceptives and hormone replacement therapy can lead to the development of meningioma.
• Overweight. Obese people are more likely to develop cancer. Several large studies note that a high body mass index is associated with an increased likelihood of developing meningioma.
• Hereditary diseases. In patients with type II neurofibromatosis, tumors of the central nervous system, including meningioma, are more often detected.
• Traumatic brain injury. Meningiomas sometimes occur at the site of an injury or skull fracture.
• Radiation therapy. Irradiation of the head area for benign and malignant tumors can lead to the development of meningioma.

This does not mean that a person with a risk factor will necessarily get sick over time, but the likelihood of getting the disease increases.

Meningioma symptoms

Meningioma is characterized by asymptomatic onset and growth. In the initial stages, the patient may not be bothered by anything. Symptoms appear gradually, but sometimes the patient needs urgent help. The nature of the symptoms depends on the size and location of the tumor in the brain or spinal cord. The patient may have the following complaints:

• Headaches, with peak intensity in the morning;
• Visual impairment: feeling blurred, double vision, decreased visual acuity;
• Epileptic seizures;
• Loss or decrease in memory;
• Smell disorder;
• Speech impairment;
• Weakness in the upper and lower limbs.

It is immediately necessary to consult a doctor in case of changes in vision, new-onset epileptic seizures and prolonged headaches. The patient can undergo a quick and safe diagnosis of meningioma abroad. Leave a request on the MedTour platform to learn about possible treatment options.

Diagnosis of meningioma

Meningioma can be discovered incidentally when other conditions are diagnosed, for example, with a head injury or during a preventive examination. This is due to the asymptomatic course of the tumor, if the important centers of the brain are not affected.

Doctor’s consultation

The doctor should familiarize himself with the patient’s medical history, collect a detailed history and clarify the onset and nature of the symptoms. For an accurate diagnosis, it may be necessary to consult several specialists: a neurosurgeon, ophthalmologist, endocrinologist, neurologist.

The doctor can test hearing, memory, reflexes and visual acuity. This is necessary to clarify the possible localization of the meningioma.

Radiological examination

CT (Computed tomography)

The tomograph examines the penetration and attenuation of X-rays. Unlike radiography, CT provides images after complex computer processing. This makes it possible to explore the internal structure of a person in layers. In some cases, for a clearer visualization of the meningioma, an iodine-containing dye is injected into the patient.

MRI (Magnetic Resonance Imaging)

The method is based on measuring the difference in magnetic fields in certain tissues. It allows the doctor to obtain high-quality images of all brain structures and meningiomas. Radiological tests allow doctors to distinguish benign growths from cancer. The pictures show whether the tumor grows into adjacent tissues and organs or is located separately.

Biopsy

If the tumor is removed, its samples are sent to the pathohistological laboratory for further examination. Fabric samples are treated with special dyes and placed on glass. Thus, specialists prepare a micropreparation for examination under a microscope.

A biopsy provides information about tumor cells, their degree of malignancy. Based on the results of the biopsy, doctors decide if additional treatments are needed besides surgery.

Large foreign clinics have their own pathological laboratory for the study of histological material. This saves valuable time. Patients do not need to wait a month for biopsy results. The results of the study are ready within 3-5 days from the date of admission to the clinic.

Examples of the cost of diagnosing meningioma in clinics around the world:

• Ukraine – from $850;
• Turkey – from $1 500;
• Germany – from $2 700;
• Israel – from $3 500.

How long do people live with meningioma?

Life expectancy with a diagnosis of meningioma depends on the age of the patient, the size of the tumor, its location in relation to the structures of the brain, and the degree of malignancy. Life expectancy is higher in patients with meningioma at a young age, compared with patients in older age groups.

Surgical treatment for a non-malignant form of meningioma provides a longer life expectancy: 96% for spinal forms and 83% for meningiomas of the meninges. The five-year survival rate in patients with anaplastic (second degree) and malignant (third degree) meningioma is 63.8%.

Complex therapy in combination with surgery allows patients to get rid of the tumor and recover completely. To do this, you must immediately contact a neurosurgeon for qualified help.

Classification of meningiomas

Experienced doctors use the World Health Organization (WHO) tumor classification. It is based on the division of tumors depending on the cellular structure, which is visible under a microscope:

• First-degree meningioma is a slow-growing benign tumor;
• Second-degree meningioma – a tumor with atypical cells and a high chance of recurrence after treatment;
• A third-degree meningioma is a cancerous tumor that can invade nearby nerve tissue. Malignant meningiomas can spread outside the brain to other tissues and organs.

Dividing meningiomas into three classes allows the doctor to predict the rate of growth and the likelihood of recurrence based on past experience.

Another classification of meningiomas is based on the location of the tumor relative to the brain and nearby anatomical structures of the central nervous system. This classification is important when planning the surgery to remove the tumor.

Meningioma treatment

When drawing up a treatment plan, doctors take into account the following factors:

• The age of the patient;
• General condition and the presence of concomitant diseases;
• The size of the tumor;
• The location of the tumor relative to the structures of the brain and spinal cord;
• The degree of malignancy of the meningioma cells.

Surgical treatment of meningioma

If the tumor actively grows or causes acute symptoms, the patient will be offered options for surgical removal of the meningioma. The following methods of surgical treatment of meningioma are available abroad:

• Craniotomy;
• Endoscopic tumor removal.

As a rule, a craniotomy is performed – a small window is made on the skull through which all surgical manipulations are performed and the neoplasm is removed. The incision is made along the hairline, so after healing, no traces of the operation are visible.

In some cases, endoscopic removal of the tumor through the nose and sinuses is possible if the tumor is small and located in a place accessible to this technique.

Doctors try to remove the entire tumor, but sometimes this cannot be achieved due to the location of the meningioma near important centers of the brain and spinal cord. In these cases, the patient undergoes additional treatment – radio- or chemotherapy.

If the tumor has been completely removed and the biopsy results show that the cells are benign, surgery may be the only treatment.

How long does the operation to remove a meningioma take

Benign tumors of the central nervous system operate faster than malignant neoplasms, since the tumor does not grow into the surrounding tissues. On average, the duration of an operation to remove a meningioma is 4-6 hours. If the intervention is carried out through the sinuses (transsphenoidal approach), the operation takes 3 to 4 hours.

Examples of the cost of surgical removal of meningioma in clinics around the world:

• Ukraine – from $10 000;
• Turkey – from $18 000;
• Germany – from $25 000;
• Israel – from $30 000.

Radiation therapy

Radiation therapy is a method of treating benign and malignant neoplasms using radioactive particles directed directly to tumor cells. Radiation is generated and directed to the tumor by special devices – linear accelerators.

Radiation therapy for patients with meningioma is given in order to reduce the likelihood of recurrence and to destroy cells that could not be removed during surgery.

Modern foreign clinics can offer different options for radiation therapy:

• Stereotactic radiosurgery (SRS). Before irradiation, the patient undergoes a radiological examination (MRI or CT) and an accurate map of the location of the tumor with a diameter of up to 0.1 mm is modeled. During the procedure, beams with powerful ionizing radiation are collected in one narrowly targeted beam and destroy tumor cells, without affecting healthy tissues.
• Fractional stereotactic radiotherapy (SRT). Irradiation is carried out in small fractions for 30 days. This is necessary for patients with large meningiomas.
• Intensive modulated radiation therapy (IMRT). Radioactive radiation is programmed using a computer, which allows you to control radiation in different parts of the tumor. This enables doctors to design an individual radiation therapy session based on the volume of the tumor.
• Proton beam therapy. Unlike classical radiation therapy, which uses X-rays, proton therapy involves irradiation with protons. This radiotherapy is less damaging to healthy tissue.

Examples of the cost of radiation therapy for meningioma in clinics around the world:

• Ukraine – from $6 500;
• Turkey – from $12 000;
• Germany – from $25 000;
• Israel – from $27 000.

Benefits of treating meningioma abroad

• Each patient with meningioma is treated by a team of experienced specialists: neurosurgeon, ophthalmologist, neuropathologist, radiation therapist and other highly specialized specialists. This approach is called multidisciplinary. With its help, doctors can draw up an effective treatment plan and avoid possible mistakes.
• Operations are performed in a minimally invasive way. Before surgery, the exact location of the tumor is found using neuronavigation systems.
• The therapy plan is developed in accordance with European and American treatment protocols. The protocols are based on many years of research, which have been shown to be effective in practice.
• International patients are treated by doctors with more than 15 years of experience and scientific achievements in the field of neuroscience.
• Large medical centers are equipped with their own laboratory, pharmacy and new diagnostic equipment. The patient undergoes diagnostics in one building without long waiting times and queues. The average duration of meningioma diagnosis is 3 days.
• Non-surgical methods of treating meningioma using radiosurgery are available in foreign clinics. Medical centers are equipped with radiosurgical units – X-Knife, CyberKnife, Varian TrueBeam, etc.
• At all stages of diagnosis and treatment, the patient is accompanied by a representative of the international department of the clinic. He can answer all questions, accompany to procedures and translate medical documentation.

How much does meningioma treatment cost?

The price will depend on the selected country, the medical center and the complex of prescribed procedures during diagnosis and treatment. Therefore, the final cost is calculated individually for each patient.

When planning treatment in a foreign clinic, it is important to take into account that additional costs for air travel and accommodation in another country must be included in the budget. Ask the medical coordinator of MedTour about the preliminary cost of diagnostics and treatment.

Published: 08.07.2021

Updated: 29.07.2021

Medical expert:

PhD. Olexandr Voznyak

Medical author:

Ilona Baidiuk

Information on this webpage verified by the medical expert

Medical Doctor, oncologist, PHD student

Kateryna Maliarchuk