Meningioma
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Synopsis

A meningioma is a tumor arising from the meninges that attaches to the dura mater of the brain or spinal cord. They are the most common intracranial tumor in adults, accounting for 34% of all primary central nervous system tumors. This dural-based tumor is twice as common in women than in men. Peak incidence is in the sixth decade of life; the tumor is uncommon in children.
Meningiomas are typically slow growing and benign, but the condition can be complicated by size and rate of growth and compression of surrounding brain tissue. In rare cases, meningiomas can become malignant. Small tumors may be asymptomatic. Large tumors may cause a variety of symptoms including headaches, focal seizures, weakness, numbness, incontinence, apathy, aphasia, anosmia, and increased intracranial pressure.
Risk factors include hormonal factors (progesterone > estrogen > androgens), genetic syndromes such as neurofibromatosis type 2, and exposure to ionizing radiation. Prognosis is generally good, with a 5-year survival rate of 70%. Patients with a history of radiation exposure tend to have more aggressive and atypical tumors with a worse prognosis.
Meningiomas are typically slow growing and benign, but the condition can be complicated by size and rate of growth and compression of surrounding brain tissue. In rare cases, meningiomas can become malignant. Small tumors may be asymptomatic. Large tumors may cause a variety of symptoms including headaches, focal seizures, weakness, numbness, incontinence, apathy, aphasia, anosmia, and increased intracranial pressure.
Risk factors include hormonal factors (progesterone > estrogen > androgens), genetic syndromes such as neurofibromatosis type 2, and exposure to ionizing radiation. Prognosis is generally good, with a 5-year survival rate of 70%. Patients with a history of radiation exposure tend to have more aggressive and atypical tumors with a worse prognosis.
Codes
ICD10CM:
D32.9 – Benign neoplasm of meninges, unspecified
SNOMEDCT:
302820008 – Intracranial meningioma
D32.9 – Benign neoplasm of meninges, unspecified
SNOMEDCT:
302820008 – Intracranial meningioma
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Metastases (eg, dural metastases)
- Schwannoma (eg, vestibular schwannoma)
- Oligodendroglioma
- Glioblastoma multiforme
- Central nervous system lymphoma
- Chondrosarcoma
- Pituitary tumor
- Craniopharyngioma
- Hemangiopericytoma
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.
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References
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Last Reviewed:03/04/2018
Last Updated:07/25/2021
Last Updated:07/25/2021