DEAR DR. ROACH: In January 2014, I was diagnosed with a benign neoplasm of my cerebral meninges (meningioma). I am a healthy 64-year-old Caucasian woman. I do not take any medications. The finding was incidental. I have no symptoms from the meningioma. I sometimes feel as if my mental capacity has declined somewhat (such as memory), but I attribute this to the normal aging process. I have been getting an MRI every year since the diagnosis.
The last test showed that the tumor was 2.9 cm by 1.6 cm by 2.7 cm. The mass measured 2.3 cm by 1.3 cm by 2.1 cm when I had the first MRI in 2014. It seems to be slowly growing. What are your thoughts on this? Do you advise surgery at this time? — C.C.
ANSWER: A meningioma is a type of brain tumor that arises from the meninges, the lining of the brain. Most of these are benign, although they do range from benign to cancerous. Even the cancerous tumors very rarely spread.
The main problem with this type of tumor is that they grow, and there is not a lot of room inside the skull to spare. An enlarging tumor can compress the brain, and that can lead to symptoms. Depending on the exact location of the tumor, it can cause weakness, loss of vision or loss of hearing or smell. Another common symptom is a seizure. Changes in mental function are less common, but I am very cautious about ascribing symptoms to aging.
Although the change in size seems small, the tumor has approximately doubled in size since 2014. That is a clear indication for treatment. It will likely keep growing and cause symptoms. Surgery is a treatment option, as is radiation, but only an expert can make the assessment of what is best in your situation. If the tumor is in a favorable location, most authorities would recommend surgical removal of the tumor.