Your Visual Guide Meningioma

Understand this diagnosis through data, infographics, and evidence based on modern classification and current research.

~35,000
New Meningioma Cases per Year (U.S. est.)
Understanding Meningioma
What is it and how is it classified?
Learn how this condition is classified and described in modern neuro-oncology.
Meningeal Tumor
WHO Grade?
Grade 1
Benign (~80%)
Slow-growing, well-circumscribed
Meningothelial Fibrous Transitional Psammomatous Angiomatous Microcystic Secretory
Grade 2
Atypical (~15-18%)
Higher recurrence rate
Atypical Clear Cell Chordoid
Grade 3
Malignant (~2-3%)
Aggressive, high recurrence
Anaplastic Papillary Rhabdoid
Tumor Grading
Tumor Grades
Classification and grade help explain how the tumor behaves and how treatment is planned.
Grade 1 — Benign Grade 3 — Malignant
1
Benign
~80% of cases. Slow-growing. Often curable with complete resection. 5-year survival >90%.
Subtypes: Meningothelial, Fibrous, Transitional, Psammomatous, Angiomatous, Microcystic, Secretory, Lymphoplasmacyte-rich, Metaplastic
2
Atypical
~15-18% of cases. Higher recurrence rate. May require adjuvant radiation. 5-year survival ~80%.
Subtypes: Atypical, Clear cell, Chordoid. Criteria: 4-19 mitoses/10 HPF, or brain invasion, or ≥3 atypical features.
3
Anaplastic / Malignant
~2-3% of cases. Aggressive. High recurrence. 5-year survival ~55-65%.
Subtypes: Anaplastic, Papillary, Rhabdoid. Criteria: ≥20 mitoses/10 HPF, or frank anaplasia.
Molecular Markers
The Key Biomarkers
Modern classification depends on specific molecular markers. Each reveals something different about the tumor.
Diagnostic
NF2
Chromosome 22q Loss
Most common genetic alteration in meningioma. Loss of NF2/merlin function is associated with all grades and is foundational to meningioma biology.
~60% of meningiomas
Diagnostic
AKT1
E17K Mutation
Found predominantly in Grade 1 meningothelial meningiomas with skull base predilection. Potential therapeutic target.
~10% of meningiomas
Diagnostic
TRAF7
TRAF7 Mutation
Often co-occurs with KLF4 or AKT1 mutations. Plays a key role in non-NF2 meningioma pathogenesis.
~25% of meningiomas
Diagnostic
SMO
Hedgehog Pathway Mutation
Activating mutations in the Hedgehog signaling pathway. Preferentially found in olfactory groove meningiomas.
~5% of meningiomas
Diagnostic
KLF4
K409Q Mutation
Co-occurs with TRAF7 mutations. Strongly associated with secretory meningioma subtype.
~10% of meningiomas
Diagnostic
PIK3CA
PI3K Pathway Mutation
Activating mutations in the PI3K signaling pathway. Found in skull base meningiomas. Potential therapeutic target.
~5% of meningiomas
Prognostic
TERT
TERT Promoter Mutation
Associated with higher grade and increased recurrence risk. Considered a poor prognostic marker across meningioma subtypes.
Poor prognostic marker
Prognostic
CDKN2A/B
Homozygous Deletion
Associated with Grade 3 meningioma. WHO 2021 allows grading upgrade to anaplastic based on this deletion alone. More aggressive course.
Key grading criterion
Predictive
SMARCE1
SMARCE1 Mutation
Defines clear cell meningioma subtype. Associated with familial clear cell meningioma predisposition.
Clear cell subtype
Predictive
BAP1
BAP1 Loss
Associated with rhabdoid morphological features. Part of the BAP1 tumor predisposition syndrome affecting multiple organ systems.
BAP1 syndrome marker
Signs & Symptoms
Meningioma Symptoms by Location
Symptoms depend on the tumor location, size, and growth rate. Many symptoms result from pressure on surrounding structures.

Convexity

Headache, seizures, focal neurological deficits depending on the cortical region involved.

Parasagittal / Falcine

Leg weakness (bilateral if large), seizures, and progressive motor deficits.

Skull Base

Cranial nerve deficits: vision changes, hearing loss, facial numbness, or double vision.

Sphenoid Wing

Proptosis (eye bulging), vision changes, temporal swelling, and facial pain.

Posterior Fossa

Balance problems, headache, hydrocephalus, and cranial nerve palsies.

Olfactory Groove

Anosmia (loss of smell), personality changes, and frontal lobe dysfunction.

Spinal

Back pain, weakness, sensory changes, and bowel/bladder issues from cord compression.

General / Incidental

Many meningiomas are incidental findings on imaging performed for other reasons (asymptomatic).

Diagnosis
The Diagnostic Journey
From first scan to treatment plan — the typical path to a meningioma diagnosis.
1

MRI with Contrast

Gold standard: reveals “dural tail” sign, well-circumscribed extra-axial mass

2

CT Scan

Calcifications are common; useful complement to MRI for bone involvement

3

Angiography

For surgical planning: identify blood supply, consider preoperative embolization

4

Histopathology

WHO grading from biopsy or surgical resection specimen

5

Molecular Testing

NF2, AKT1, TRAF7 analysis and DNA methylation profiling for subtype classification

6

Treatment Plan

Personalized plan based on grade, location, size, and molecular profile

Treatment
Treatment Options for Meningioma
Treatment depends on tumor grade, location, size, symptoms, and your overall health. Many approaches may be combined.

Surgery

Primary treatment. Simpson grading scale (I-V) for extent of resection. Skull base approaches for complex locations.

Radiation Therapy

Post-operative for incompletely resected or higher-grade tumors. IMRT and proton therapy options available.

Stereotactic Radiosurgery

Gamma Knife, CyberKnife for small tumors (<3cm), residual, or recurrent meningiomas. Single fraction delivery.

Observation

For small, asymptomatic tumors. Serial MRI monitoring at regular intervals to track growth rate.

Systemic Therapy

Limited role currently. Hydroxyurea, bevacizumab for refractory cases. Emerging: SMO inhibitors, CDK4/6 inhibitors, FAK inhibitors.

Clinical Trials

Access cutting-edge experimental treatments and emerging targeted therapies

Browse clinical trials &rarr;
Care Team
Your Multidisciplinary Care Team
Meningioma treatment involves a team of specialists working together to provide the best possible care.
Core Specialists

Neurosurgeon

Primary specialist for surgical resection and skull base approaches

Radiation Oncologist

Plans and delivers radiation therapy and stereotactic radiosurgery

Neuro-oncologist

For higher-grade or refractory meningiomas requiring systemic therapy

Support Team

Neuroradiologist

Specialized imaging interpretation and monitoring

Neuropathologist

Tissue analysis, WHO grading, and molecular profiling

Nurse Navigator

Guides you through appointments, insurance, and logistics

Resources
Support Organizations
You are not alone. These organizations provide information, community, and support for patients and caregivers.

Meningioma Mommas

A dedicated meningioma-specific support community offering peer connection, resources, and hope for patients and families.

Visit Meningioma Mommas →

National Brain Tumor Society

Leading nonprofit investing in research, advocacy, and patient services for all brain tumors including meningioma.

Visit NBTS →

American Brain Tumor Association

Comprehensive brain tumor information, patient support programs, and research funding for all tumor types.

Visit ABTA →

The Brain Tumour Charity (UK)

The world&rsquo;s leading brain tumour charity, funding research and providing support and information across the UK.

Visit Brain Tumour Charity →

Ben and Catherine Ivy Center

Advanced treatment and research programs for brain tumors at leading academic medical centers.

Visit Ivy Center →

CBTRUS

Central Brain Tumor Registry of the United States &mdash; the largest population-based registry for primary brain tumors.

Visit CBTRUS →

Brain Science Foundation

Dedicated to meningioma and brain science research, funding innovative studies and providing patient education resources.

Visit Brain Science Foundation →

NF2 BioSolutions

Supporting research and patient resources for NF2-related meningiomas and other NF2 tumors.

Visit NF2 BioSolutions →

NCI-CONNECT

National Cancer Institute&rsquo;s rare brain and spine tumor network, offering expert guidance and clinical trial information.

Visit NCI-CONNECT →