obsolete meningioma by site

Based on the search results, here are some signs and symptoms of meningioma by site:

1. Frontal Lobe Meningioma:
   • Personality changes
   • Mood disorders (e.g., depression, anxiety)
   • Psychosis
   • Memory issues
   • Personality changes
2. Supratentorial Meningioma:
   • Seizures (10-50% of cases)
3. Temporal Lobe Meningioma:
   • Seizures
   • Changes in vision or hearing
4. Occipital Lobe Meningioma:
   • Visual problems (e.g., blindness, double vision)
5. Parietal Lobe Meningioma:
   • Weakness or numbness of the face or limbs
6. Cerebellar Meningioma:
   • Ataxia (loss of coordination and balance)
7. Spinal Cord Meningioma:
   • Back pain
   • Weakness or numbness in the arms or legs

Please note that these symptoms can vary depending on the size, location, and growth rate of the meningioma, as well as individual factors.

Diagnostic Tests for Meningiomas

Meningiomas are typically diagnosed using imaging tests, which provide detailed images of the brain and surrounding tissues. The following diagnostic tests can be used to diagnose meningiomas, depending on the location and characteristics of the tumor:

• MRI (Magnetic Resonance Imaging): MRI is usually the first imaging test used to diagnose meningioma. It provides a detailed image of the brain and surrounding tissues, allowing doctors to identify the location and size of the tumor [10]. MRI can also help determine if the tumor is benign or malignant.
• CT Scan: A CT scan may be used in addition to an MRI to provide more information about the tumor's location and characteristics. However, a CT scan alone may not be sufficient to diagnose meningioma accurately [11].
• Immunohistochemistry: Immunohistochemistry tests can help identify specific proteins on the surface of cancer cells, which can aid in diagnosing meningiomas. For example, loss of SMARCE1 expression is a specific diagnostic marker for clear cell meningioma [3].

Diagnostic Tests by Site

The following diagnostic tests may be used to diagnose meningiomas depending on their location:

• Olfactory Groove Meningiomas: These tumors are typically diagnosed using MRI and CT scans, which can help identify the tumor's location and size. Extended endoscopic endonasal approaches may also be used for surgical treatment [13].
• Clivus Meningiomas: Similar to olfactory groove meningiomas, clivus meningiomas are typically diagnosed using MRI and CT scans. Extended endoscopic endonasal approaches may also be used for surgical treatment [13].

Additional Diagnostic Tests

Other diagnostic tests that may be used to diagnose meningioma include:

• Genetic Testing: Genetic testing can help identify genetic mutations associated with meningiomas, such as the SMARCE1 gene mutation [3].
• Molecular Profiling: Molecular profiling can help identify specific molecular characteristics of meningiomas, which can aid in diagnosis and treatment planning [15].

It's essential to note that a thorough neurological exam is usually conducted before any imaging tests are performed to diagnose meningioma.

Based on the provided context, it appears that there are various treatment options for meningiomas, depending on their location and size. Here's a summary of the relevant information:

• Inoperable meningiomas: In some cases, drug treatment can be used for tumors deemed inoperable due to their size and location [1]. However, the effectiveness of this approach may vary.
• Meningioma management by site:
  • Observation: Meningiomas can be managed with observation, surgery, and/or radiation therapy. In some cases, active intervention may be delayed and will only be considered when symptoms arise [4][6].
  • Surgery: Surgical resection remains the optimal initial treatment approach in the management of meningiomas [14]. However, these brain tumors often come back, requiring repeat surgery or radiotherapy.
  • Radiation therapy: Radiation therapy can be used to treat meningiomas, especially when surgical removal is not possible. In some cases, radiation therapy may be delayed until symptoms arise [4][6].
• Drug treatments:
  • Mifepristone: A case study describes a patient with an inoperable meningioma who was treated with mifepristone for 26 years without interruption [3].
  • Cyproterone acetate (CPA): There is evidence that meningiomas may be more common and grow faster when taking CPA, a hormonal treatment drug. In patients with a documented meningioma, CPA should be discontinued to prevent tumor growth [8][9].
  • Bevacizumab: Bevacizumab, also known as Avastin, is a monoclonal antibody medication that may help reduce blood flow to meningiomas, preventing them from growing. However, its effectiveness in treating meningiomas remains uncertain [7][12].

It's essential to note that these treatment options are not mutually exclusive, and a multidisciplinary approach may be necessary to manage meningiomas effectively.

References:

[1] Medina-Lopes et al. (2020) - Cited by 3 [3] Medina-Lopes (Cited by 3) [4] (2024) - Aug 19 [6] (2024) - Aug 19 [7] Kumthekar et al. (2022) - Cited by 21 [8] (Cited by 114) [9] Weill et al. (2021) - Cited by 114 [12] (Cited by 3) [14] Simpson (1957)

The differential diagnosis for obsolete meningiomas can vary depending on their location in the brain or spine. Here are some possible diagnoses to consider:

• Foramen magnum meningiomas: The differential diagnosis includes dermoids, epidermoids, teratomas, lipomas, and hemangioblastomas [15].
• Olfactory groove meningiomas and clivus meningiomas: These can be treated through extended endoscopic endonasal approaches, but large-size tumors with a hard consistency and close proximity to vascular structures are contraindications to transabasal approaches [3].
• Meningiomas of the spinal cord: The differential diagnosis includes schwannomas, ependymomas, and metastases from primary tumors such as breast, lung, or prostate cancer [10].

It's worth noting that the Simpson grading system is considered obsolete by some authors, who instead adopt a more conservative treatment approach [12]. However, stereotactic radiotherapy (single or multiple fractions) may still be used for small residual disease after resection of a WHO grade I meningioma [13].

In terms of specific tumor markers, SSTR2A or SOX10 IHC can be used alone or in combination as the initial assessment to differentiate between schwannoma and meningioma [4]. For other differential diagnoses, SSTR2A alone or in combination with EMA are the most specific markers for the diagnosis of meningioma, with the exception of meningioma vs synovial sarcoma [4].

References:

[3] Selected cases of olfactory groove meningiomas and clivus meningiomas: [3] [10] The differential diagnosis of meningioma includes dural metastases from primary tumors such as breast, lung, or prostate cancer: [10] [12] A narrative review discussing the Simpson grading system: [12] [13] Stereotactic radiotherapy for small residual disease after resection of a WHO grade I meningioma: [13] [15] The differential diagnosis of a foramen magnum meningioma can include dermoids, epidermoids, teratomas, lipomas, and hemangioblastomas: [15]

Note: The references provided are based on the information available in the search results and may not be an exhaustive list.