cerebral convexity meningioma

Cerebral Convexity Meningioma: A Tumorous Growth on the Brain Surface

A cerebral convexity meningioma is a type of tumor that grows on the surface of the brain, specifically on the upper part of the cerebral cortex. This growth occurs directly under the skull and accounts for approximately 20 percent of all meningiomas [1].

Characteristics and Symptoms

Convexity meningiomas may not produce symptoms until they reach a significant size. When symptoms do occur, they can be diverse and include headache, seizures, weakness, numbness, and other neurological issues [2]. These tumors grow on the surface of the brain and can exert pressure on the surrounding brain tissue as they expand.

Definition and Location

A cerebral convexity meningioma is defined as a tumor that affects the cerebral sulcus. It is located on the upper surface of the cerebral cortex, away from the midline [3]. This type of meningioma represents 15-20% of all intracranial meningiomas, which develop from the leptomeninges of the cerebral convexities over all lobes of the brain [4].

Common Symptoms and Location

Convexity meningiomas are characterized by their location on the surface of the brain away from the midline. Common symptoms associated with this type of tumor include seizures, headache, extremity weakness, and other neurological issues [5].

Common Signs and Symptoms of Cerebral Convexity Meningioma

Cerebral convexity meningiomas are a type of tumor that grows on the surface of the brain, near the convexity. These tumors can exert pressure on the surrounding brain tissue, leading to various symptoms. Here are some common signs and symptoms associated with cerebral convexity meningioma:

• Headaches: Morning headaches are often reported by individuals with cerebral convexity meningioma [1].
• Vision problems: Changes in vision, such as seeing double or blurring, can occur due to the tumor's pressure on the brain tissue [1].
• Hearing loss or ringing in the ears: Some people may experience hearing loss or tinnitus (ringing in the ears) as a result of the tumor's proximity to the auditory nerve [3].
• Weakness or numbness: As the tumor grows, it can cause weakness or numbness in the extremities, affecting coordination and muscle strength [6].
• Personality changes: In some cases, cerebral convexity meningioma can lead to personality changes, which may be subtle at first [2].
• Neurological complications: The tumor's pressure on the brain tissue can cause neurological deficits, such as seizures or loss of coordination [4].

It is essential to note that these symptoms can vary depending on the size and location of the tumor. In some cases, individuals with cerebral convexity meningioma may not experience any noticeable symptoms at all.

References:

[1] Symptoms of a meningioma most often begin slowly. They may be hard to notice at first. Symptoms may depend on where in the brain the meningioma is. Rarely, it can be in the spine. Symptoms may include: Changes in vision, such as seeing double or blurring. Headaches that are worse in the morning.

[2] Convexity meningiomas, which grow on the surface of your brain and can exert pressure on your brain as they grow. Intraventricular meningiomas, which grow within the ventricles of your brain. Your ventricles carry cerebrospinal fluid (CSF). Olfactory groove meningiomas are located between your brain and nose at the base of your skull.

[3] Meningioma is the most common type of primary brain tumor, accounting for approximately 30 percent of all brain tumors. These tumors originate in the meninges, which are the outer three layers of tissue between the skull and the brain.

[4] Symptoms tend to develop over a long period of time. Depending on the size and location of the tumor and which part of the brain or spine is affected, symptoms will vary.

[5] Convexity meningioma-- This type of tumor grows on the surface of the brain and may compress the brain causing neurological problems such as weakness or sensory loss.

[6] Symptoms of a convexity meningioma are diverse and include headache, seizures, weakness, numbness, vision loss or other focal neurological deficits.

Treatment Options for Cerebral Convexity Meningiomas

Cerebral convexity meningiomas are a type of tumor that grows on the surface of the brain, directly under the skull. While surgery is often the primary treatment option, drug treatment may also be considered in certain cases.

• Surgical Resection: Surgical removal of the tumor is usually the first line of treatment for cerebral convexity meningiomas. This approach can be effective in removing the tumor completely, especially if it's located on the surface of the brain (convexity).
• Drug Treatment: However, some patients may not be good candidates for surgery due to various reasons such as age, medical conditions, or tumor location. In these cases, drug treatment may be considered.
  • Gefitinib: A study published in 2018 found that gefitinib, an EGFR inhibitor, showed promise in treating recurrent or progressive meningioma (1). However, more research is needed to confirm its effectiveness.
  • Temozolomide and Hydroxyurea: These agents have been studied as potential treatments for meningiomas, but their efficacy is still unclear. A phase 2 study found that temozolomide had no effect against recurrent meningiomas (7). Hydroxyurea has been shown to reduce edema around the tumor, leading to symptomatic and objective improvement in symptoms (8).
  • Dexamethasone: This corticosteroid can help alleviate symptoms by reducing inflammation and swelling around the tumor. However, its long-term effects on meningioma growth are not well understood.

Current Research and Limitations

While some studies suggest that drug treatment may be effective in treating cerebral convexity meningiomas, more research is needed to confirm these findings. The current understanding of meningioma biology and the effectiveness of various treatments is still evolving.

• Recurrence: Meningiomas can recur after surgical resection or radiation therapy. In such cases, drug treatment may be considered as an adjunctive therapy.
• Obesity Link: Research has shown that meningiomas are more common in obese individuals, but the exact link between obesity and meningioma development is unclear (10).

Conclusion

While surgery remains the primary treatment option for cerebral convexity meningiomas, drug treatment may be considered in certain cases. Further research is needed to fully understand the effectiveness of various treatments and their potential long-term consequences.

References:

(1) Study on gefitinib in treating recurrent or progressive meningioma (2018) (7) Phase 2 study on temozolomide for recurrent meningiomas (8) Use of hydroxyurea to reduce edema around the tumor (10) Link between obesity and meningioma development

Differential Diagnosis of Cerebral Convexity Meningioma

Cerebral convexity meningiomas are a type of brain tumor that can be challenging to diagnose due to their similarity in appearance with other dural masses. The differential diagnosis for these tumors includes:

• Other dural masses: Such as schwannomas, which arise from the peripheral portions of the cranial nerves [3-12].
• Dural metastases: In patients with a history of cancer, particularly breast cancer [1].
• Primary, solitary lymphoma: Which can have similar CT features to meningiomas and may be considered in the differential diagnosis [13].

Key Points

• Cerebral convexity meningiomas are attached to the dura of the cerebral convexities over all lobes of the brain.
• They represent 15-20% of intracranial meningiomas and offer a good potential for radical gross total resection due to their accessible location [14].
• The differential diagnosis generally includes other dural masses as well as some location-specific entities [7].

Imaging Studies

• Brain MRI (magnetic resonance imaging) with contrast is the best imaging test to diagnose meningioma, including cerebral convexity meningiomas [8].
• CT scans can also be used for diagnosis and may show similar features to other dural masses.

References

[1] Context 1: An important differential diagnosis of “en plaque” meningiomas are dural metastases in the appropriate clinical setting (e.g., in a patient with CA breast). [3-12] Context 1: Schwannomas arise from the peripheral portions of the cranial nerves. [7] Context 7: The differential diagnosis generally includes other dural masses as well as some location-specific entities. [13] Context 13: Primary, solitary lymphoma involving the brain adjacent to the convexity can have the CT features of a meningioma. [14] Context 14: Convexity meningiomas develop from the leptomeninges of the cerebral convexities over all lobes of the brain and represent 15-20% of intracranial meningiomas.