Often both benign and malignant meningiomas require some form of treatment. These treatment options could include surgery and/or stereotactic radiosurgery, depending upon the location of the tumor and symptoms.
Our neurosurgical team may recommend a combination of surgical and non-surgical approaches to maximize the benefits of surgery while minimizing the risks.
Malignant meningiomas are surgically removed whenever possible, while benign meningiomas are removed if they are large and/or causing neurologic problems.
The type of procedure depends on the size and location of the tumor.
At UPMC, we take a 360° approach to treatment when evaluating you. We look at your condition from every direction to find the path that is least disruptive to your brain, critical nerves, and ability to return to normal functioning.
Minimally invasive surgery
Several minimally invasive surgical options allow UPMC surgeons to access areas that previously were difficult or impossible to reach.
Meningiomas of the skull base and upper spine may be approached directly using the Endoscopic Endonasal Approach (EEA). This state-of-the-art, minimally invasive approach allows surgeons to access the tumor through the natural corridor of the nose, without making an open incision. Surgeons then remove the meningioma through the nose and nasal cavities.
EEA treatment offers the benefits of no incisions to heal, no disfigurement, and a faster recovery time.
Tumors located in the following areas can be treated with EEA:
- Transribriform: olfactory groove meningiomas
- Transplanum: planum sphenoidale meningiomas and tuberculum sellae meningiomas
- Transsellar: sellar meningiomas
- Transclival: petroclival meningiomas and foramen magnum
- Transodontoid: foramen magnum meningiomas, anterior upper spine
- Transpterygoid: infratemporal fossa meningiomas
- Transorbital: intraconal meningiomas (located inside the orbit) or extraconal meningiomas (pushing on the periorbit)
If you need complementary treatments, such as radiation, those therapies can begin soon after EEA surgery.
Neuroendoport surgery offers a minimally invasive option for tumors within the ventricles (fluid spaces) or deep-seated tumors within the substance of the brain. A narrow tube or port allows surgeons to access these tumors through a tiny incision in the scalp, in contrast to traditional brain surgery.
Gamma Knife® radiosurgery
Gamma Knife radiosurgery is a painless procedure that uses hundreds of highly focused radiation beams to target tumors and lesions within the brain, with no surgical incision.
Gamma Knife treatment may be used as a primary management option or after surgery for residual meningiomas. For small skull base meningiomas it may be the primary, minimally invasive option. For malignant meningiomas, in addition to surgery, both Gamma Knife radiosurgery and radiation therapy may be needed.
As the nation's leading provider of Gamma Knife procedures, UPMC has treated more than 12,000 patients with tumors, vascular malformations, pain, and other functional problems.
Chemotherapy is used only in the treatment of malignant meningiomas. Several medications are available and are generally used in conjunction with surgery and radiation therapy.
Read the EEA Olfactory Groove Meningioma case study.