Brain, Pituitary and Skull Base Tumor Forum Expert Forum
How soon is too soon for meningioma surgery?
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How soon is too soon for meningioma surgery?

I was diagnosed January of 2012 with two tumors, a pituitary adeanoma and a small meningioma. The pituatary tumor is being dealt with medically and has shrunk to half its origional size in the last year. The meningioma however has doubled. It started at 1.5 x1.7 cm and after one year has grown to 2.4 x 1.7 cm.  It's located in the prosterier fossa on the back right of my brain. I understand these types of tumors typically only grow 1-4 mm per year. With this level of growth is surgery my best option? Should it be sooner than later, and if so, how difficult is the location of my tumor to get to for removal? I have a referal to the Mayo Clinic in Phoenix AZ. but I'd like to go in as informed as possible. I'd appreciate any information I can get.

Thanks
1382849_tn?1337552730
Dear Mlhawk,

Meningiomas are very benign tumors that grow around the brain. The problem is that they end up causing mass effect and pushing on the brain and brainstem. The primary treatment is surgical resection.
Please let me know if you would like for me to take a look at your films free of charge. I will be happy to give you further information in relation to your specific case.
3 Comments
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657231_tn?1390151580
There is a gal on the patient forum who had been dealing with one of these too that is a faster than usual type.

I cannot comment on location etc. But I would get your records and shop them around. Read up in pubmed on papers and look for institutions and doctors that do a lot of surgeries, contact them and get their advice on who to seek out for surgery. As well the expert here may have some advice, so sending him a CD (after contacting his office) may be helpful as well.
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171768_tn?1324233699
Hi,
With growth like that, if the location makes surgery an option, it will likely be recommended that you have it removed soon. There are other options like gamma knife, cyber knife, IMRT and proton therapy that you can research in advance so that you are prepared to ask questions about it. However, if it were me and surgery was an option, I would opt for it. You don't state your age, but your profile pic shows you are relatively young and would probably recover better from surgery now than if you needed it later on. Meningiomas are "benign" but they cause damage by compressing healthy brain tissue and other structures. Other treatments generally do not shrink them so if you have any symptoms, GK or the others would not relieve symptoms. Also, since you have 2 growths and one of them (meningioma) shows rapid growth, you have to consider the possibility that you may get more in the many years you have ahead of you. There is a max limit to radiation that a person's brain can get in a lifetime. Radiation is a good back up plan if the tumor regrows or can only be partially removed.

I know you are waiting on one consult. While you wait, I very strongly recommend that you line up a second opinion. I was shocked by how different the recommendations can be. When consulting for surgery, I ended up not going with the first neurosurgeon I saw. After surgery I also consulted about radiation. The opinions of radiation oncologists were so different I ended up selecting the FIFTH one I saw. If I had gone with the first 2 opinions, I would have received a treatment too soon that was not the best option for me and would have left me with lifetime deficits.

Ask the NS about the rapid growth of yours. Sometimes they do have unexplained rapid growth. In females, they often grow rapidly during hormonal events like pregnancy or menopause. But sometimes it is indicative of a grade II meningioma. Only surgery and biopsy can confirm what you are dealing with.

good luck and let me know if you have any questions. I am still struggling with some issues from mine so I do not get this forum often anymore so if I do not respond immediately, send me a PM and I'll be sure to check back.
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