Spinal meningioma
What is it?
The meninges are the protective membranes encasing the brain and spinal cord. Meningiomas are typically slow-growing and benign, but in rare cases, they can be malignant and spread to nearby tissues. Meningiomas account for about 25% of all tumors that affect the spinal canal. They can arise anywhere along the spine but are commonly found in the thoracic region. Spinal meningiomas are more common in women than in men, occurring approximately four times as often. However, men are more likely to develop the rare malignant form of meningioma. These tumors are typically diagnosed around the age of 45 years.
Symptoms
Spinal meningioma causes symptoms due to the tumor growth exerting pressure on the spinal cord or nerves. The severity of these symptoms depends on the tumor’s location, which may result in numbness or weakness in the arms or legs, and difficulty in bowel, bladder, and sexual function. The symptoms worsen as the tumor grows.
Diagnosis
Imaging studies play a crucial role in diagnosing meningiomas. Magnetic resonance (MR) scans provide detailed information on the tumor’s size, location, and effect on the surrounding structures. Contrast dye injection also helps highlight the tumor tissue against normal tissue. Computed tomography (CT) is helpful for patients with pacemakers or other metallic devices who cannot undergo MR imaging. CT uses X-rays and computer technology to produce detailed images of bones and soft tissues. Calcium deposits, commonly found in meningiomas, are more accurately identified by CT scans.
Treatment
If a meningioma is small and asymptomatic, observation over time may be a safer alternative to surgical removal. In cases where treatment is necessary, surgery is usually the first line of defense. Since the tumors are usually benign, complete removal often leads to a cure. However, some tumors may be challenging to remove. Some examples include tumors that contain unusual amounts of calcium, those located in hard-to-reach areas, or those that invade surrounding tissues. In some instances, meningiomas may recur even after complete removal.