meningioma?

[vjharris]

I was told I had a 2.2 x1.7 cm AN in February '05 with no hearing loss or other symptoms, except migraigne headaches. I have been "waiting and watching".
On New Year's Day I had a temporary hearing loss and very loud ringing in that ear. It lasted about a day and a half. My hearing has since tested back to normal. When I went for a new MRI, my neurosurgeon said the radiologist now indicated that my tumor is a meningioma, NOT an AN. The neurosurgeon took my scans to a meeting with other brain tumor specialists at Cleveland Clinic, and it seems they are divided...I'm not sure what kind of tumor I have.
Sheesh! As if there wasn't enough uncertainty already.
Has anyone else had this problem? I was leaning toward gammaknife when treatment was necessary, but the Dr. says meningiomas tend to "swell" more, and it might be a problem for me.
vjh

[Larry]

VJ,

A real dilemma. I would suggest going to a completely different hospital. keep going until you get some concensus. You need certainty as to what it is. Then you can have a clear view as to the treatment available.


Larry

[russ]

 Hi VJ
  I would get another person to interpret the MRI. They should be able to tell by the tumor's location. It would tail off of the brain's 'meninges' somewhere if a meningioma. Seems to me if your symptomology matches that of an acoustic neuroma sufferer, the tumor is an AN, not a meningioma. Both are generally benign.
  I believe these type tumors are near the brain surface in general but have a potential of more rapid growth than a AN. I've read of some very large ( 5 - 6 cm. ) ones being removed because they went so long undetected.
  Guess if I had to choose between the two tumor types as to what I would prefer to have, ha ha..., I'd rather have a meningioma.
  Re: Radiation. I personally haven't read about them being radiated but that probably doesn't mean they wouldn't if in reasonable location and within reasonable size limit. Generally, max. at 3 cm.
  Best wishes to you!
  Russ

[vjharris]

Thanks Russ and Larry for your replies. The Drs. who reviewed my scans are all from the Brain Tumor Institiute of Cleveland Clinic. There were many different Drs. at that meeting, and they were divided as to an answer. The location of the tumor is in the same place as an AN (CPA), and there is no visible "dural tail" which would point to an AN, but the characteristics of the tumor itself look like meningioma.
This is the second team of Drs. I have seen, and three different radiologists have read the scans. Since the first MRI, there has been some question about the type of tumor, but I thought this team was more sure of the AN diagnosis, until my last scan.
Normally, a meningioma would be at an easier place to "get to" with surgery, but they do happen in the CPA. This one gives me all the same risks as AN surgery, with the additional burden of a tumor that is more likely to recur. (If it is meningioma.)
I'm still concerned about the NF2 connection with a menigioma, as my daughter was born with a cataract. My Dr. says my brain does not look like one of an NF2 patient (but that doesn't stop my fears for my daughter).
If I did have NF2, is radiation less likely to work for me? Any ideas would be appreciated.
vjh

[eve]

Hi vjh

I also have a 1.4cm meningioma (in the cerebellopontine angle).  And at first, it was diagnosed as an AN.  But when I went for my "second opinion", they said it was a meningioma not an AN.  The third opinion agreed - meningioma.  Whether it's an AN or meningioma in this particular location, there isn't much difference in terms of treatment or outcome. The only difference that I'm aware of (that's relevant) is that some meningiomas have been found to be 'hormone receptive".  So pregnancy may increase the rate of tumor growth in some women.

Someone upthread mentioned they'd rather have a meningioma.  I have no idea why.  A meningioma should be taken just as seriously as an AN --  and in this location, the exact same physical threats apply, the exact same treatments apply, and the exact same outcomes apply. 

BTW -- I'm currently in the wait and watch mode -- but am leaning towards surgery (but ask me tomorrow and I might say radiosurgery)!!  I'

I'm very curious -- what are your sysmtoms?  Mine have been around for six years (but I just got diagnosed 1 year ago).  I constantly feel like I just got off a boat (not vertigoo - more like  a 'swimming' kind of feeling), tinnitus and neck ache.

Hang in there....

Eve





 It's been one year since my diagnosis and my meningioma has not grown.  But like ANs, every individual's tumor is different in terms of how it grows. 

[vjharris]

Thanks for your comments Eve. I agree that meningioma or AN doesn't make too much difference in treatment, except I was warned about the chances for recurrance and the increased tendency to "swell" with radiation. Were you also told this? As a 46 year old woman, should I worry that menopause in the coming years could affect the tumor? (I certainly hope there would be no more pregnancies.)  :>)
My tumor is much larger than yours (2.2x1.7 cm).  I was also diagnosed about a year ago, and have not seen any growth yet in my tumor.
My symptoms have been tinnitus and migraine headaches. I also lost my hearing for a couple of days earlier this month. The hearing came back and my Drs. have prescribed steroids as an emergency treatment should that happen again.
I was pretty sure that GK was going to be my treatment choice, but now I'm not sure what to do OR when to do it.
My thoughts are with you as we both find our way.
vjh

[eve]

Hi again vjh

I wasn't told that meningiomas swell more after GK.  I also wasn't told that they tend to grow back more than ANs. Just our luck....
I would sure hate to go through surgery only to have the little alien grow back!

Are you considering GK, Cyberknife or FSR?  Or surgery?  And for surgery, what approach would they use?  For me -- the surgeon said he would go in through the back -- I think its the retrosigmoid (sp?) approach.  That way they have a better chance of saving your hearing.  I told my surgeon that I prefer him to save my brainstem, balance, face, and then hearing in that order of priority! 

Any ways, I'm still considering the radiation options too -- if it weren't for the constant balance problem I have (which has changed my life significantly), I would wait as long as I could.  But lately, I just want to get the whole thing over with. 

Like you, I'm in my forties (44).  I sometimes wonder how our hormones could be affecting the tumor.  I know that the hormones are affecting other parts of me!! 

Take care  : - ))

Eve