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Spinal Meningioma

Disease Details

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Description: A spinal meningioma is a generally benign tumor that arises from the meninges, the protective membranes covering the spinal cord, often leading to symptoms such as back pain or neurological deficits due to spinal cord compression.
Type: Spinal meningioma is a type of benign tumor that develops from the meninges, the protective membranes covering the spinal cord. It is typically a sporadic condition and not usually inherited. There is no specific type of genetic transmission associated with most cases of spinal meningioma. However, in rare instances, it can be associated with neurofibromatosis type 2 (NF2), a genetic disorder that follows an autosomal dominant pattern of inheritance.
Signs And Symptoms: Small tumors (e.g., < 2.0 cm) usually are incidental findings at autopsy without having caused symptoms. Larger tumors may cause symptoms, depending on the size and location.
Focal seizures may be caused by meningiomas that overlie the cerebrum.
Progressive spastic weakness in legs and incontinence may be caused by tumors that overlie the parasagittal frontoparietal region.
Tumors of the Sylvian aqueduct may cause myriad motor, sensory, aphasic, and seizure symptoms, depending on the location.
Increased intracranial pressure eventually occurs, but is less frequent than in gliomas.
Diplopia (Double vision) or uneven pupil size may be symptoms if related pressure causes a third and/or sixth nerve palsy.
Prognosis: Spinal meningioma is generally a benign, slow-growing tumor that arises from the meninges of the spinal cord. The prognosis is usually favorable, especially when the tumor is detected early and completely surgically removed. Factors influencing the prognosis include the size and location of the tumor, the patient's overall health, and the presence of any neurological deficits. Early diagnosis and treatment often result in good outcomes, with many patients experiencing significant symptom relief and a low recurrence rate.
Onset: The onset of spinal meningioma can vary, but it typically presents in middle-aged to older adults. The symptoms often develop gradually over time and may include back pain, weakness, numbness, or other neurological deficits due to compression of the spinal cord or nerve roots.
Prevalence: The prevalence of spinal meningiomas is relatively low. They account for approximately 25-45% of all spinal tumors and are most commonly found in adults, particularly women, with a higher incidence in the 40-70 age range.
Epidemiology: Many individuals have meningiomas, but remain asymptomatic, so the meningiomas are discovered during an autopsy. One to two percent of all autopsies reveal meningiomas that were unknown to the individuals during their lifetime, since there were never any symptoms. In the 1970s, tumors causing symptoms were discovered in 2 out of 100,000 people, while tumors discovered without causing symptoms occurred in 5.7 out of 100,000, for a total incidence of 7.7/100,000. With the advent of modern sophisticated imaging systems such as CT scans, the discovery of asymptomatic meningiomas has tripled.Meningiomas are more likely to appear in women than men, though when they appear in men, they are more likely to be malignant. Meningiomas may appear at any age, but most commonly are noticed in men and women age 50 or older, with meningiomas becoming more likely with age. They have been observed in all cultures, Western and Eastern, in roughly the same statistical frequency as other possible brain tumors.
Intractability: Spinal meningioma is usually not considered intractable. These tumors, which are generally benign and slow-growing, can often be effectively treated with surgery. Outcomes tend to be favorable if the tumor is detected early and completely removed, though some cases may present more challenges depending on the tumor's size, location, and the patient's overall health. Radiation therapy is also an option for tumors that are not completely resectable or recur after surgery.
Disease Severity: Spinal meningiomas are typically benign, slow-growing tumors that develop in the meninges, the protective membranes covering the spinal cord. While they are usually non-cancerous, their location can lead to significant neurological symptoms and complications due to compression of the spinal cord and nerves. Early diagnosis and treatment are important to prevent serious damage. The severity can vary based on the size, location, and the degree of neurological impairment they cause.
Healthcare Professionals: Disease Ontology ID - DOID:1138
Pathophysiology: Meningiomas arise from arachnoidal cap cells, most of which are near the vicinity of the venous sinuses, and this is the site of greatest prevalence for meningioma formation. Some subtypes may arise from the pial cap cells that migrate during the development together with blood vessels into the brain parenchyma. They most frequently are attached to the dura over the superior parasagittal surface of frontal and parietal lobes, along the sphenoid ridge, in the olfactory grooves, the Sylvian region, superior cerebellum along the falx cerebri, cerebellopontine angle, and the spinal cord. The tumor is usually gray, well-circumscribed, and takes on the form of the space it occupies. They usually are dome-shaped, with the base lying on the dura.
Carrier Status: Carrier status is not applicable for spinal meningioma. Spinal meningioma is typically a sporadic tumor arising from the meninges of the spinal cord and is not associated with a carrier state or inherited genetic mutation in most cases.
Mechanism: Spinal meningioma is a type of tumor that arises from the meninges, the protective layers covering the spinal cord.

**Mechanism:**
1. **Tumor Formation:** Spinal meningiomas originate from the meningothelial (arachnoid) cells of the meninges.
2. **Growth:** These tumors are typically slow-growing and can press on the spinal cord, nerves, and surrounding structures, leading to neurological symptoms such as pain, weakness, or sensory loss.

**Molecular Mechanisms:**
1. **Genetic Mutations:** Commonly, mutations in the NF2 (neurofibromin 2) gene are found in spinal meningiomas. NF2 encodes the merlin protein, which acts as a tumor suppressor by regulating cell growth and contact inhibition.
2. **Chromosomal Abnormalities:** Loss of chromosome 22, where the NF2 gene is located, is a frequent finding in these tumors.
3. **Growth Factor Pathways:** Abnormal expression of growth factors and their receptors, such as PDGF (platelet-derived growth factor) and VEGF (vascular endothelial growth factor), contribute to tumor growth and angiogenesis.
4. **Epigenetic Changes:** DNA methylation and histone modifications can also play a role in the development and progression of spinal meningiomas.

Understanding these mechanisms is critical for developing targeted therapies and improving patient outcomes.
Treatment: Treatment for spinal meningioma typically involves:

1. **Surgery**: The primary treatment. Complete surgical removal of the tumor is the goal to relieve spinal cord compression and prevent neurological damage.
2. **Radiation Therapy**: In cases where the tumor cannot be entirely removed or if it recurs, radiation therapy may be used to target residual tumor cells.
3. **Observation**: For small, asymptomatic tumors, regular monitoring with MRI scans may be advised instead of immediate intervention.

Consultation with a neurosurgeon and an oncologist is essential for a tailored treatment plan.
Compassionate Use Treatment: Spinal meningioma is typically managed with surgical resection, and the treatment can vary based on the case specifics. Currently, there are no widely recognized compassionate use or experimental treatments specifically for spinal meningiomas. However, some ongoing research and off-label treatments in the broader context of meningiomas and related tumors may include:

1. **Targeted Therapies**: Treatments such as bevacizumab, a monoclonal antibody against VEGF, are being explored for their potential in targeting tumor angiogenesis.

2. **Tyrosine Kinase Inhibitors**: Drugs like sunitinib or sorafenib are sometimes considered for experimental use due to their ability to inhibit pathways involved in tumor growth.

3. **Immunotherapy**: Use of immune checkpoint inhibitors, such as pembrolizumab, may be investigated in certain cases, especially if conventional treatments are not viable.

4. **Clinical Trials**: Participation in clinical trials may provide access to experimental drugs or new combinations of existing treatments that are not yet widely available.

Consultation with a healthcare professional specializing in neuro-oncology is essential for exploring these options.
Lifestyle Recommendations: Spinal meningioma is a typically benign tumor that occurs in the spinal cord's meninges, the protective layers covering the spinal cord. Here are some lifestyle recommendations for managing spinal meningioma:

1. **Regular Medical Check-ups**: Regular follow-up with a healthcare provider is crucial for monitoring the tumor and any symptoms.

2. **Physical Activity**: Engage in low-impact exercises such as walking, swimming, or yoga to maintain mobility and overall health. Avoid activities that may strain the spine.

3. **Healthy Diet**: Maintain a balanced diet rich in fruits, vegetables, lean proteins, and whole grains to support your general well-being and strengthen your immune system.

4. **Pain Management**: Adopt strategies for pain management, such as physical therapy, pain relievers as prescribed, and possibly complementary therapies like acupuncture.

5. **Mental Health**: Support your mental health through activities like mindfulness meditation, counseling, or support groups to cope with the emotional impact of the diagnosis and treatment.

6. **Post-surgery Care**: If surgery is required, follow all post-operative care instructions meticulously, including attending physiotherapy sessions to aid in recovery.

7. **Avoid Smoking and Alcohol**: Smoking and excessive alcohol can impair healing and overall health; quitting smoking and limiting alcohol intake can be beneficial.
Medication: Spinal meningiomas are typically treated with surgical resection to remove the tumor. Medications are generally not the primary treatment but may be used to manage symptoms. For example, corticosteroids can help reduce inflammation and swelling before or after surgery. In some cases, pain management medications might be prescribed to alleviate discomfort. Routine monitoring and follow-ups with imaging studies like MRI are crucial for tracking any recurrence or growth of the tumor.
Repurposable Drugs: Currently, there are no widely recognized repurposable drugs specifically for spinal meningioma. Treatment often involves surgical resection, and in some cases, radiation therapy. However, ongoing research may identify potential repurposable drugs in the future. It is important to consult with a medical professional for the most up-to-date and individualized treatment options.
Metabolites: Spinal meningioma is typically a benign tumor of the meninges (the membranes that cover the brain and spinal cord) located in the spinal column. There are no specific metabolites directly associated with spinal meningiomas, as they are not typically a metabolic or biochemical disorder but rather a structural one. Diagnostic focus usually includes imaging techniques like MRI rather than metabolic profiling. If you have more specific inquiries or need information on related topics, feel free to ask.
Nutraceuticals: There is limited evidence supporting the use of nutraceuticals specifically for the treatment of spinal meningiomas. Management typically involves surgical intervention and, in some cases, radiation therapy. Nutraceuticals may play a supportive role in overall health but should not be considered a primary treatment for spinal meningiomas. Always consult with a healthcare provider for treatment options tailored to individual conditions.
Peptides: Spinal meningiomas are typically treated using surgical resection, and research into peptide-based therapies is still in the early stages. There has been interest in using peptides for targeting tumor cells or modulating immune responses, but this is not a standard treatment for spinal meningiomas as of now.

Regarding nanoparticles, there is ongoing research exploring their use in delivering drugs directly to tumor cells, improving imaging, and potentially reducing side effects. However, these nanotechnologies are not yet widely implemented in clinical practice for spinal meningiomas. Current standard treatments remain focused on surgery, sometimes supplemented with radiotherapy.