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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What is the long term prognosis for Atypical Meningioma?

Ok, What is the long term prognosis for Atypical Meningioma? I have had 2 craniotomies for atypical meningioma in both 1999 and a further recurrence in 2004! Following the recurrence in 2004, I had Stereotactic Radiosurgery in 2006. I didn t remain tumour free and had a further recurrence of 2 new tumours in 2011! Subsequent SRS followed....which leads me to now? I ll bet you can t give me an honest answer!!!
Wed, 21 Nov 2018
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Neurologist 's  Response
Hi,

I'm not sure what to exactly make of your statement "bet you can't give me an honest answer!!!" but the BEST and most truthful information I would share from available data on the subject is that few studies on this topic that have looked at in terms of LONG TERM recurrence rates. However, suffice it to say that it is in fact quite high (48% after 10 years).

Atypical meningiomas (AM) do recur after resection..unfortunately, that is their nature, and the use of radiation therapy and surgery does not ELIMINATE the HIGH RISKS of recurrence.

In fact, the data shows that increased numbers of stereotactic surgeries with high recurrence rates tends to shorten survivability of patients.

It is not clear whether this implies FEWER surgeries should be performed as recurrence occurs and patients get older or if it is the simple ongoing recurrence of the tumors that leads to shortened survivability and that surgery itself is not the factor driving this statistic.

You've not mentioned the symptoms you get when there is a recurrence since not ALL meningiomas need to be resected just because they are present.

Surgeons may be willing to go on and remove them but in the face of the last statistic I mentioned, my approach for any patient with AM who has already had at least one STEREOTACTIC resection with or without radiation therapy is to consider repeat surgery ONLY IF the recurrent tumor(s) are causing impossible symptoms to occur that cannot be treated or controlled by any other means.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Dariush Saghafi,
Neurologist
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