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Meningiomas
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Meningiomas occur twice as often in women as in men and account for 20% of all primary brain tumors. The incidence increases with age and the mean age of presentation is 55 years. They may be found incidentally in up to 2-3% of autopsy cases. These tumors are slow-growing extrinsic lesions that generally produce symptoms from compression of adjacent brain. Symptoms will vary according to the tumor location (i.e., convexity, parasagittal, skull base, intraventricular, and posterior fossa). Thirty-five percent of patients present with headaches. Hemiparesis is found in 30% of patients. The neurological examination is normal only 25% of the time. Complete surgical resection is often possible, but recurrence varies widely and is influenced not only by extent of resection, but also by tumor location.
Stereotactic radiosurgery can be used to treat inaccessible, incompletely resected, or recurrent meningiomas with low morbidity. As some of these tumors are hormonally sensitive, there has been a great deal of interest in the controversial anti-progestational agent RU-486, especially for unresectable or recurrent tumors. There is some evidence to suggest that tumor growth can be halted and even reversed in some cases. There is also recent data to suggest that the chemotherapy agent hydrea may be beneficial for recurrent tumors. |
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