How Likely is My Meningioma to Return?

Scheduling brain tumor surgery to remove a meningioma can bring you a substantial amount of emotional relief, but it can also leave you with a whole new set of questions and concerns. For many patients, the possibility of recurrence is one of the biggest concerns.

Although many cases of meningioma are fully resolved following treatment, these primary brain tumors sometimes return. Research indicates that nearly half of surgically removed meningioma tumors eventually grow back, often many years later.  

This is why routine brain screenings are a key component of aftercare in every meningioma case. Read on as fellowship-trained neurosurgical oncologist Jose Valerio, MD, explores the probability of meningioma recurrence, and the factors that make its regrowth more likely. 

Understanding meningiomas 

Meningioma originates in the meninges, or the three layers of protective tissue between the brain and skull. Specifically, it forms along the outermost meninges layer, a tough sheet of tissue called the dura mater.  

As the most common primary brain tumor, meningioma accounts for about one in three brain tumor diagnoses. It tends to grow very slowly and often exists for years before symptoms occur. Asymptomatic meningioma tumors are sometimes discovered by chance when an MRI is being done for other reasons. 

Meningioma tumors are categorized by type based on their location. They’re also graded based on their subtype and disease characteristics, as determined by molecular testing:

Grade I meningiomas 

The most common meningioma type, these low-grade tumors grow very slowly. 

Grade II atypical meningiomas 

As mid-grade tumors, atypical meningiomas have a higher chance of coming back after they’re removed. Subtypes include choroid and clear cell meningioma.

Grade III anaplastic meningiomas 

Anaplastic meningiomas are malignant (cancerous), fast-growing tumors. Subtypes include papillary and rhabdoid meningioma.  

Meningioma treatment depends on the grade, size, and location of the tumor, among other factors. A small Grade I tumor that doesn’t cause symptoms may simply be monitored regularly for progression, while a larger Grade II tumor may be surgically removed before it has the chance to invade surrounding tissues. Grade III malignancies are always removed when possible.   

Meningioma recurrence rates

The good news about meningioma tumors is that about 90% of them are slow-growing and benign, meaning they’re not likely to invade other tissues or spread throughout the body. The other good news about these primary brain tumors is that a majority are treatable. Most can be fully removed with surgery, and many don’t return.  

Unfortunately, some meningiomas do return after they’ve been removed — often many years later. Factors that can increase the odds that a meningioma will return include:

Incomplete removal

Tumors that aren’t totally removed (or can’t be for some reason) are more likely to grow back. 

Greater severity

Grade II and Grade III tumors are more likely to reoccur, and reoccur more quickly. 

Problematic characteristics

Large or multiple meningioma tumors, and tumors that occur in a challenging treatment location, such as around the optic nerve, are more likely to grow back. 

Patient age and health

Older patients and patients who are less healthy have an increased risk of tumor recurrence.  

Complete removal of the meningioma and its attached membrane (the dura mater) offers the best chance of avoiding future recurrence. But even when a meningioma and its dura mater are totally removed, there’s still a 24-32% chance that it will reoccur within 15 years. 

When a meningioma tumor isn’t removed completely, it’s likely to regrow within 10-20 years. About 95% of recurring meningiomas develop in the exact same place as the original tumor.

Post-treatment brain monitoring

Given that nearly half of surgically removed meningiomas eventually grow back, it’s easy to grasp the importance of regular post-treatment brain monitoring. When a meningioma does recur, it’s important to address it promptly. Problems caused by a tumor invading brain tissue or pushing on nerves are far more difficult to treat than they are to prevent.   

When it comes to treating or monitoring brain tumors, you’re in good hands with Dr. Valerio. To get the care you need, book an appointment over the phone with the practice of Jose Valerio, MD, today. He has offices in South Miami, Hialeah, and Weston, Florida.