Frontal Meningioma – Surgical Indication — SCE Neurology MCQ

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EasyNeuro-oncologyFrontal Meningioma – Surgical IndicationSCE Neurology

A 65-year-old woman with a right frontal meningioma compressing the frontal lobe presents with progressive personality change, urinary incontinence, and anosmia. She has had two focal seizures. The tumour is 5 cm and causing significant mass effect. What is the most appropriate management?

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Correct answer: E — Surgical resection

A symptomatic meningioma (WHO grade 1 is most common) causing neurological deficits, seizures, and significant mass effect should be surgically resected. Complete resection (Simpson grade I) is curative for most WHO grade 1 meningiomas, with very low recurrence rates. The frontal location is surgically accessible. Anosmia results from compression of the olfactory groove/tract. A: Observation is for small, incidental, asymptomatic meningiomas. C: Radiotherapy is adjunctive for incompletely resected or higher-grade meningiomas. D: Temozolomide is for gliomas. E: SRS is for small residual or recurrent meningiomas.

Reference: NICE NG99 Brain Tumours (2021); EAN Meningioma Guidelines