Newly diagnosed meningioma - where to go from here?

I would definitely get a second option, be sure to spell out your concerns. It's scary to hear about a meningioma - but you are stronger than you think. I applaud your pro-activeness. Keep us posted

@ladytri

I agree with the recommendation of getting a second opinion. The concern of one’s health deteriorating in the next decade is a valid one. Things happen as we age. (I am 83).

I had a 4cm meningioma discovered by accident also. The neurologist urged me to have it treated as soon as possible. There was some edema and it was near my optic nerve. There is also a risk of seizures with these. I had Gamma knife procedure which killed the tumor without surgery. I have been fine for 4 years, but still take anti seizure medication for any edema. I would get a second opinion if your doctor said wait and watch.

My tumor is 1.9 x 1.4 also an incidental finding and no symptoms. It is left occipital with a small amount of edema. I met with a neurologist and 3 different neurosurgeons at 3 facilities before I made my decision for watch and wait. I whole heartedly agree with the other folks that it is important to get an additional opinion(s). Also watchful waiting for me is MRI every 6 months. I would not want to wait a whole year before having it visualized again. Best wishes and thanks for sharing on this site. Keep in touch!

bkyoung: I agree with a 2nd opinion. My meningioma was close to the optic nerve and waiting 6 months would have most likely resulted in not being able to have surgery. Even having gamma knife, I was told, would be tricky when very close to the optic nerve so, for me, every millimeter would have had a big impact. It sounds like your meningioma is not in an as threatening location. I am assuming this based on the fact that you mentioned after the next 6 month MRI your doctor is comfortable with putting you on a yearly scan protocol. As an aside, I had a craniotomy when I was just about to turn 73. I brought up to my neurosurgeon my worry about having brain surgery at my age. He only does surgeries for meningiomas and reassured me that he frequently operates on 80 year old people. It all depends on one's health status, not age. And if it were to happen that because of a health hiccup you couldn't have surgery there is always gamma knife/cyber knife. As long as the meningioma remains stable, I would assume you don't need to do anything at all given that you aren't having symptoms. I have two remaining meningiomas, one the same size as yours, and they haven't grown in 3 years. I will admit that a few weeks before my annual MRI scan I get a little nervous thinking about if they have grown. But otherwise, the other 11 1/2 months of the year, I don't worry about them.

I’m sorry to hear about your recent meningioma diagnosis. I was ‘incidentally’ diagnosed with a symptom-free 1.5 x 0.5 x 1.4 cm meningioma near my left optic nerve in February and felt like a hamster on a wheel for a few days. Fortunately for me, my neighbor’s son, who is in the medical field, had a meningioma successfully treated five years ago at the UCD Medical Center in Sacramento. He and his colleagues researched hospitals and specialists, so I didn’t have to.

I had a six-month MRI on July 30th, which showed 1mm of possible growth. My neurosurgeon referred me to a radiologist and neuro-ophthalmologist for further evaluation. If I remain symptom-free and my vision hasn’t changed, I will have a third MRI in February. If not, I will opt for 30 doses of fractionated radiation over six weeks.

I didn’t get a second opinion at UCSF because my doctor did his surgical fellowship there, has been a brain tumor specialist for 20 years, has excellent reviews, was recommended by someone I trust, and is 20 miles from my home. Had this not been the case, I would have gone for a second opinion.

I am 75 and have no other health problems. Knowledge, a trusted doctor, and this forum have given me peace of mind. I wish the same for you.

Thank you all for responding. I have decided to pursue a 2nd opinion at UCSF as it is only 4 hours from me. In a way, I want to just ignore it for now but I find myself thinking about it all the time and wondering where I will end up with all this. In all fairness, I have only had my initial diagnosis for 2 weeks, so it is all still sinking in.

@dailygift
Hi was this the size at the initial finding?

Hi! I think my original scan in the ER said 1.7. however my neurosurgeon calls it 1.9, and say the picture is stable. I am just one year out from my original diagnosis after a car accident 9/9/25. Supposedly the swelling and tumer have not changed looking at the scans side by side. I have no symptoms and right or wrong I'm not worrying about the difference. I'm 74 and hoping to never need treatment. If my situation worsens I'll have gamma knife surgery. How are you?

@bkyoung, there are good reasons for getting a second opinion. Here is an article the Mayo Clinic cancer staff wrote explaining why and how:
- Tips for seeking a second opinion https://connect.mayoclinic.org/blog/cancer-education-center/newsfeed-post/tips-for-seeking-a-second-opinion/

I will also add that watch and wait, sometimes also called active surveillance, is a treatment approach that can be suitable for some meningiomas. Sometimes surgery is not needed. As Mayo Clinic describes and other members have posted, this may depend on growth, size, location, and symptoms. https://www.mayoclinic.org/diseases-conditions/meningioma/diagnosis-treatment/drc-20355648

Here's another discussion you might be interested in:
- Meningioma - I'm scared to watch and wait https://connect.mayoclinic.org/discussion/have-had-a-mri-that-revealed-a-large-structure-that-is-presumed/
- Meningioma tracking for 6 years: Good visit with neurologist https://connect.mayoclinic.org/discussion/visit-to-my-neurologist-for-meningioma/

It's understandable that this is on your mind. I think your concern about changes to health in the future need to be considered. Those are questions you can prepare for your upcoming second opinion appointment, such as:

- What changes would indicate it is time for treatment? What treatment options would be considered?
- What are the risks and benefits of treatment now vs later?
- As I age and/or if other health issues arise, will my treatment options be limited?

What questions would you add?