Management of Atypical and Anaplastic Meningiomas

Meningiomas are the most prevalent primary tumor of central nervous system origin, and although most of these neoplasms are benign, a small proportion exemplifies an aggressive profile characterized by high recurrence rates, pleomorphic histology, and overall resistance to standard treatment. Standard initial therapy for malignant meningiomas includes maximal safe surgical resection followed by focal radiation. The role for chemotherapy during recurrence of these aggressive meningiomas is less clear. Prognosis is poor, and recurrence of malignant meningiomas is high. This article provides an overview of atypical and anaplastic "malignant" meningiomas, their treatment, and ongoing research looking for more effective treatments.