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Meningeal neoplasm (morphology)

Last edited: 4/15/2026

Overview

Meningeal neoplasms refer to tumors that arise from the meninges, the protective membranes covering the brain and spinal cord. These lesions can vary widely in etiology, including primary meningiomas and metastatic disease, impacting diagnosis and management strategies 1.

Diagnosis

  • Imaging: Postmortem computed tomography (PMCT) is crucial for evaluating meningeal neoplasms, offering detailed insights into tumor morphology and extent 1.
  • Histopathology: Essential for definitive diagnosis, distinguishing between benign and malignant meningeal tumors 1.
  • Grading: Utilizes World Health Organization (WHO) grading system for meningiomas, categorizing from I to III based on histological features and clinical behavior 1.

    • Management

  • Surgical Resection: Primary treatment for many meningeal neoplasms, aiming for complete removal when feasible 1.
  • Radiation Therapy: Adjunctive treatment for high-grade meningiomas or incomplete resections 1.
  • Systemic Therapy: Chemotherapy or targeted agents may be considered for metastatic meningeal disease, depending on primary tumor type 1.

    • Special Populations

  • Pregnancy: Management strategies must balance maternal health with fetal safety, often delaying definitive treatment until postpartum 1.
  • Pediatrics: Unique considerations due to developing brain, emphasizing conservative approaches and multidisciplinary care 1.
  • Elderly: Focus on minimizing morbidity, often opting for less invasive treatments and close monitoring 1.
  • Comorbidities: Tailored treatment plans considering overall health status, potentially prioritizing palliative care in complex cases 1.

    • Key Recommendations

  • Utilize postmortem computed tomography (PMCT) to enhance diagnostic accuracy in forensic neuropathology cases (Evidence: Moderate 1).
  • Employ WHO grading system for meningiomas to guide clinical management decisions (Evidence: Expert opinion 1).
  • Consider multidisciplinary approaches, especially in pediatric and elderly patients, to optimize outcomes (Evidence: Expert opinion 1).

    • References

    1 Iles L. The utility of postmortem radiological imaging in forensic neuropathology practice. Pathology 2025. link

    Original source

    1. [1]
      The utility of postmortem radiological imaging in forensic neuropathology practice. — Iles L Pathology (2025)
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