Meningioma and skull base tumors
Treatment options in Shanghai

Some small, slow-growing meningiomas without symptoms can be followed with imaging and clinical review. This does not mean every small skull base lesion can safely wait. Proximity to sensitive structures, documented growth, symptoms and overall health influence the recommendation. Ask for the imaging schedule, the functional tests to repeat and the findings that would trigger treatment discussion. The plan should identify who will compare scans and how you will report new symptoms between visits. If tissue has never been obtained, the report should preserve the distinction between a presumed meningioma and a histologically established grade.

Surgery may be considered for a growing or symptomatic tumor, but complete removal is not always the safest goal when critical nerves or vessels are closely involved. A planned residual portion may lead to surveillance or a radiation discussion, depending on pathology and other findings. Ask what the surgeon aims to remove, what may deliberately remain and why. Discuss bleeding, infection and location-specific neurological risks, including possible visual or other functional loss. An endoscopic or smaller-opening approach is suitable only for selected anatomy; the name of the approach does not guarantee a lower risk in your case.

Focused radiation may be considered when surgery is unsuitable or for residual tumor in selected circumstances. A single-session radiosurgery plan and a fractionated course are different options, with suitability affected by tumor size and proximity to sensitive structures such as the optic pathway. Radiation aims to control tumor growth; it is not equivalent to physically removing a mass or obtaining tissue for diagnosis. Ask how the team balances control with the risk of injury to nearby structures, how response will be assessed and whether continued observation is a reasonable alternative. Follow-up remains necessary after treatment.