Intracranial meningiomas: an update of the 2021 World Health Organization classifications and review of management with a focus on radiation therapy

Meningiomas account for approximately one third of all primary intracranial tumors. Arising from the cells arachnoid mater, these neoplasms are found along meningeal surfaces within calvarium and spinal canal. Many discovered incidentally, most idiopathic, although risk factors associated with meningioma development include age, sex, prior radiation exposure, familial genetic diseases. The World Health Organization grading system is based on histologic criteria, as follows: grade 1 meningiomas, a benign subtype; 2 which intermediately aggressive behavior usually manifest atypia; 3, demonstrate malignant behavior. Management heavily dependent tumor location, grade, symptomatology. While many imaging-defined low appearing meningiomas suitable observation serial imaging, others require management surgery adjuvant radiotherapy. For patients needing intervention, optimal definitive approach therapy guided by extent resection, location in addition to patient specific such life expectancy. lesions, can also be used monotherapy form stereotactic radiosurgery or standard fractionated depending size, anatomic proximity dose-limiting organs at risk. Optimal paramount because generally long life-expectancy morbidity that arise growth recurrence well itself.