The Morning Journal (Lorain, OH)
Are new symptoms from return of previous tumor or dementia for 100-year-old woman?
DEAR DR. ROACH »
My mother was diagnosed with right frontal lobe meningioma 17 years ago when she was 83 years old. Surgery was successful in that most of it was removed and it was found to be nonmalignant. The doctor told us he couldn’t remove it completely, and that it was a very slow-growing type of tumor and wouldn’t return for about 20 years. Mom is now 100 and doing pretty well in general. She lives at home with family caregivers. We notice normal signs of aging ... confusion, forgetfulness, some lack of concentration and not much interest in TV or reading anymore. While those behaviors are common signs of dementia for someone her age, sometimes her behavior reminds us of the time shortly before she was diagnosed with the tumor back in 2004. Should we have an MRI of her brain done? If we find that the tumor has grown back and is putting pressure on areas of her brain, what would you suggest? What will happen if we do nothing?
— J.A.L.
DEAR READER » A meningioma is the most common and (usually) benign tumor of the brain. Specifically, it’s a tumor of the meninges, the lining of the brain. These tumors cause problems by taking up space in the skull and compressing the brain.
It is impossible to say without imaging whether her symptoms are due to the meningioma returning, or due to some other process, such as Alzheimer’s or other dementia.
If you choose to get imaging, and the tumor has regrown to the point where it seems likely it could be causing symptoms, there are other choices besides surgery.
Radiation therapy, including very precisely guided radiation, can be effective at relieving symptoms without performing surgery. Without treatment, symptoms will likely slowly progress.
The choice is yours, but I would tend to recommend getting the CT or MRI, so you at least know what you are dealing with. If it isn’t the meningioma, she might benefit looking for other causes, such as medications, or from medication therapy for dementia.