Meningiomas, the most prevalent primary brain tumors in adults, exhibit a complex interplay of genetic and molecular factors influencing their pathophysiology. Recent studies have focused on the molecular alterations associated with meningiomas, including the identification of somatic mutations and germline mutations that predispose individuals to these tumors. For instance, a study developed mouse models harboring mutations found in human meningiomas, confirming the role of specific genetic alterations in tumorigenesis (ref: Peyre doi.org/10.1056/NEJMoa2100440/). Another significant contribution is the proposal of a molecularly integrated grading system that aims to enhance the predictive power of clinical behavior beyond the traditional World Health Organization grading, which often fails to accurately reflect tumor aggressiveness (ref: Driver doi.org/10.1093/neuonc/). Furthermore, research into meningoangiomatosis, a rare condition linked to epilepsy, has revealed critical insights into the molecular landscape of these lesions, highlighting the need for comprehensive genetic profiling in clinical practice (ref: Dono doi.org/10.1093/jnen/). The exploration of germline BAP1 mutations in families with multi-generational meningiomas underscores the hereditary aspects of these tumors, particularly in aggressive rhabdoid variants (ref: Prasad doi.org/10.3389/fonc.2021.721712/). Lastly, innovative imaging techniques such as somatostatin receptor PET have been employed to assess tumor progression and receptor expression, providing valuable information for treatment planning (ref: Treglia doi.org/10.3390/diagnostics11091669/).

The management of meningiomas has evolved significantly, with recent studies emphasizing the role of stereotactic radiosurgery (SRS) and preoperative embolization in improving clinical outcomes. An international multicenter study demonstrated that SRS is a safe treatment option for meningiomas in direct contact with the optic apparatus, with a visual decline observed in only 9.6% of patients, indicating its efficacy in preserving vision while managing tumor growth (ref: Asuzu doi.org/10.3171/2021.3.JNS21328/). Additionally, the assessment of frailty as a preoperative risk factor has gained traction, revealing that frailty may provide a more accurate prognostic tool than age alone in predicting postoperative morbidity and mortality (ref: Dicpinigaitis doi.org/10.1007/s11060-021-03841-4/). A comparative analysis of surgical outcomes in elderly versus younger patients found that while total tumor resection rates were higher in the elderly cohort, they also faced increased postoperative complications, highlighting the need for tailored surgical approaches (ref: Ahmeti doi.org/10.1007/s11060-021-03832-5/). Furthermore, a preliminary study on the use of diffusion-weighted MRI to predict treatment response in meningiomas treated with proton therapy showed promising results, suggesting that early imaging changes could guide clinical decisions (ref: Feraco doi.org/10.3390/diagnostics11091684/). Lastly, preoperative embolization was shown to significantly reduce perioperative blood loss, enhancing the safety profile of surgical interventions (ref: Al-Mufti doi.org/10.1080/02688697.2021.1979191/).

Surgical techniques for meningioma resection have been refined to enhance safety and efficacy, with recent studies comparing various approaches. A comparative analysis of the combined petrosal and pretemporal transcavernous anterior petrosal approach revealed that the former allows for greater exposure of critical neurovascular structures, which may facilitate more complete tumor resection (ref: Labib doi.org/10.3171/2020.12.JNS202740/). Additionally, a multicenter study focused on transcranial motor-evoked potential (Tc-MEP) monitoring during surgery for intradural extramedullary tumors provided insights into the neurophysiological changes associated with different tumor locations, emphasizing the importance of intraoperative monitoring to prevent neurological deficits (ref: Kobayashi doi.org/10.1097/BRS.0000000000004112/). The minimally invasive posterolateral transcavernous-transtentorial approach has also shown promising outcomes in treating complex sphenopetroclival meningiomas, with a high rate of independence among patients at follow-up (ref: Martínez-Pérez doi.org/10.1016/j.wneu.2021.08.108/). These advancements underscore the ongoing evolution of surgical techniques aimed at maximizing tumor removal while minimizing complications.

Radiological assessment plays a crucial role in the diagnosis and management of meningiomas, with recent advancements in imaging techniques enhancing diagnostic accuracy. A multicenter study demonstrated that radiomics features derived from brain MRI can effectively predict invasive meningioma, providing valuable insights for treatment planning (ref: Xiao doi.org/10.3389/fonc.2021.708040/). The development of advanced segmentation techniques, such as the Dual Attention U-Net, has improved the accuracy of meningioma detection and characterization on MRI, particularly for smaller tumors (ref: Bouget doi.org/10.3389/fradi.2021.711514/). Furthermore, the application of volumetric analysis from T2-weighted MRI has shown high accuracy in detecting changes in tumor volume, which is critical for monitoring tumor progression and treatment response (ref: Raban doi.org/10.1111/jon.12926/). These innovations in imaging not only enhance diagnostic capabilities but also facilitate personalized treatment strategies by providing detailed insights into tumor behavior and response to therapy.

The epidemiology of meningiomas is characterized by various risk factors that influence their incidence and clinical outcomes. Recent studies have highlighted the significance of peripapillary retinal nerve fiber layer (RNFL) atrophy in differentiating between glaucoma and meningioma-related optic nerve sheath meningioma, indicating that RNFL thickness can serve as a potential biomarker for early diagnosis (ref: Tonagel doi.org/10.1007/s00417-021-05354-2/). Additionally, the role of somatostatin receptor imaging has been explored in assessing meningioma progression, providing insights into the biological behavior of these tumors (ref: Treglia doi.org/10.3390/diagnostics11091669/). The integration of these findings into clinical practice could enhance early detection and management strategies for patients at risk of developing meningiomas. Furthermore, the identification of molecular alterations and genetic predispositions continues to shape our understanding of meningioma pathogenesis, emphasizing the need for ongoing research into the hereditary aspects of these tumors (ref: Prasad doi.org/10.3389/fonc.2021.721712/).

Quality of life (QoL) assessments are increasingly recognized as vital components of meningioma management, with recent studies focusing on the correlation between QoL and various clinical factors. The translation and validation of the Urdu version of the EORTC QLQ-C30 and QLQ-BN20 questionnaires among primary brain tumor patients in Pakistan demonstrated high reliability and relevance, underscoring the importance of culturally adapted tools in evaluating patient outcomes (ref: Zahid doi.org/10.1186/s41687-021-00354-6/). Additionally, the integration of molecular grading systems into clinical practice aims to improve prognostication and treatment planning, as traditional grading often fails to predict clinical behavior accurately (ref: Driver doi.org/10.1093/neuonc/). Furthermore, studies investigating treatment response through imaging techniques, such as diffusion-weighted MRI, highlight the potential for early identification of therapeutic efficacy, which is crucial for optimizing patient management (ref: Feraco doi.org/10.3390/diagnostics11091684/). These findings collectively emphasize the need for a holistic approach to meningioma care, integrating clinical, molecular, and QoL considerations to enhance patient outcomes.