Meningiomas, the most prevalent primary intracranial tumors in adults, exhibit varying prognoses based on treatment strategies and molecular profiles. A study on postoperative radiotherapy in patients with subtotally resected recurrent WHO grade 1 meningiomas revealed that those with intermediate/high-risk molecular profiles had significantly worse progression-free survival (PFS) rates, with only 40% PFS after subtotal resection (ref: Deng doi.org/10.1093/neuonc/). Additionally, the management of spheno-orbital meningiomas (SOMs) highlighted the importance of postoperative tumor volume in predicting recurrence, where a volume greater than 3.7 mm3 was associated with a 1.342-fold increased risk of recurrence (ref: Porto doi.org/10.3171/2025.1.JNS241846/). In thoracic spinal meningiomas, factors such as age at diagnosis and tumor dimensions were significant predictors of recovery in motor scores post-surgery, emphasizing the need for tailored surgical approaches (ref: Feng doi.org/10.3171/2025.2.FOCUS24955/). Furthermore, innovative surgical techniques, such as a dura-splitting strategy, demonstrated improved outcomes in pain reduction and lower complication rates compared to traditional methods (ref: Wang doi.org/10.3171/2025.2.FOCUS24659/). Overall, these studies underscore the complexity of meningioma treatment, where molecular profiling and surgical techniques play critical roles in patient outcomes.

Recent research has significantly advanced the understanding of the genetic landscape of meningiomas, revealing novel germline and somatic variants associated with both familial and sporadic cases. A study utilizing exome sequencing identified nine potential novel meningioma genes, expanding the genetic framework beyond the well-known NF2 mutations, which account for approximately 60% of cases (ref: Bencheikh doi.org/10.1038/s41525-025-00494-4/). However, the utility of merlin immunohistochemistry as a predictive marker for NF2 mutations was challenged, indicating that it may not reliably predict genetic alterations in meningiomas (ref: Tollefsen doi.org/10.1093/jnen/). Additionally, the aggressive nature of radiation-induced meningiomas (RIM) was highlighted, with studies indicating a distinct genetic signature that may contribute to their more aggressive clinical course compared to sporadic meningiomas (ref: Kim doi.org/10.3346/jkms.2025.40.e62/). Furthermore, a Mendelian randomization analysis identified 12 genes significantly associated with meningioma risk, paving the way for potential biomarkers and therapeutic targets (ref: Du doi.org/10.1016/j.jocn.2025.111348/). Collectively, these findings emphasize the need for continued exploration of the molecular underpinnings of meningiomas to enhance diagnostic and therapeutic strategies.

Advancements in imaging techniques have revolutionized the diagnosis and management of meningiomas, particularly through the integration of deep learning and radiomics. A study employing deep learning techniques on a dataset of 17,136 brain MRI images achieved high accuracy in brain tumor classification, underscoring the potential of artificial intelligence in enhancing diagnostic precision (ref: Wong doi.org/10.1371/journal.pone.0322624/). Additionally, systematic reviews and meta-analyses have demonstrated the efficacy of MRI radiomics in differentiating high-grade from low-grade meningiomas, providing a non-invasive method to assess tumor aggressiveness (ref: Xiao doi.org/10.1038/s41598-025-88315-7/). The development of an MRI-based deep transfer learning radiomics nomogram further exemplifies the integration of clinical and imaging data to predict meningioma grade, enhancing preoperative planning (ref: Li doi.org/10.1038/s41598-025-01665-0/). Moreover, innovative techniques such as laser interstitial thermal therapy (LITT) have emerged, with studies indicating that the proximity of perilesional heatsink structures significantly impacts treatment outcomes (ref: Berke doi.org/10.3171/2025.1.JNS241377/). These innovations highlight the critical role of advanced imaging in improving the management of meningiomas.

The characterization of meningiomas has been enhanced through the application of radiomics and machine learning, which have shown promise in differentiating tumor types and predicting outcomes. A study utilizing the XGBoost model demonstrated superior performance in classifying sellar region lesions based on contrast-enhanced MRI features, achieving a balanced accuracy of 0.83 (ref: Qu doi.org/10.1186/s12880-025-01690-5/). Additionally, the limitations of virtual contrast prediction in brain tumor imaging were explored, emphasizing the potential of deep learning models to reduce reliance on gadolinium-based contrast agents (ref: Caragliano doi.org/10.1002/nbm.70062/). The systematic review on MRI radiomics further confirmed its diagnostic value in distinguishing high-grade from low-grade meningiomas, reinforcing the need for robust imaging biomarkers in clinical practice (ref: Xiao doi.org/10.1038/s41598-025-88315-7/). Furthermore, the identification of delayed cerebrospinal fluid leaks as a late complication of endoscopic transnasal surgery in patients with aggressive tumors highlights the importance of understanding tumor characteristics in surgical planning (ref: Umekawa doi.org/10.1007/s10143-025-03591-1/). These findings collectively underscore the significance of tumor characteristics and biomarkers in guiding clinical decision-making.

The tumor microenvironment and immune response play crucial roles in the behavior and treatment response of meningiomas. Recent studies have highlighted the presence of tumor-associated macrophages (TAMs) in meningiomas, with findings indicating a higher quantity of M2 macrophages in skull-base tumors compared to non-skull base tumors, suggesting a potential immunosuppressive environment (ref: Meta doi.org/10.1371/journal.pone.0319960/). Additionally, the infiltration of TAMs was shown to differ across meningioma genotypes, influencing tumor dynamics and potentially affecting treatment outcomes (ref: Zhang doi.org/10.1186/s13046-025-03419-2/). The risk stratification of meningiomas using methylation profiles has also been proposed, with studies indicating that combining WHO grade with methylation class improves predictions of early recurrence risk (ref: Ruiz doi.org/10.1111/nan.70018/). Furthermore, the aggressive clinical course of radiation-induced meningiomas has been linked to unique genetic signatures, emphasizing the need for tailored therapeutic approaches in this subset of patients (ref: Kim doi.org/10.3346/jkms.2025.40.e62/). These insights into the tumor microenvironment and immune response underscore the complexity of meningioma biology and the potential for immunotherapeutic strategies.

Surgical techniques for meningioma resection have evolved, focusing on improving patient outcomes and minimizing complications. A multicenter cohort study on thoracic spinal meningiomas identified significant predictors of postoperative recovery, including tumor dimensions and age at diagnosis, which are critical for tailoring surgical approaches (ref: Feng doi.org/10.3171/2025.2.FOCUS24955/). The innovative dura-splitting strategy for spinal meningioma resection demonstrated superior pain reduction and lower rates of cerebrospinal fluid-related complications compared to traditional methods (ref: Wang doi.org/10.3171/2025.2.FOCUS24659/). Additionally, the long-term efficacy of peptide receptor radionuclide therapy (PRRT) in refractory meningioma patients showed a favorable safety profile, suggesting its potential as an adjunctive treatment option (ref: Zhang doi.org/10.1097/RLU.0000000000005845/). Furthermore, advancements in treatment planning software for stereotactic radiosurgery have improved the precision of gamma knife treatments for meningiomas, enhancing the overall management of these tumors (ref: Hamáčková doi.org/10.1159/000546214/). These developments in surgical techniques and approaches reflect a commitment to optimizing patient care in meningioma management.

The epidemiology of meningiomas has garnered attention, particularly concerning risk factors associated with their development. A disproportionality analysis of hormonal contraceptives revealed an increased risk of meningiomas associated with specific progestogens and estrogens, highlighting the need for awareness regarding the implications of hormonal therapies (ref: Frey doi.org/10.1016/j.jocn.2025.111328/). Additionally, a systematic review of stereotactic radiosurgery for tumor-related trigeminal neuralgia demonstrated varying outcomes based on the underlying etiology, with meningiomas presenting unique challenges (ref: Hajikarimloo doi.org/10.1186/s12883-025-04204-6/). Furthermore, a study on the epidemiology of brain tumors in the Philippines identified 766 cases over a four-year period, emphasizing the importance of establishing a national brain tumor registry to better understand the incidence and characteristics of these tumors in lower-middle-income countries (ref: Pascual doi.org/10.1016/j.jocn.2025.111305/). These findings underscore the significance of epidemiological research in informing clinical practice and public health strategies.

Clinical outcomes and quality of life for meningioma patients are critical areas of research, particularly in the context of treatment efficacy and patient well-being. A systematic review and meta-analysis on stereotactic radiosurgery for tumor-related trigeminal neuralgia revealed a pooled complete pain-free rate of 38%, with specific outcomes varying based on the underlying etiology, including meningiomas (ref: Hajikarimloo doi.org/10.1186/s12883-025-04204-6/). The long-term efficacy of peptide receptor radionuclide therapy (PRRT) in patients with refractory meningioma demonstrated a favorable safety profile and minimal side effects, suggesting its viability as a treatment option (ref: Zhang doi.org/10.1097/RLU.0000000000005845/). Additionally, outcomes from surgically treated thoracic spinal meningiomas indicated that factors such as tumor dimensions and age significantly influenced recovery in motor scores, emphasizing the importance of personalized surgical strategies (ref: Feng doi.org/10.3171/2025.2.FOCUS24955/). Moreover, innovative cranial reconstruction techniques using advanced imaging and 3D printing have shown promise in addressing the challenges posed by infiltrative meningiomas, potentially improving patient quality of life post-surgery (ref: Jacob doi.org/10.1227/ons.0000000000001596/). These studies collectively highlight the need for a comprehensive approach to assessing clinical outcomes and enhancing the quality of life for meningioma patients.