Current RMA Instruments:
| Reasonable Hypothesis SOP | 3 of 2018 |
| Balance of Probabilities SOP | 4 of 2018 |
Changes from previous Instruments
ICD Coding
- ICD-9-CM Codes: 192.1
- ICD-10-AM Codes: C70.0, C70.9
Brief description
This SOP covers malignant meningiomas arising in the lining of the brain. It does not cover benign cerebral meningiomas, which are much more common and which are covered by a separate SOP.
Confirming the diagnosis
The diagnosis may be suspected based on imaging findings (CT or MRI of the brain), but definitive diagnosis requires histology.
The relevant medical specialist is a neurosurgeon or oncologist.
Additional diagnoses covered by SOP
- Anaplastic meningioma
- Malignant meningioma
- Papillary meningioma
- Rhabdoid meningioma
- Any WHO grade III meningioma
Conditions excluded from SOP
- Atypical meningioma (WHO grade II)* - meningioma SOP
- Benign meningioma*
- Intermediate grade meningioma (WHO grade II)* - meningioma SOP
- Malignant meningioma arising in the spinal cord meninges#
- Carcinoid tumour of the meninges#
- Hodgkin’s lymphoma of the meninges*
- Non-Hodgkin’s lymphoma of the meninges*
- Soft tissue sarcoma of the meninges*
- Primary malignant melanoma of the cerebral meninges#
* another SOP applies
# non-SOP condition
Clinical onset
The condition tends to be asymptomatic or minimally symptomatic and be found incidentally on imaging (or at autopsy). Clinical features may include seizures and focal defects related to the tumour location.
Clinical worsening
The condition rarely metastasises to other sites but local recurrence occurs in the majority of cases and overall 5 year survival is less than 50%. Evidence of clinical worsening beyond the normal course of the disease is required for a clinical worsening factor to apply.
World Health Organisation 2016 Classification of Meningiomas
WHO Grade 1 (covered by meningioma SOP)
- Meningiothelial meningioma
- Fibrous (fibroblastic) meningioma
- Transitional (mixed) meningioma
- Psammomatous meningioma
- Angiomatous meningioma
- Microcystic meningioma
- Secretory meningioma
- Lymphoplasmacyte-rich meningioma
- Metaplastic meningioma
WHO Grade 2 (covered by meningioma SOP)
- Chordoid meningioma
- Clear cell meningioma
- Atypical meningioma
WHO Grade 3 (covered by MN cerebral meninges SOP)
- Papillary meningioma
- Rhabdoid meningioma
- Anaplastic meningioma