A petroclival meningioma is a type of brain tumor located near the skull base, in an area known as the petroclival junction. Such tumors are challenging to treat, as they are located deep inside the brain and may be difficult to access surgically. Treatment is usually supervised by an oncologist, working with a neurosurgeon to determine whether the tumor is operable and to develop an appropriate approach to treatment. The prognosis is variable, depending on the size of the tumor, when it is identified, and the precise position.
Meningiomas are relatively common brain tumors. Many are benign, although they can cause symptoms as they grow larger by increasing the pressure on the brain. Patients may develop headaches, nausea, and vomiting. In the case of the petroclival meningioma, the tumor is close to a number of very important structures, including the trigeminal nerve, responsible for facial sensation. The patient may develop abnormal sensation in and around the face as the tumor grows.
Patients who develop neurological symptoms like those seen in a petroclival meningioma usually end up in the care of a neurologist, who can identify the cancer with imaging studies like MRI scans of the brain. Several sets of scans may be recommended to get as complete a picture as possible without having to enter the skull. The doctor can pinpoint the location of the tumor in relation to other structures in the brain to learn more about the patient's prognosis and the treatment options.
The petroclival junction is located almost in the middle of the skull. In surgery, this area is difficult to approach without injuring neighboring tissue, including delicate veins and nerves supplying various regions of the brain. Historically, these tumors were often regarded as inoperable. Improvements in surgical technique and the development of technology like gamma ray surgery, where surgeons use carefully directed radiation to destroy a tumor, have improved outcomes for patients with petroclival meningioma.
In cases where the tumor can be reached surgically, a surgeon can remove as much of the growth as possible, and may recommend chemotherapy and radiation to kill remaining cancer cells. Inoperable tumors may still respond to treatment. Each case is different, and examination of medical imaging studies, along with a review of the patient's history can be used to provide guidance for a treatment plan; in an older patient in poor health, for example, treatment might be focused on maintaining patient comfort rather than taking measures to try and save the patient.
