Management of Petroclival Meningiomas: A Review of the Development of Current Therapy

Abstract

The surgical management of petroclival meningioma remains challenging, due to the difficulty of accessing the region and the vital structures adjacent to the origin of these tumors. Petroclival meningiomas were originally considered largely unresectable. Until the 1970s, resection carried a 50% mortality rate, with very high rates of operative morbidity if attempted. However, in the past 40 years, advances in neuroimaging and approaches to the region were refined, and results from resection of petroclival meningiomas have become more acceptable. Today, the developments of a multitude of surgical approaches as well as innovations in neuroimaging and stereotactic radiotherapy have proved powerful options for multimodality management of these challenging tumors.

Keywords

petroclival - meningioma - resection - radiosurgery - review

• References

• 1 Couldwell WT, Fukushima T, Giannotta SL, Weiss MH. Petroclival meningiomas: surgical experience in 109 cases. J Neurosurg 1996; 84 (1) 20-28
• 2 Al-Mefty O. Operative Atlas of Meningiomas. Philadelphia, PA: Lippincott-Raven; 1998
• 3 Bricolo AP, Turazzi S, Talacchi A, Cristofori L. Microsurgical removal of petroclival meningiomas: a report of 33 patients. Neurosurgery 1992; 31 (5) 813-828 ; discussion 828
• 4 Yaşargil MG, Mortara RW, Curcic M. Meningiomas of basal posterior cranial fossa. . In: Krayenbühl H, Brihaye J, Loew F, , et al., eds. Advances and Technical Standards in Neurosurgery. . Vol 7. Vienna, Austria: Springer; 1980: 3-115
• 5 Castellano F, Ruggiero G. Meningiomas of the posterior fossa. Acta Radiol Suppl 1953; 104: 1-177
• 6 Sekhar LN, Schramm VL , eds. Tumors of the Cranial Base: Diagnosis and Treatment. Mount Kisco, NY: Futura; 1987
• 7 Kawase T, Shiobara R, Ohira T, Toya S. Developmental patterns and characteristic symptoms of petroclival meningiomas. Neurol Med Chir (Tokyo) 1996; 36 (1) 1-6
• 8 McElveen Jr JT, Dorfman BE, Fukushima T. Petroclival tumors: a synthesis. Otolaryngol Clin North Am 2001; 34 (6) 1219-1230 , x
• 9 Van Havenbergh T, Carvalho G, Tatagiba M, Plets C, Samii M. Natural history of petroclival meningiomas. Neurosurgery 2003; 52 (1) 55-62 ; discussion 62–64
• 10 Cherington M, Schneck SA. Clivus meningiomas. Neurology 1966; 16 (1) 86-92
• 11 Cushing HE, Eisenhardt L. Meningiomas: Their Classification, Regional Behaviour, Life History, and Surgical End Results. New York, NY: Hafner; 1962
• 12 Olivecrona HT. W. Handbuch der neurochirurgie. . Vol 4. Berlin, Germany: Springer; 1967
• 13 Hallopeau H. Note sur deux faits de tumeur de mésocéphale. Gaz Med Paris 1874; 3: 111-112
• 14 Campbell E, Whitfield RD. Posterior fossa meningiomas. J Neurosurg 1948; 5 (2) 131-153
• 15 Samii M, Ammirati M, Mahran A, Bini W, Sepehrnia A. Surgery of petroclival meningiomas: report of 24 cases. Neurosurgery 1989; 24 (1) 12-17
• 16 Russell JR, Bucy PC. Meningiomas of the posterior fossa. Surg Gynecol Obstet 1953; 96 (2) 183-192
• 17 Markham JW, Fager CA, Horrax G, Poppen JL. Meningiomas of the posterior fossa; their diagnosis, clinical features, and surgical treatment. AMA Arch Neurol Psychiatry 1955; 74 (2) 163-170
• 18 Hakuba A, Nishimura S, Tanaka K, Kishi H, Nakamura T. Clivus meningioma: six cases of total removal. Neurol Med Chir (Tokyo) 1977; 17 (1 Pt 1) 63-77
• 19 Mayberg MR, Symon L. Meningiomas of the clivus and apical petrous bone. Report of 35 cases. J Neurosurg 1986; 65 (2) 160-167
• 20 Wara WM, Sheline GE, Newman H, Townsend JJ, Boldrey EB. Radiation therapy of meningiomas. Am J Roentgenol Radium Ther Nucl Med 1975; 123 (3) 453-458
• 21 Petty AM, Kun LE, Meyer GA. Radiation therapy for incompletely resected meningiomas. J Neurosurg 1985; 62 (4) 502-507
• 22 Broders AC. Squamous-cell epithelioma of the lip a study of five hundred and thirty-seven cases. J Am Med Assoc 1920; 74 (10) 656-664
• 23 Sekhar LN, Wright DC, Richardson R, Monacci W. Petroclival and foramen magnum meningiomas: surgical approaches and pitfalls. J Neurooncol 1996; 29 (3) 249-259
• 24 Decker RE, Malis LI. Surgical approaches to midline lesions at the base of the skull: a review. [in French]. Mt Sinai J Med 1970; 37 (2) 84-102
• 25 Derome P. The transbasal approach to tumors invading the base of the skull. . In: Schmidek HH, Sweet WS, , eds. Current Techniques in Operative Neurosurgery. New York, NY: Grune & Stratton; 1977: 223-245
• 26 Derome P. The trans-bucco-pharyngeal approach and tumoral pathology of the clivus. [in French]. Neurochirurgie 1977; 23 (4) 298-306
• 27 Derome P, Caron JP, Hurth M. Indications of the trans-bucco-pharyngeal approach and malformations of the cranio-vertebral joint. [in French]. Neurochirurgie 1977; 23 (4) 282-285
• 28 King DL, Chang CH, Pool JL. Radiotherapy in the management of meningiomas. Acta Radiol Ther Phys Biol 1966; 5: 26-33
• 29 Al-Mefty O, Fox JL, Smith RR. Petrosal approach for petroclival meningiomas. Neurosurgery 1988; 22 (3) 510-517
• 30 Nishimura S, Hakuba A, Jang BJ, Inoue Y. Clivus and apicopetroclivus meningiomas—report of 24 cases. Neurol Med Chir (Tokyo) 1989; 29 (11) 1004-1011
• 31 Samii M, Tatagiba M. Experience with 36 surgical cases of petroclival meningiomas. Acta Neurochir (Wien) 1992; 118 (1-2) 27-32
• 32 Tatagiba M, Samii M, Matthies C, Vorkapic P. Management of petroclival meningiomas: a critical analysis of surgical treatment. Acta Neurochir Suppl (Wien) 1996; 65: 92-94
• 33 Erkmen K, Pravdenkova S, Al-Mefty O. Surgical management of petroclival meningiomas: factors determining the choice of approach. Neurosurg Focus 2005; 19 (2) E7
• 34 Lang Jr J, Samii A. Retrosigmoidal approach to the posterior cranial fossa. An anatomical study. Acta Neurochir (Wien) 1991; 111 (3-4) 147-153
• 35 Samii M, Gerganov VM. Petroclival meningiomas: quo vadis?. World Neurosurg 2011; 75 (3-4) 424
• 36 Chanda A, Nanda A. Retrosigmoid intradural suprameatal approach: advantages and disadvantages from an anatomical perspective. Neurosurgery 2006; 59 (1) (Suppl. 01) ONS1 –ONS6; discussion ONS1–ONS6
• 37 Samii M, Tatagiba M, Carvalho GA. Retrosigmoid intradural suprameatal approach to Meckel's cave and the middle fossa: surgical technique and outcome. J Neurosurg 2000; 92 (2) 235-241
• 38 Samii M, Gerganov V, Giordano M, Samii A. Two step approach for surgical removal of petroclival meningiomas with large supratentorial extension. Neurosurg Rev 2010; 34 (2) 173-179
• 39 Sekhar LN, Jannetta PJ, Burkhart LE, Janosky JE. Meningiomas involving the clivus: a six-year experience with 41 patients. Neurosurgery 1990; 27 (5) 764-781 ; discussion 781
• 40 Hirsch BE, Cass SP, Sekhar LN, Wright DC. Translabyrinthine approach to skull base tumors with hearing preservation. Am J Otol 1993; 14 (6) 533-543
• 41 Cantore G, Delfini R, Ciappetta P. Surgical treatment of petroclival meningiomas: experience with 16 cases. Surg Neurol 1994; 42 (2) 105-111
• 42 Abdel Aziz KM, Sanan A, van Loveren HR et al. Petroclival meningiomas: predictive parameters for transpetrosal approaches. Neurosurgery 2000; 47: 139-150 ; discussion 150-132
• 43 Safavi-Abbasi S, Zabramski JM, Deshmukh P , et al. Moving toward the petroclival region: a model for quantitative and anatomical analysis of tumor shift. J Neurosurg 2007; 107 (4) 797-804
• 44 Siwanuwatn R, Deshmukh P, Figueiredo EG, Crawford NR, Spetzler RF, Preul MC. Quantitative analysis of the working area and angle of attack for the retrosigmoid, combined petrosal, and transcochlear approaches to the petroclival region. J Neurosurg 2006; 104 (1) 137-142
• 45 Horgan MA, Anderson GJ, Kellogg JX , et al. Classification and quantification of the petrosal approach to the petroclival region. J Neurosurg 2000; 93 (1) 108-112
• 46 Horgan MA, Delashaw JB, Schwartz MS, Kellogg JX, Spektor S, McMenomey SO. Transcrusal approach to the petroclival region with hearing preservation. Technical note and illustrative cases. J Neurosurg 2001; 94 (4) 660-666
• 47 Dyke CG. Roentgen Treatment of Diseases of the Nervous System. Philadelphia, PA: Lea & Febiger; 1942
• 48 Pack GT, Ariel IM. Treatment of Cancer and Allied Diseases. . Vol 4. New York, NY: Hoeber; 1960
• 49 Simpson D. The recurrence of intracranial meningiomas after surgical treatment. J Neurol Neurosurg Psychiatry 1957; 20 (1) 22-39
• 50 McWhirter R, Pennybacker J , et al. Radiation treatment of cerebral tumours. Proc R Soc Med 1946; 39: 673-680
• 51 Luk KH, Caderao J, Leavens ME. Radiotherapy for treatment of meningioma and meningiosarcoma. Cancer Bull 1979; 31: 220-225
• 52 Yamashita J, Handa H, Iwaki K, Abe M. Recurrence of intracranial meningiomas, with special reference to radiotherapy. Surg Neurol 1980; 14 (1) 33-40
• 53 Friedman M. Irradiation of meningioma: a prototype circumscribed tumor for planning high-dose irradiation of the brain. Int J Radiat Oncol Biol Phys 1977; 2 (9–10) 949-958
• 54 Subach BR, Lunsford LD, Kondziolka D, Maitz AH, Flickinger JC. Management of petroclival meningiomas by stereotactic radiosurgery. Neurosurgery 1998; 42 (3) 437-443 ; discussion 443–445
• 55 Iwai Y, Yamanaka K, Yasui T , et al. Gamma knife surgery for skull base meningiomas. The effectiveness of low-dose treatment. Surg Neurol 1999; 52 (1) 40-44 ; discussion 44–45
• 56 Roche PH, Pellet W, Fuentes S, Thomassin JM, Régis J. Gamma knife radiosurgical management of petroclival meningiomas results and indications. Acta Neurochir (Wien) 2003; 145 (10) 883-888 ; discussion 888
• 57 Stippler M, Kondziolka D. Skull base meningiomas: is there a place for microsurgery?. Acta Neurochir (Wien) 2006; 148 (1) 1-3
• 58 Couldwell WT, Cole CD, Al-Mefty O. Patterns of skull base meningioma progression after failed radiosurgery. J Neurosurg 2007; 106 (1) 30-35
• 59 Noël G, Bollet MA, Calugaru V , et al. Functional outcome of patients with benign meningioma treated by 3D conformal irradiation with a combination of photons and protons. Int J Radiat Oncol Biol Phys 2005; 62 (5) 1412-1422
• 60 Goldsmith B, McDermott MW. Meningioma. Neurosurg Clin N Am 2006; 17 (2) 111-120 , vi
• 61 Rowe J, Grainger A, Walton L, Silcocks P, Radatz M, Kemeny A. Risk of malignancy after gamma knife stereotactic radiosurgery. Neurosurgery 2007; 60 (1) 60-65 ; discussion 65–66
• 62 Kleinschmidt-Demasters BK, Kang JS, Lillehei KO. The burden of radiation-induced central nervous system tumors: a single institution s experience. J Neuropathol Exp Neurol 2006; 65 (3) 204-216
• 63 Kranzinger M, Jones N, Rittinger O , et al. Malignant glioma as a secondary malignant neoplasm after radiation therapy for craniopharyngioma: report of a case and review of reported cases. Onkologie 2001; 24 (1) 66-72
• 64 Salvati M, Frati A, Russo N , et al. Radiation-induced gliomas: report of 10 cases and review of the literature. Surg Neurol 2003; 60 (1) 60-67 ; discussion 67
• 65 Shamisa A, Bance M, Nag S , et al. Glioblastoma multiforme occurring in a patient treated with gamma knife surgery. Case report and review of the literature. J Neurosurg 2001; 94 (5) 816-821
• 66 Sheehan J, Yen CP, Steiner L. Gamma knife surgery-induced meningioma. Report of two cases and review of the literature. J Neurosurg 2006; 105 (2) 325-329
• 67 Yu JS, Yong WH, Wilson D, Black KL. Glioblastoma induction after radiosurgery for meningioma. Lancet 2000; 356 (9241) 1576-1577
• 68 Park CK, Jung HW, Kim JE, Paek SH, Kim DG. The selection of the optimal therapeutic strategy for petroclival meningiomas. Surg Neurol 2006; 66 (2) 160-165 ; discussion 165–166
• 69 Starke RM, Williams BJ, Hiles C, Nguyen JH, Elsharkawy MY, Sheehan JP. Gamma knife surgery for skull base meningiomas. J Neurosurg 2012; 116 (3) 588-597
• 70 Zentner J, Meyer B, Vieweg U, Herberhold C, Schramm J. Petroclival meningiomas: is radical resection always the best option?. J Neurol Neurosurg Psychiatry 1997; 62 (4) 341-345
• 71 Jung HW, Yoo H, Paek SH, Choi KS. Long-term outcome and growth rate of subtotally resected petroclival meningiomas: experience with 38 cases. Neurosurgery 2000; 46 (3) 567-574 ; discussion 574–575
• 72 Kreil W, Luggin J, Fuchs I, Weigl V, Eustacchio S, Papaefthymiou G. Long term experience of gamma knife radiosurgery for benign skull base meningiomas. J Neurol Neurosurg Psychiatry 2005; 76 (10) 1425-1430
• 73 Flannery TJ, Kano H, Lunsford LD , et al. Long-term control of petroclival meningiomas through radiosurgery. J Neurosurg 2010; 112 (5) 957-964
• 74 Little KM, Friedman AH, Sampson JH, Wanibuchi M, Fukushima T. Surgical management of petroclival meningiomas: defining resection goals based on risk of neurological morbidity and tumor recurrence rates in 137 patients. Neurosurgery 2005; 56 (3) 546-559 ; discussion 546–559
• 75 Zhu W, Mao Y, Zhou LF, Zhang R, Chen L. Combined subtemporal and retrosigmoid keyhole approach for extensive petroclival meningiomas surgery: report of experience with 7 cases. Minim Invasive Neurosurg 2008; 51 (2) 95-99
• 76 Natarajan SK, Sekhar LN, Schessel D, Morita A. Petroclival meningiomas: multimodality treatment and outcomes at long-term follow-up. Neurosurgery 2007; 60 (6) 965-979 ; discussion 979–981
• 77 Bambakidis NC, Kakarla UK, Kim LJ , et al. Evolution of surgical approaches in the treatment of petroclival meningiomas: a retrospective review. Neurosurgery 2008; 62 (6) (Suppl. 03) 1182-1191
• 78 Diluna ML, Bulsara KR. Surgery for petroclival meningiomas: a comprehensive review of outcomes in the skull base surgery era. Skull Base 2010; 20 (5) 337-342
• 79 Nanda A, Javalkar V, Banerjee AD. Petroclival meningiomas: study on outcomes, complications and recurrence rates. J Neurosurg 2011; 114 (5) 1268-1277
• 80 Seifert V. Clinical management of petroclival meningiomas and the eternal quest for preservation of quality of life: personal experiences over a period of 20 years. Acta Neurochir (Wien) 2010; 152 (7) 1099-1116
• 81 Yamakami I, Higuchi Y, Horiguchi K, Saeki N. Treatment policy for petroclival meningioma based on tumor size: aiming radical removal in small tumors for obtaining cure without morbidity. Neurosurg Rev 2011; 34 (3) 327-334 ; discussion 334–335
• 82 Yang J, Fang T, Ma S , et al. Large and giant petroclival meningiomas: therapeutic strategy and the choice of microsurgical approaches—report of the experience with 41 cases. Br J Neurosurg 2011; 25 (1) 78-85