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Meningiomas are brain tumors that grow from the meninges. Fossa meningiomas grow in or around hollow areas between the bones of the skull and can affect various bodily functions. Surgical removal is the most effective remedy for symptomatic tumors.
Meningiomas, which make up about a third of cancers that originate in the brain, are so called because they grow from the meninges, the membranes that protect the brain and spinal cord. A fossa meningioma grows in or around a hollow area, or pit, between the bones of the skull. Most notable are the three cranial fossae at the base of the brain that house the lobes: the anterior fossa at the front; the middle fossa, also called the sides of the base; and the posterior fossa, on the underside of the brain in the back. A tumor may also occupy one of many minor fossae, hence a possible diagnosis of meningioma involving the jugular fossa, pituitary fossa, temporal or infratemporal fossa, pterygopalatine fossa, or supraclavicular fossa. The development of meningiomas is unpredictable, and while uncommon, it is possible for one tumor to affect more than one pit.
As for the less prominent sites for meningiomas, the jugular fossa is located in the jugular notch, at the base of the throat. Housing the pituitary gland, the pituitary fossa is a small pocket within the sphenoid bone, which in turn straddles the middle cranial fossa. The temporal fossae, where the jaw muscles are located, are located on the sides of the skull, just above and behind the infratemporal fossae. The pterygopalatine fossa is located behind the upper jaw. Furthest from the brain, the supraclavicular pits are above the clavicle bones, which connect the breastbone to the shoulders.
A fossa meningioma can be further classified based on its point of origin. It is often not found in the pit at all, but rather in adjacent tissue, spaces, or bones. Among many possibilities, a tumor growing in one of the three main fossae might carry an additional label such as sphenoid ala, parasagittal, suprasellar, petrosal, foramen magnum, tentorial, or clival meningioma to designate its precise origin.
The impact of a fossa meningioma on an individual’s health depends on the pattern of the tumor: its growth rate, the direction of growth, and whether it has grown through or around bone. Pit meningiomas, which occur primarily in the elderly, are almost always benign, with perhaps more than half of them asymptomatic. However, severe symptoms can occur when these tumors grow large enough to put pressure on adjacent parts of the brain that control the central nervous system, senses, or critical bodily functions.
A meningioma that develops in the anterior fossa can impair the senses of smell and vision or impair pituitary activity. A middle fossa meningioma can affect eye movements and facial sensations or put dangerous pressure on the internal carotid artery, which supplies blood to the brain. The deepest and largest of the three cranial fossae, the posterior fossa, is especially critical as it houses the brainstem and cerebellum, which control all mental organs and activities. A tumor growing in this area can cause problems breathing, swallowing and speaking, damage the senses of hearing or taste, or affect balance and coordination.
The most effective remedy for a symptomatic fossa meningioma is to have it surgically removed, along with the immediately adjacent brain tissue or bone. If the edges of the tumor are well defined, removal can be relatively simple. As with other types of tumors, however, a fossa meningioma can be complex and less defined, growing in and around the bones of the skull, requiring a more complex operation. The preferred course of treatment for an asymptomatic meningioma is to leave the tumor alone and monitor its activity, if any.
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