When Dean Metzler’s personality drastically changed from easygoing to short-tempered, neither he nor his wife knew what was going on. “I was a happy, fun joker, and suddenly I was angry all the time.” Candelle, his wife of 30 years, said he would start slamming things around, adding “it was so not him.”
After looking at MRI images of his brain, Jacques Morcos, M.D., director of skull base and cerebrovascular surgery at UHealth – the University of Miami Health System, found an orange-sized tumor called a meningioma was arising from the base of his skull and pressing on the frontal lobe of his brain.
“Most meningiomas are benign, but they can affect personality, motor function, speech, hearing, vision or smell, depending on the affected brain area. We remove them through either minimally invasive or sometimes maximally invasive means. These are the principles of skull base surgery.,” said Dr. Morcos, who is professor and co-chairman of Neurological Surgery at the Miller School of Medicine; professor of clinical neurosurgery and otolaryngology, director of cerebrovascular surgery, director of skull base surgery, and division chief of cranial neurosurgery at UM/Jackson Memorial Hospital.
While only one percent of meningiomas are clearly malignant, about 19 percent have abnormal cellular characteristics, and 80 percent are completely benign. “New research on the DNA of tumor cells is helping clinicians better understand why some meningiomas are more aggressive than others,” said Dr. Morcos, an internationally renowned neurological surgeon, who leads one to the largest and most diverse skull base programs in the U.S.
Fellowship trained in both cerebrovascular and skull-based surgery, Dr. Morcos has treated thousands of meningioma patients like Metzler in the past 26 years. He is widely recognized for his surgical skills, and regularly trains other specialists and speaks at neurosurgical conferences. He is a former president of the North American Skull Base Society, as well as the Society of University Neurosurgeons, and is currently vice-president of the American Association of Neurological Surgeons.
“Meningiomas are most common in older patients, although they can occur at almost any age,” said Dr. Morcos. “The symptoms of a brain tumor can be a change in personality, memory, cognitive ability, vision, hearing or smell. Therefore, it’s important to get a thorough diagnosis of these symptoms as soon as possible to determine the cause and begin treatment.”
To treat meningioma patients like Metzler, Dr. Morcos used skull base surgical techniques that involve making an incision at the top of the head and drilling into the bone at the base of the skull to preserve the brain. “Our goal is to remove both the tumor and its roots to prevent it from growing back.”
In Metzler’s case, Dr. Morcos and his team of specialists were able to remove 100 percent of his tumor in a 10.5-hour procedure. “We have all the talent under one roof,” said Dr. Morcos, noting the importance of having otolaryngologists, ophthalmologists, oculoplastic surgeons, neurologists and radiation oncologists available for personalized patient care.
After the surgery, Candelle Metzler noticed a positive change in her husband’s personality. “He's fun-loving, he's loving again, and patient and fun – the man I knew and married,” she said.
Metzler himself is happy to be making a strong recovery. “I'm thankful to still be able to be here and be a part of my family,” he said. “My family and I are forever grateful to Dr. Morcos and his team for such great care.”