Now that she has been discharged from their care aside from routine follow-up imaging, Carla Runco is going to miss her surgical team. “Who misses their surgeon?” she asked. When Carla shares her story, however, it is evident why she feels this way.
Her tumor was found by accident almost four years ago. She had been seeing Libby Smith, DO, FAOCO, at UPMC Mercy because of an issue with a growth in her throat, necessitating a head and neck CT scan.
Turns out Carla had a planum meningioma. Her doctor, Georgios A. Zenonos, MD, Neurosurgical Director, Center for Cranial Base Surgery, had her undergo MRIs and a visual field test once a year to monitor the tumor. Then in October 2025, he called her on a Monday evening after she was home from work to tell her that it grew and would need to be removed. The tumor had actually come in contact with her optic nerve, which is why she had daily retro-orbital headaches. While she never lost her vision, the goal was to prevent that from happening.
Due to the proximity of the tumor to the optic nerve, radiation was not a favorable option. The 63-year-old Pittsburgh resident met Garret Choby, MD, that November. He and Dr. Zenonos recommended she undergo an endoscopic endonasal approach (EEA) for resection of her tumor. Of note, her history of rheumatoid arthritis meant she was on an immunomodulating medication, which had the potential to affect her post-operative healing.
Carla felt extremely nervous about the surgery — which took place December 8, 2025 — but relieved that it would be less invasive than the alternative. She underwent an endoscopic endonasal transplanum approach for resection of the tumor. The tumor was carefully dissected from her optic chiasm, and all involved dura was also resected. Her skull base was reconstructed with a right sided nasoseptal flap.
According to Dr. Choby, Carla recovered very well from surgery. She had some persistent headaches for a few weeks afterwards, but her vision was excellent and she had no post-operative cerebral spinal fluid (CSF) leak. Her sense of smell had a full recovery by about six weeks after surgery. The tumor was removed in its entirety and her prognosis is excellent. “There is a very low chance that this tumor would recur, or she would require further treatment,” Dr. Choby said.
Currently back at work at UPMC Presbyterian, where she is an expert medical laboratory scientist in the drug testing area of the Special Chemistry laboratory, Carla feels the pressure because her job requires high level critical thinking and problem solving. While her recovery is not 100% after her surgery, she is doing much better. She still experiences some symptoms that will take additional time to improve. “People don’t always see that,” Carla said, “which can be difficult for me to deal with sometimes.” At times like these — and in fact, every day — she recalls what Dr. Choby told her at each visit: “Give yourself grace. You had major surgery. You’re still healing.”
Carla has nothing but praise for her surgical team. “Everyone took such wonderful care of me and made me feel so comfortable,” she said. “They all made me feel like I was the only patient they had. They went out of their way to help me and explain everything. They were also so kind to my daughters and my partner. When he came to my visits, they explained everything to him as well, and were just so kind, attentive, and compassionate.”
She also praised the collaboration between Drs. Zenonos and Choby, calling them a wonderful team whose offices are well connected. For example, if Carla needed a quick response from Dr. Zenonos’ team, Dr. Choby would pull his cell phone out of his pocket and call himself.
When Dr. Choby told Carla at her last visit, “Well, I think you’ve graduated from my care,” she hugged him and cried.
Dr. Choby is equally as positive about Carla as she is about him. He said Carla maintained “an incredibly positive attitude throughout her diagnosis and treatment course,” and added that her family has been a wonderful and supportive resource for her. “She is a shining light!”