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Skull base tumors

Skull base tumors arise in the highly complex region that begins behind the eyes and nose and slopes down to the back of the head. They may start in areas below the skull base, such as the sinus or inner ear; begin as brain tumors that grow down toward the skull base; or grow into the bones of the skull base.

The skull base has anterior, middle and posterior compartments. Tumors are classified based on the type of cells present, and surgical approaches are selected based on the location of the tumor.

Anterior Skull Base

Tumors of the anterior skull base include those located in the nasal cavity and paranasal sinuses. They may be benign or malignant.

Benign Tumors

  • Ossifying fibromas


Malignant Tumors

  • Esthesioneuroblastoma
  • Inverted papilloma
  • Lymphoma
  • Nasoparyngeal carcinoma
  • Orbital glioma
  • Osteogenic sarcomas
  • Rhabdomyosarcomas


Middle Skull Base

Tumors of the middle skull base are usually benign:

  • Cholesteatomas
  • Craniopharyngiomas
  • Cavernous sinus meningiomas
  • Enchrondromas
  • Pituitary adenomas
  • Temporal bone tumors


Posterior Skull Base

Benign Tumors

  • Chondromas
  • Chordomas
  • Clivus and cerebellopontine angle
  • Dermoids
  • Epidermoids
  • Meningiomas of the foramen magnum


Malignant Tumors

Skull base metastases usually arise from a primary tumor in the prostate, breast, lung, or head and neck, or from lymphoma.

Our medical team has expertise in the diagnosis and treatment of benign neoplasms, acoustic neuroma and lateral skull base tumors, esthesioneuroblastoma and malignant skull base tumors, cerebrospinal fluid leak repair, pituitary tumors, intraoperative imaging and computer-aided surgery.

Symptoms

Symptoms of most skull base tumors appear slowly and may include:

  • Headaches
  • Altered sense of smell
  • Trouble swallowing
  • Difficulty breathing
  • Loss of balance
  • Nausea and vomiting
  • Hearing loss
  • Blurred or double vision
  • Memory loss


Diagnosis

Your physician will use the following diagnostic tests for skull base tumors:

  • CT scan of the brain
  • Brain MRI to evaluate soft tissue masses and structures
  • Cerebral angiography if the tumor puts pressure on the carotid artery or other major intracranial arteries
  • Magnetic resonance arteriography and venography to assess the arteries and veins surrounding the tumor


If a tumor has metastasized from an unknown primary source, your doctor will perform a complete physical workup. Diagnostic studies may include posteroanterior and lateral chest radiography; contrast-enhanced CT scan of the chest, abdomen and pelvis; and a bone scan.

Treatment

Treatments may include medical intervention, radiation therapy, surgical intervention or a combination of these therapies.

Chemotherapy can be used as a primary or adjunctive treatment of many skull base tumors. Stereotactic radiosurgery [link to the existing Novalis page], a form of radiation therapy that focuses high-powered x-rays on a small area of the body, may be used to accurately target the tumor. Radiosurgery may also be used as an adjuvant therapy following surgical removal of the tumor.

Advances in surgical techniques have revolutionized skull base surgery in the past decade. Endoscopic surgery, infection prevention methods and improved techniques for reconstruction enable surgeons to perform biopsies and removal of most skull base tumors. Stereotactic radiosurgery has become a powerful tool in treating skull base tumors. Surgical approaches to the skull base have expanded dramatically, giving doctors and their patients choices that improve outcomes.

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