Skull Base Tumors

Diagnosis

Each tumor requires a thorough evaluation involving imaging and/or biopsy.

If you have symptoms, a skull base tumor diagnosis involves a brain MRI scan, which will help your care team determine the size and location of your tumor. You may further undergo a biopsy prior to a more definitive procedure. This will provide information on the specific characteristics of your mass, including whether it is benign or malignant. There are several ways your doctor may collect a biopsy sample, including:

• Fine-needle aspiration, which involves inserting a thin needle into the mass
• Endoscopic endonasal approach, during which your doctor will insert a thin, lighted tube into the nasal cavity.
• Craniotomy, which is when a neurosurgeon will access the tumor through the skull

Depending on the pathology of your tumor, your doctor may order additional imaging to gather other necessary information, including if it has spread to other parts of the body.

In addition, functional tests can help determine the impact of your tumor on your daily life. These will vary person-to-person, but may include tests that evaluate:

• Hearing
• Vision
• Balance
• Memory
• Hormones
• Sense of smell
• Swallowing

What are the types of skull base tumors?

There are benign and malignant tumors.

Masses at the skull base can be cancerous (malignant) or noncancerous (benign) tumors. At MedStar Health, our neuropathologists are experts in evaluating tumor under the microscope. This allows us to determine the unique profile of your tumor, which helps us tailor treatment to your specific tumor type.

We provide diagnosis and treatment options for both rare and common types of skull base tumors. Common types of benign skull base tumors include:

• Meningioma: A meningioma is a tumor that grows from the membranes surrounding your brain and spinal cord, known as the meninges.
• Acoustic neuroma (Vestibular schwannoma): An acoustic neuroma is a benign brain tumor that grows on the vestibulocochlear nerve, influencing balance and hearing. Acoustic neuromas are rare and usually slow growing.

Pituitary tumor: A pituitary tumor arises from the pituitary gland, the gland primarily responsible for regulating your hormones. We work closely with endocrinologists and ophthalmologists at MedStar Health to treat the full range of pituitary tumors. Malignant tumors that can develop in the skull base include:  

• Chondrosarcomas, a type of sarcoma that begins in the cartilage around the skull base bones
• Esthesioneuroblastoma, which arises in the olfactory nerves that control your sense of smell
• Nasopharyngeal carcinomas, which develop in the upper part behind the nose (nasopharynx)
• Metastases that spread from other parts of the body
• Sinus cancers

Learn More About Brain Tumors and Brain Cancer

Treatments

Exceptional expertise that delivers advanced, comprehensive treatment for tumors at the skull base.

Treating this part of the body requires expert knowledge and skill. The best outcomes can be achieved by well-equipped, experienced surgeons working as part of a multidisciplinary team.

Each patient at MedStar Health receives compassionate, individualized care. Experts in neurosurgery, head and neck surgery, radiation oncology, otolaryngology, interventional and neuroradiology, neuro-ophthalmology, and medical oncology work closely with other clinical specialists throughout MedStar Health. These specialists meet regularly in a Skull Base Tumor Board to review and plan personalized care for each patient, considering the size, type, and location of your tumor. This ensures your skull base tumor treatment is tailored to your unique needs, leveraging the latest evidence-based approaches.

Surgery

At MedStar Health, we have a team of surgeons who are trained in, and focused solely on, treating skull base tumors. We’re one of few teams in the region with a dedicated endoscopic skull base team with fellowship-trained neurosurgeons and otolaryngologists working together to maximize your outcomes.

Our team is equipped with the latest technology. We’re highly skilled at performing advanced lateral skull base surgery using endoscopy or microsurgery, as well as an open craniotomy, to operate on tumors in this part of the skull base. 

Learn More About Neurosurgery

Microsurgery

Microsurgery utilizes specialized tools and techniques to remove brain tumors. At MedStar Health, our surgeons are skilled in the use of sophisticated technologies that allow access and removal of complex skull base tumors. One such technology is neuro-navigation, a GPS-like tool that guides surgeons through critical brain structures and pathways before and during surgery.

Endoscopy

Endoscopy is a minimally invasive procedure using a specially designed endoscope (a long, tube equipped with a light at the end) with high-definition cameras and monitors to gain access to your tumor through your nose. This approach often leads to a quick recovery with few complications following surgery.

Learn More About Endoscopy

Chemotherapy

If you have a skull base tumor that is malignant, your neuro-oncology team may recommend chemotherapy to destroy cancer cells. Chemotherapy medications may be given orally via a pill, through an injection, or intravenously. A medical oncologist or neuro-oncologist may recommend chemotherapy in combination with other treatment options, depending on your unique needs.

Learn More About Chemotherapy

Immunotherapy and targeted therapy

In addition to chemotherapy, there are other emerging drugs that can circulate throughout the body and target cells that affect tumor growth. We continue studying how immunotherapies and targeted therapies may be used to treat skull base tumors.

Learn More About Immunotherapy

Learn More About Targeted Therapy

Radiation therapy

At MedStar Health, our radiation oncologists are experts in using state-of-the-art technology to deliver radiation with unmatched precision, limiting side effects and improving effectiveness of treatment. Your multidisciplinary team will determine if you would benefit from this type of treatment, working closely with your surgeons and medical oncologists to plan the right course of action.

For some skull base tumors, proton therapy or stereotactic radiosurgery (SRS) can be  standalone treatments or used in conjunction with surgical techniques, including microsurgery or endoscopy. We were one of the first to use both to treat brain tumors, making us one of the most advanced radiation teams in the area. 

Proton therapy is a highly targeted form of radiation that administers high-energy beams in the exact shape and size of your tumor, causing less damage to nearby structures. SRS is a non-invasive radiation treatment utilizing high-powered x-rays, computers, robotics, and image-guidance technology to pinpoint and destroy small tumors. At MedStar Health, we use both CyberKnife® and Zap-X® Radiosurgery to accurately deliver radiation in fewer treatments than traditional radiation therapy. Both technologies are incredibly precise, sparing nearby healthy structures and preserving critical functions.

Learn More About Radiation Therapy