A skull base tumour is an abnormal growth of tissue arising from the base of the skull.
The anatomy of the skull base is composed of 5 complex bony frameworks that join together and form the three different levels of flooring that not only support the brain and brainstem, but also for the openings of major cerebral blood vessels, cranial nerves and spinal cord.
The lesions arising from the skull base are almost always complex and complicated because of their complex configuration of bony framework and the involvement of major vascular structures and sensitive cranial nerve fibres despite the lesion being benign in nature.
The approach to tumours, to prevent the damaging of important major blood vessels and cranial nerves, and the total removal of lesions with the reconstruction of the skull base are major obstacles for skull base surgeons.
Surgical intervention alone is not always possible in the treatment of skull base tumours. Sometimes, multiple surgical interventions and reconstructive surgery, combined with radiotherapy and subsequent rehabilitation are norms for the management of patients with complex skull base tumours in major neurosurgical centres.
There are several types of skull base tumours, which are generally categorised according to their location. The most common examples of skull base tumours are:
A pituitary tumour is a growth located at the pituitary gland, which can be found at the small bony depression of the anterior skull base. These tend to be benign but may cause problems in pituitary hormone dysfunctions as well as eyesight impairment due to the compression of the optic nerve and pituitary gland.
There are many tumours arising from the tissue around the sellar and parasellar regions rather than the pituitary gland. The commonest tumours are craniopharyngioma, meningioma, Rathke Cleft cyst and very rarely, germinoma, lymphoma and granulomatous lesion arising from the sellar and parasellar areas.
A clival lesion or tumour is a growth on the clivus, which forms part of the surface of the skull base.
These are growths found on the upper portion of the clivus, at the petroclival junction. Surgically, this can be a challenging area to reach.
The cerebellopontine angle is a triangular space that can be found between the cerebellum and the pons. Any growths located in this space are known as cerebellopontine angle tumours.
Craniocervical tumours grow where the skull meets the neck, particularly at the opening at the base of the skull, which is called the foramen magnum.
Skull base tumours can have varying causes, depending on the type and location of the tumour. In general, tumours are caused by mutations in the DNA of a cell, resulting in their rapid division and growth.
These abnormal cells eventually accumulate into a large mass known as a tumour. When such mutations arise in the cells of the skull base, this will result in a skull base tumour. Skull base tumours may also be metastatic, meaning that they are caused by cancerous cells spreading to the skull base from other parts of the body.
The symptoms caused by a skull base tumour will vary greatly depending on the type, size, and location of the tumour. Some general symptoms to watch out for include:
The risk factors for developing a skull base tumour include:
You should see a doctor if you are experiencing any of the above symptoms, especially if they are persistent. It is possible that such symptoms may have another cause, which your doctor will be able to diagnose after rigorous testing. However, there will be a higher chance of successful treatment if a skull base tumour is caught early on.
During your first consultation, your doctor will ask about your symptoms, your personal medical history, and your family medical history. If possible, you should describe what you were doing at the time that your symptoms occurred. Your doctor will also perform a basic physical examination and a neurological exam, which typically involves checking your vision, hearing, balance, and so on.
Depending on your symptoms and medical history, your doctor may suggest that you undergo one or more diagnostic tests, which can be scheduled for a later date. In such cases, you should allow some time for these tests to be done and for your doctor to evaluate the results.
Several methods can be used to diagnose skull base tumours, ranging from diagnostic imaging tests to blood tests. Some examples of such tests are:
This is similar to a normal MRI Brain, but with scans obtained at more frequent intervals to create a more detailed picture of the tumour.
A CT Sinus examines the paranasal sinus cavities and can help to accurately locate a skull base tumour.
When a skull base tumour requires surgical treatment, a CT Angiogram will be used to map out the blood vessels within the brain.
This blood test will measure your hormone levels in cases of a suspected pituitary tumour.
These are performed in cases where skull base tumours have affected vision.
This a test that assesses your ability to hear, and is performed when a skull base tumour has resulted in hearing loss.
Skull base tumours can be treated using radiation, chemotherapy, surgery, or a combination of the three. However, the first line of treatment is endoscopic transsphenoidal surgery.
This describes an endoscopic endonasal approach for the excision of any tumours and skull base repair. During this minimally invasive procedure, a skull base tumour can be removed via the nose rather than through the skull. As such, any potential complications or risks associated with open surgery can be avoided.
When it comes to skull base tumours, it is important to get diagnosed early in order to increase your chances of successful treatment. If you are experiencing any of the symptoms associated with skull base tumours, please do not hesitate to see a doctor as soon as possible. Your doctor will be able to accurately diagnose your condition and find a treatment method that is best suited to your needs.
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We provide quality specialised care for neuro and spine conditions.
For enquiries, leave a message and our friendly team will get in
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