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A skull-base tumour or a cerebral tumour is an abnormal growth of tissue that emerges from the base of the skull. The skull-base anatomy comprises five complex bone frameworks that come together to form three levels of flooring, which support the brain, brainstem, cranial nerves, spinal cord, and openings of major cerebral blood vessels. Despite being benign in nature, lesions developing from the skull base are always complex and challenging to treat. This is mainly due to the intricate configuration of the bony framework and the involvement of major vascular structures and sensitive cranial nerve fibres.
Skull-base surgeons face significant challenges in approaching tumours, avoiding damage to vital blood vessels and cranial nerves, and completely removing lesions while reconstructing the skull base. When treating skull-base tumours, surgical intervention alone is not enough. In neurosurgical centres, treating patients with complex skull-base tumours can sometimes include multiple surgical procedures, reconstructive surgery, radiotherapy, and rehabilitation.
There are several types of cerebral tumours, which are generally categorised according to their location. The most common examples of skull-base tumours are:
A pituitary tumour is a growth formed at the pituitary gland, which can be found at the small bony depression of the anterior skull-base. These tend to be benign but can lead to pituitary hormone dysfunctions as well as vision impairment due to the compression of the optic nerve and pituitary gland.
There are many tumours developing from the tissue around the sellar and parasellar regions rather than the pituitary gland. The most common tumours are craniopharyngioma, meningioma, Rathke Cleft Cyst and very rarely, germinoma, lymphoma and granulomatous lesions emerging from the sellar and parasellar areas.
A clival lesion or tumour is a growth on the clivus, which forms part of the skull-base surface.
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 that develop in this area are known as cerebellopontine angle tumours.
Craniocervical tumours develop where the skull meets the neck, particularly at the foramen magnum, an opening at the base of the skull.
Depending on their nature and location, skull-based tumours can be caused by a variety of factors. In general, tumours develop due to mutations in the DNA of a cell, which leads to their rapid division and growth. Over time, these abnormal cells form a huge mass known as a tumour. When such mutations occur in the skull-base cells, it will result in a cerebral tumour. Moreover, skull-base tumours can be metastatic, which means that they can be caused by cancerous cells from other places of the body spreading to the skull-base.
The symptoms of a cerebral tumour will vary greatly depending on its type, size, and location. Some general skull-base tumour symptoms to watch out for include:
The risk factors for developing a skull-base tumour include:
During your first consultation, the doctor will ask about your symptoms, personal medical history, and family medical history. If possible, you should describe what you were doing at the time your symptoms started. Your doctor will also perform a basic physical examination and a neurological assessment, which typically involves checking your vision, hearing, balance, and so on.
Depending on your symptoms and medical history, your doctor may recommend 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 completed 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 scans are obtained at more frequent intervals to get a more detailed picture of the tumour.
A CT Sinus examines the paranasal sinus cavities and can help locate a skull-base tumour accurately.
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 is a test that assesses your ability to hear, and it is performed when a skull-base tumour has resulted in hearing loss.
Skull-base or cerebral tumours can be treated with radiation, chemotherapy, surgery, or a combination of the three. However, the initial course of treatment is endoscopic transsphenoidal surgery. This outlines an endoscopic endonasal approach for tumour removal and skull-base repair. With this minimally invasive treatment, a skull-base tumour can be removed through the nose instead of opening the skull.
When it comes to skull-base tumours, it is critical to get an early diagnosis to improve your chances of successful treatment. If you are experiencing any of the symptoms associated with skull-base tumours, do not hesitate to consult a doctor as soon as possible. Your doctor will be able to precisely diagnose your condition and recommend an effective course of treatment for you. Get in touch with us today to consult a Singapore neurosurgeon and receive personalised care for your medical requirements.
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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 touch with you.
Monday – Friday: 9:00AM – 5:00PM
Saturday: 9:00AM – 12:30PM
Sunday & Public Holiday: Closed
We provide quality specialised care for neuro and spine conditions.
For enquiries, leave a message and our friendly team will get in touch with you.
Monday – Friday: 9:00AM – 5:00PM
Saturday: 9:00AM – 12:30PM
Sunday & Public Holiday: Closed
We provide quality specialised care for neuro and spine conditions.
For enquiries, leave a message and our friendly team will get in
touch with you.
Monday – Friday: 9AM – 1PM | 2PM – 5PM
Weekends & Public Holidays: CLOSED
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