Many different tumor types originate from or extend into the skull base. Skull base tumors can be classified based on their specific location in the head (the tumor site) or based on the cell structure and identifying characteristics of the tumor (the tumor type).
The skull base is the area behind the eyes and nose that slopes down to the back of the head. It forms the floor, or base, of the skull. The spinal cord, multiple nerves and the major blood vessels of the brain, head and neck pass through openings in the skull base.
Not all tumors in the skull base are malignant (cancer). Even benign (non-cancerous) tumors can cause symptoms or threaten the health and well-being of the patient.
At MD Anderson, physicians and specialists in the Skull Base Tumor Program treat patients with both cancerous and noncancerous tumors of the skull base.
Tumors of the skull base are categorized based on the unique characteristics and cell structure of each type. Tumor typing is determined during the patient's diagnostic workup. Radiologists and pathologists who have special expertise in tumors of the head and brain work closely with the head and neck surgeons and the neurosurgeons to determine tumor type.
The tumor type, together with the unique health profile and needs of each patient, helps the skull base team specifically tailor treatment for each patient.
The most common malignant skull base tumors include:
- Adenocarcinoma
- Adenoid cystic carcinoma
- Esthesioneuroblastoma or olfactory neuroblastoma
- Nasopharyngeal carcinoma
- Non-Hodgkin’s lymphoma
- Squamous cell carcinoma
Other malignant skull base tumors:
- Chondrosarcoma
- Chordoma
- Endolymphatic sac tumor
- Melanoma
- Metastases
- Mucoepidermoid carcinoma
- Myeloma/plasma cell tumors
- Neuroendocrine carcinoma
- Sarcomas. The more common sarcomas are as follows:
- Ewing's sarcoma
- Osteosarcoma
- Rhabdomyosarcoma
- Sinonasal undifferentiated carcinoma
The most common benign skull base tumors include:
- Acoustic neuroma (vestibular schwannoma)
- Cholesteatoma
- Meningioma (the most common skull base tumor)
- Pituitary tumors
Other benign skull base tumors:
- Angiofibromas
- Cholesterol granuloma, epidermoid and dermoid cysts
- Craniopharyngiomas
- Fibro-osseous lesions. These include the following:
- Fibrous dysplasia
- Ossifying fibroma
- Osteoma
- Hemangioma
- Inverting Papilloma
- Lipoma
- Paraganglioma:
- Carotid body tumors
- Glomus jugulare
- Glomus tympanicum
- Glomus vagale
- Schwannomas:
- Jugular foramen schwannoma
- Trigeminal schwannoma
Head and neck tumors may also extend to the skull base. Examples include:
- Salivary gland tumors. (The most common types of salivary gland cancers are mucoepidermoid carcinoma and adenoid cystic carcinoma.)
- Skin cancers such as squamous cell carcinoma, melanoma and basal cell carcinoma that can travel along nerves and spread to the brain and skull base
Skull Base Tumor Risk Factors
Anything that increases your chance of getting a skull base tumor is a risk factor. Since skull base tumors are rare, risk factors are hard to determine.
Previous exposure to ionizing radiation and certain occupational exposures have been identified as risk factors for meningioma, some sarcomas and certain sinonasal malignancies. Exposure to wood dust, heavy metals and a history of working with leather are also risk factors for developing some sinus and nose cancers. Certain types of nasopharyngeal cancers are related to childhood exposure with the Epstein-Barr virus.
Sometimes, inherited genetic conditions are linked to skull base tumors. In these cases, our genetics experts are part of the patient’s care team. The types of tumors that may be caused by genetic conditions include:
Bilateral acoustic neuromas, as well as other brain and spine tumors, may be caused by the genetic disorder neurofibromatosis type 2.
Paragangliomas (also called glomus tumors or carotid body tumors) may be caused by a familial predisposition for other tumors.
Pituitary tumors may be associated with multiple endocrine neoplasia 1 (MEN1) or family isolated pituitary adenoma (FIPA) which may be familial and predispose to other tumors.
Not everyone with risk factors gets skull base tumors. However, if you have risk factors, it’s a good idea to discuss them with your doctor.
Research shows that many cancers can be prevented.
Learn more about skull base tumors:
Some cases of skull base tumors can be passed down from one generation to the next. Genetic counseling may be right for you. Learn more about the risk to you and your family on our genetic testing page.
Skull base tumor surgeons Ehab Hanna, Franco DeMonte and Paul Gidley examine a patient.
Why choose MD Anderson for your skull base tumor treatment?
MD Anderson's team approach to skull base tumors brings together renowned experts from many specialties to give you comprehensive, personalized care. Our team is comprised of surgeons dedicated exclusively to skull base tumors and sub-specialized to different types of skull base tumors. Although skull base tumors are rare, we see dozens of patients and perform skull base surgery every day.
A group of specialists meets regularly to discuss your needs and options. This exchange of ideas sets the stage for delivering the highest level of care for skull base tumors.
Our approach begins with your first visit and continues through diagnosis, treatment, rehabilitation and follow-up. Your team may include surgeons, radiation and medical oncologists, ophthalmologists, nutritionists, nurses and social workers. And they have at their fingertips the latest technology and techniques to diagnose and treat skull base tumors, including minimally invasive surgery, innovative radiotherapy and one of the few proton therapy centers in the nation.
Surgical Skill
Surgery is often part of the treatment for skull base tumors. The location deep in the structures of the head presents significant challenges because important nerves, blood vessels and brain structures may be involved.
Our surgeons have pioneered techniques and surgical approaches that allow for maximum safe removal of tumors in this delicate and complex area. They are experts in open and minimally invasive diagnostic and surgical approaches to skull base tumors.
Members of both MD Anderson's Brain and Spine Center and Head and Neck Center, our surgeons have extensive experience in skull base tumor procedures. They have been recognized in US News & World Report's list of Best Doctors in America, and they are respected around the world.
Advanced Radiation Therapy
For patients with skull base tumors that are responsive to irradiation, radiation oncologists prepare three-dimensional treatment plans for the precise delivery of radiation therapy. MD Anderson's Proton Therapy Center provides an additional treatment option for patients with specific tumors that are well suited to this innovative therapy.
Rehabilitation, Symptom Management, Side Effects and Quality of Life Issues
Giving patients with skull base tumors the opportunity and the tools to enjoy life fully is an important part of care at MD Anderson. Skull base tumor patients may experience symptoms of tumors and side effects from treatment, like changes in hearing, vision, balance, smell, speech or memory. We understand that quality of life is an important consideration during cancer treatment and recovery. Many patients can overcome limitations caused by skull base tumors or treatment effects with the help of caring professionals, who may include audiologists, speech and language and swallowing therapists, behavioral psychologists, neuropsychologists, ophthalmologists, nutritionists, and occupational and physical therapists.
Personalized Treatment
Treatment for tumors of the skull base may involve surgery, radiation therapy, chemotherapy or a combination of therapies. Surgeons in the Skull Base Tumor Program use both open and minimally invasive diagnostic and surgical approaches, depending on each patient's unique characteristics. For patients with tumors that are responsive to irradiation, radiation oncologists plan three-dimensional treatment algorithms for the precise delivery of radiation therapy. And with MD Anderson's Proton Therapy Center, proton radiation therapy now provides an additional treatment option for patients with specific tumors that are well suited to this innovative, state-of-the-art therapy.
And, as one of the nation's leading cancer center, MD Anderson is able to offer a range of clinical trials of new treatments for skull base tumors.
Every time I see beauty through my eyes, I am reminded of my miracle and how fortunate I was to be treated at MD Anderson.
MD Anderson is committed to the diagnosis and treatment of brain tumors, spine tumors and skull base tumors.
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