Skull base tumor treatment depends on a few factors: the location of the tumor, whether the tumor is benign or malignant, the size of the tumor and the patient’s overall health and preferences. Each patient’s treatment plan is highly individualized and can involve observation, neurosurgery, radiation therapy, chemotherapy or a combination of these options.
For benign (noncancerous) skull base tumors that aren’t causing symptoms that impede one’s quality of life, observation can be the appropriate course of action. During this phase, patients receive regular imaging tests (often an MRI) to monitor the tumor. Given every three to six months at first, the frequency of the imaging tests will be reduced to yearly if the tumor is not growing or causing symptoms.
Patients with skull base tumors may undergo neurosurgery to remove the tumor. This type of surgery is highly specialized with the goal of removing as much of the tumor as possible while preserving brain tissue. The different procedures include:
Minimally Invasive Keyhole Surgery
A minimally invasive approach (also known as keyhole surgery) may be applicable to different skull base locations. It involves making a small, precise opening in the skull to access the tumor. The surgeon may use a surgical microscope or funnel an endoscope (a long, thin tube with a tiny camera at the end) into the opening to gain a wide view of the tumor, its margins and the surrounding structures. From there, the surgeon can remove the tumor.
Endonasal endoscopic surgery
Endonasal endoscopic surgery is a minimally invasive procedure in which an endoscope is inserted through a nostril and the nasal sinuses to reach the skull base.
During the surgery, the patient remains awake throughout the procedure and a local anesthetic is used to minimize discomfort. By remaining conscious during an awake craniotomy, a patient can help a surgeon avoid essential gray matter surrounding a tumor by responding to questions and performing a list of simple tasks (such as blinking or moving fingers). This can also help reduce the chance of complications impacting the patient’s sight, speech or movement.
During radiation therapy, beams of high-energy X-rays, gamma rays or protons are directed at the tumor to kill the cancer cells. Radiation therapy for skull base tumors can involve:
- Stereotactic radiosurgery that can precisely deliver high-dose radiation beams with decisive accuracy
- Fractionated stereotactic radiation therapy (FSRT) or intensity-modulated radiotherapy (IMRT) uses technology to deliver highly controlled and targeted radiation beams at different intensities and angles
- Proton therapy delivers high doses of radiation directly to the site of the tumor, lessening the risk of damaging healthy surrounding brain tissue
Chemotherapy is a type of cancer treatment that uses specialized drugs to destroy cancer cells or prevent new cancer cells from forming. While chemotherapy is not commonly used to treat skull base tumors, it can be effective for patients with specific types of tumors, including sinonasal cancers. It may also be used in combination with surgery and radiation therapy.
Skull base tumor treatment at Moffitt Cancer Center
Moffitt Cancer Center offers a comprehensive range of treatment options for skull base tumors within our Neuro-Oncology and Head and Neck Programs. Our neurosurgeons, head and neck surgeons, neurologists, medical oncologists, pathologists, radiation oncologists and neuropsychologists work together to develop highly individualized, highly specialized treatment plans for our patients.
Medically reviewed by Andre Beer Furlan, MD, PhD, skull base and endovascular neurosurgeon.
To speak to one of our neuro-oncology specialists about skull base tumor treatment, call 1-888-663-3488 or submit a new patient registration form online. You are a top priority for our cancer center that delivers nationally ranked care in new and transformative ways, and we’ll provide you with rapid access to a cancer expert in one day.