Skull Base Tumors

Skull base tumors grow along the bottom of your skull — or right below this area. They can start as, what we call, a primary tumor. This means the tumor starts growing from bone and tissue in your skull base. These tumors may also have come from cancers that have spread from other places in your body. We call these metastatic tumors.

These tumors can affect many different things because you have a lot of nerves running through this area. That’s why you may have symptoms like hearing loss, balance problems, ringing in your ears, trouble with swallowing, headaches and more.

Types of skull base tumors

There are many types of skull base tumors — cancerous and not. Some benign ones we commonly treat are:

• Acoustic neuromas.
• Cholesteatomas.
• Craniopharyngiomas.
• Meningiomas.
• Pituitary adenomas.
• Schwannomas.

We also treat many cancerous skull base tumors like chondrosarcomas and chordomas.  Cancers like this also affect temporal bones, part of the skull base around your middle and inner ear on each side. Basal and squamous cell carcinomas are two cancers that can cause metastatic skull base tumors.

Because there are different types of skull base tumors, getting a correct diagnosis before starting treatment is very important. That’s why you’ll first have an evaluation with our team.

What to expect at your evaluation

Your story is an essential part of your diagnosis. So, when you come to your first appointment, you’ll want to be prepared to share what’s been going on. Your provider will ask a lot of questions, like:

• What kind of symptoms are you having?
• How long have you had these symptoms?
• Are your symptoms getting worse?
• How are these symptoms affecting your life?
• Have you been diagnosed with any other health conditions?

You can expect to have a physical exam so your provider can check out your overall health and symptoms. You may also have a neurological exam. And you’ll get orders for tests so our team can rule out other conditions — and confirm a skull base tumor diagnosis.

Testing for skull base tumors

Imaging tests play a big role in making sure you have the correct diagnosis. You may have:

• MRI.
• CT scan.
• PET scan.

Our team may need to perform a biopsy. This means using a needle to take a sample of the tumor to look for cancer cells under a microscope. A biopsy can help us find out what kind of tumor it is so we can plan the best possible treatment.

Meet Our Skull Base Tumor Team

Skull base tumors can affect your body in different ways. That’s because they interfere with how the nerves send signals from your brain to the rest of your body. And we must consider that some of these tumors are cancerous.

So, we build your care team with providers from many specialties, like:

• Neurosurgeons.
• Oncologists.
• Radiation oncologists.
• Otolaryngologists.
• Neurologists.
• Anesthesiologists.
• Ophthalmologists.
• Radiologists.
• Physical therapists.
• Occupational therapists.
• Speech therapists.
• Pathologists.
• Neurotologists (specialists that treat conditions involving your brain and inner ear).
• Head and neck surgeons.
• Neuro-ophthalmologists (specialists that treat conditions involving your brain and vision).
• Audiologists.
• Neuropsychologists.

This team works together to build a treatment plan that focuses on your needs, symptoms and diagnosis.

Your treatment depends on the kind of tumor you have, where it is and if it’s cancerous. For some types of noncancerous (benign) skull base tumors, especially when they’re found without symptoms, we might do “watchful waiting.” And some benign tumors are dormant and not actively growing. We’ll keep a close eye on you and your symptoms through regular appointments and imaging tests. If it looks like the tumor is growing, we can start treatment quickly.

We use the latest technology and tools during treatment. Your care team will share their treatment recommendations with you. You may have.

Surgery

The skull base is a complex area full of nerves, blood vessels, bone and muscles. Along with the lower parts of your brain and part of your spinal cord. Tumors here can be tough to reach. But when possible, we’ll do brain surgery to remove the tumor or at least part of it.

We want to minimize brain, nerve and blood vessel damage during surgery. When we can, we’ll use a minimally invasive approach like endoscopic surgery through your nose or a keyhole craniotomy. Even in traditional open surgery, our team can do surgery through smaller openings.

You may need reconstructive surgery when removing a tumor that affects how your head or face looks or how your nerves work. We try to do reconstruction during the same surgery as tumor removal.

Radiation therapy

Some cancerous and benign tumors may respond to radiation therapy before surgery to shrink the tumor or after to kill any remaining cancer cells (adjuvant therapy). There are multiple types of radiation. Your care team will go over which they think will work best for you. We may also recommend computer-guided focused radiation called Gamma Knife^® radiosurgery to destroy the tumor instead of using surgery.

Systemic therapy

This treatment uses medication to kill cancer cells that may have spread throughout your body. It can also prevent them from spreading. You may have chemotherapy or immunotherapy. The one we use depends on what kind of skull base tumor you have.

Life After Skull Base Tumors Treatment

Once you finish treatment, we’ll still want to see you. You may have regular follow-up visits and testing so we can see if the tumor has come back (recurred). If so, we can start treatment right away. And because these tumors can affect how you walk, talk, balance and swallow, you may have physical, occupational and speech therapy.

Taking the Next Step

Finding out there’s a tumor in your skull base isn’t the news anyone wants to get. But when you do, one thing is certain — you want the best care from trusted providers. Look no further than Cleveland Clinic. We have all the healthcare providers you need. We’re ready to offer expert, compassionate care that’s personalized for your specific diagnosis. You can count on us to support you as you move forward with treatment and get back to enjoying life.