Treating skull base tumors can be challenging — and requires a team effort — because of their location to critical parts of the body.

Story by: Rebecca Hall on March 13, 2019

How does a tumor form?

A tumor forms when cells duplicate and grow into an abnormal mass of tissue.  Benign tumors typically grow slowly and do no invade neighboring areas.  Malignant, or cancerous, tumors grow more quickly and can aggressively invade surrounding regions, as well as, spread to other parts of the body.

What is a head and neck tumor?

The term refers to the area of the body where the bottom of the brain, lower skull and upper spine meet.  This region includes critical structures including large blood vessels that supply the brain, the brainstem which controls many automatic processed of the body, nerves that supply the face and throat and the spinal cord which relays messages to and from the brain and body.

Head and neck tumors that are benign often form from tissue of the pituitary gland or nervous system.  Examples include pituitary tumors, acoustic neuromas (also called vestibular schwannoma) and meningiomas.

Cancerous skull base tumors more frequently originate from the soft tissue of the head and neck and then invade the skull base.  Examples include squamous cell carcinoma and adenocarcinoma.

What are signs and symptoms of a head and neck tumor?

Depending on their size, location and type, skull base tumors may cause some of the following signs and symptoms:

• Headaches
• Difficulty breathing
• Changes in smell and vision
• Difficulty swallowing and corresponding weight loss
• Hearing loss or ringing in the ears
• Nausea or vomiting
• Memory loss
• Dizziness or loss of balance

How are head and neck tumors treated?

“The first essential step is to determine the correct diagnosis, since many of the presenting symptoms are vague,” Aaron C. Spalding, M.D., Ph.D., radiation oncologist with Norton Cancer Institute. “This requires an interdisciplinary team approach, and why there are many different specialties involved in caring for patients with skull base tumors as part of the Head, Neck and Skull Base Tumor Program at Norton Cancer Institute.”

Dr. Spalding said delays in diagnosis can occur without interdisciplinary management. With a proper diagnosis, treatment regimens can be discussed with patients and their families.

Treating head and neck tumors can be challenging because they can grow close to important nerves and blood vessels in the brain, head, neck and spine. Treatment will vary depending on a number of factors but may include surgery, stereotactic radiosurgery, external beam radiation therapy, chemotherapy, immunotherapy and targeted therapy.

In addition, treating skull base tumors often requires a team of providers. Your treatment may include the following specialties:

• Neurosurgeon
• Medical oncologist
• Radiation oncologist
• Behavioral oncologist
• Speech pathologist
• Nutritionist
• Nurse Navigator
• Neuroradiologist
• Neuropathologist
• Ear, nose and throat surgeon
• Plastic surgeon
• Oral prosthodontist

“Caring for patients with skull base tumors requires a multi-disciplinary team of experts to create an individualized treatment plan for each patient and their family,” said David Sun, M.D., Ph.D., neurosurgeon with Norton Neuroscience Institute. Dr. Sun also works with the Head, Neck and Skull Base Tumor Program. “As a collaboration between Norton Cancer Institute and Norton Neuroscience Institute, we are proud to offer these services.”