Skull Base Tumor Treatment

Sinus and skull base tumors, which can be cancerous or noncancerous (benign), are tumors that grow in the area behind the eyes and nose that extends to the base of the skull.

Even when these tumors are not cancerous, they can still cause problems as they grow and start to press against the brain, vital nerves or major blood vessels.

Types of Skull Base Tumors

Skull base tumors can either be intracranial or sinonasal.

Intracranial tumors grow within the brain, nerves or other structures inside the skull. Some examples of intracranial tumors include the following:

• Meningioma, the most common kind of brain tumor. Most cases are treatable. The tumor grows slowly, is often benign and can usually be removed surgically.
• Acoustic neuroma, also called vestibular schwannoma. This is a benign, slow-growing tumor in the inner ear. It can put pressure on nerves that control the face, hearing, speech, swallowing and balance. Because it grows so slowly, specialists sometimes just monitor these tumors with imaging scans to make sure they don’t cause problems. But in other cases, they need to be removed with surgery.
• Pituitary macroadenoma, a tumor that grows on the pituitary gland. Although it is benign, it grows quite large and can cause problems with the functions of the pituitary. Treatment involves surgery that can often be performed through the nose.
• Craniopharyngioma, a rare type of tumor that mostly appears in children, but it can appear in adults, especially over the age of 50. It is benign and grows slowly near the pituitary gland. It can stunt growth in children and cause worrying symptoms. Treatment usually involves a combination of surgery and radiation therapy but can also involve chemotherapy and other therapies.

Sinonasal tumors grow in or behind the nose and the sinuses. They include nasal cavity and paranasal sinus cancers. Following are some examples of sinonasal tumors:

• Squamous cell carcinoma, often a type of skin cancer but can also grow in the nasal and paranasal sinuses. It is the most common type of sinonasal tumor making up more than half of cases. Treatment usually involves surgery often combined with radiation therapy, and it can sometimes include chemotherapy.
• Sinonasal adenocarcinoma, a rare, cancerous tumor that forms in the salivary glands or nasal cavity behind the nose. It is usually treated with surgery that can often be performed through the nose. Sometimes surgery is followed with radiation therapy or chemotherapy, especially if the tumor is aggressive or not completely removed by surgery.
• Adenoid cystic carcinoma, a rare, cancerous tumor that most often forms in the salivary glands but can also grow in the tear or sweat glands or other areas of the body. It grows slowly but can recur after treatment. Surgery is the most common treatment, followed by radiation therapy to remove any remaining cancer cells. Patients may also need chemotherapy or targeted drug therapy.
• Sinonasal undifferentiated carcinoma, a rare, malignant tumor that tends to grow quickly from the lining of the nose or sinuses, often spreading to areas outside of the sinonasal tract. The most effective treatment usually combines surgery, radiation therapy and chemotherapy.
• Rhabdomyosarcoma, a rare tumor mostly found in children that grows in soft tissue, often in the nose, upper throat and sinuses. When it appears in adults, it often spreads, or metastasizes. Treatment often involves a combination of surgery, radiation therapy, chemotherapy and immunotherapy.
• Sinonasal lymphoma, which develops in white blood cells and is usually a form of non-Hodgkin lymphoma. Treatment often includes chemotherapy and may include radiation therapy.
• Olfactory neuroblastoma, a rare tumor of the nasal cavity that grows in the nerves and tissue that control the sense of smell. It can grow into the eyes or brain and spread to other areas of the body. Treatment usually involves surgery, which can be invasive and require reconstructive surgery afterward. But some cases can be treated with minimally invasive surgery. Radiation therapy may also be used as the main treatment or as a follow-up to surgery to reduce risks of the tumor recurring. Some patients may also need chemotherapy, especially if the tumor has spread.
• Mucosal melanoma, a type of melanoma, which affects cells that produce melanin, that grows in the mucosa, or mucus membrane that lines organs and other parts of the body. It can appear anywhere there is mucosa in the body but often affects the head and neck, including the nose, mouth and throat. It is rare but aggressive and fast-growing, and it appears more often in Asians and people over age 70. Because it doesn’t tend to cause symptoms early on, it is mostly found at later stages. Treatment usually involves surgery to remove tumors followed by radiation therapy. Some patients may also be treated with immunotherapy and targeted therapy.

Skull Base Tumor (Skull Cancer) Symptoms

If you have a skull base tumor, your symptoms will vary based on where the tumor is growing and what type of tumor it is. Skull base tumor symptoms often develop slowly as the tumor grows and starts to press against nerves, blood vessels or other important parts of the brain, head and neck.

See your doctor right away if you experience any of these possible sinus and skull base tumor symptoms:

• Headaches
• Pain, numbness, weakness or paralysis in the face
• Shortness of breath (dyspnea)
• Hoarseness or laryngitis (losing your voice)
• Difficulty swallowing (dysphagia) and frequent choking
• Blurred or double vision, or vision loss
• Hearing loss or ringing in the ears (tinnitus)
• Changes in your sense of smell
• Dizziness or problems with balance
• Nausea and vomiting
• Memory loss

Many of these are symptoms of multiple conditions, so it’s important to be evaluated by a doctor to get an accurate diagnosis.

Treatment for Skull Base Tumors

Skull base tumors are challenging to treat because they are near the brain, eyes, major blood vessels and/or spinal cord. Our skull base and pituitary surgeons pool their expertise with specialists in neurology, otolaryngology and radiation oncology to create custom treatment plans for you.

Your plan may include one or more of the following:

• Surgery: The goal of surgery is to remove as much of the tumor as possible. Some tumors require more extensive surgery and removal of surrounding tissue to make sure they don’t grow back, or recur. Surgery to remove tumors may be followed up with reconstructive surgery, especially if it will cause major scarring or alter the patient’s physical appearance.
• Minimally invasive surgery: Our skull base surgeons can treat most tumors using minimally invasive approaches that let patients go home sooner and recover faster and with less pain and visible scarring. These procedures can be done in the following ways:
  • Through the nostril, called endonasal endoscopic surgery
  • Using a small incision in the eyebrow
  • From behind the ear 
  • Minimally invasive surgery can include grafting, especially inside the nose, to prevent cerebrospinal fluid leaks while patients heal.
• Radiation therapy: High-energy beams of radiation can be targeted at cancer cells, which damages their DNA, destroying them. This can shrink tumors or prevent them from growing. Radiation therapy is commonly used in the following cases:
  • Before surgery, to improve the likelihood that the tumor can be taken out completely in one piece
  • After surgery, to destroy any remaining tumor cells
  • For prevention, to slow the growth of tumors that can’t be removed with surgery
• Rehabilitation: Most patients who have treatment for skull base and sinus tumors don’t need rehab. But for those who do, Rush offers a range of services that can enhance recovery and help regain any lost function. Our rehabilitative services include the following:
  • Physical therapy
  • Occupational therapy
  • Speech and hearing services
  • Pain management
  • Nutritional therapy

Second Opinions on Skull Base Tumors at Rush

If you’ve been diagnosed with a skull base or sinus tumor or prescribed treatment, a second opinion can help you make decisions and feel more confident in your care.

Each case at Rush is reviewed by specialists from many fields, including rhinology, oncology, chemotherapy, neurology and neurosurgery. They all work together to create a complete second opinion and personalized care plan for you. Patients also tend to have better results when they get treatment at academic medical centers.

It’s especially important to seek a second opinion if you’ve been told you have limited or no options. Rush regularly participates in clinical trials that can offer care that is not available elsewhere.

To get a second opinion on your sinus or skull base tumor diagnosis, call Rush at (888) 352-7874. You can also learn more about second opinions on our Getting a Second Opinion page.

Rush Excellence in Skull Base Tumor Treatment

• Nationally recognized care: U.S. News & World Report includes Rush University Medical Center in Chicago on its Best Hospitals Honor Roll and ranks our ENT, cancer care, neurology and neurosurgery programs among the best in the nation. Our specialists have also been named a Multidisciplinary Team of Distinction by the North American Skull Base Society.
• Safer, more accurate treatment: Skull base and pituitary surgery specialists in Chicago and the surrounding area provide the least invasive but most effective treatment possible. This includes endoscopic surgery to remove the tumors and targeted radiation therapy that kills microscopic tumor cells without harming healthy surrounding tissue.
• Experience that matters: Rush is among a handful of programs in the U.S. that have extensive experience treating these rare tumors. In fact, only about 5% of U.S. hospitals evaluate and treat as many patients with pituitary and skull base tumors as we do, and we treat more skull base cancer cases than any other hospital in Illinois. This expertise allows us to successfully treat even the most complex tumors.