Tumor of the base of the skull, benign or malignant. Malignant tumors of the bones of the skull. Types of malignant tumors of the skull bone

Removal of a skull bone tumor is a surgical procedure aimed at excising malignant or benign neoplasms of the bone part of the skull. The complexity of such operations depends on the location of the tumor. The closer it is to the vital brain systems, the more caution and professionalism it requires from a neurosurgeon.

The benign type of neoplasms of the skull bones include:

chondroma;
osteoma;
dermoid;
glomus tumor;
hemangioma.

Their removal is relevant when squeezing the structures of the brain, as well as in cases of ingrowth of tumor elements into the cranium. Malignant tumors require more complex treatment, most often radical intervention for chondrosarcoma or osteosarcoma is accompanied by radiation and chemotherapy. If drastic measures are prohibited, then partial removal is carried out.

Indications for removal of a tumor of the bones of the skull

One of the most important reasons for removing a skull tumor will be its growth. In this case, it will begin to compress the circumferential region of the brain more and more, which by itself will affect the patient's well-being. With the expansion of the tumor, serious neurological disorders are observed. If the size of the neoplasm is small, but also requires surgical intervention, then they have a negative effect on the nuclei of the cranial nerves and the brain stem. There are also tumors that are in the sinuses, they make breathing difficult.

Abscess or osteomyelitis belong to the group of indications, because they cause an extensive inflammatory process. For tumors that grow outwards during development (endovasic type), removal is advisable for cosmetic reasons.

Benign tumors of small sizes without symptoms do not need to be removed. In this situation, it is necessary to observe the dynamics of the tumor process by a specialist.

Method of removal of a tumor of the skull bones

Operational actions to remove a tumor of the skull bones begin with the choice of anesthesia. General anesthesia or local anesthesia will be relevant.

General anesthesia is used in most clinical cases, and local anesthesia is used for benign tumors of small localization.

Further, depending on the location of the tumor, the type of surgical access is determined. In most cases, resection is performed, however, the scraping method is also used (for example, with excochleation), but after it a relapse is not excluded. Re-removal occurs due to incomplete curettage. Tumors similar to chondroma make it difficult to operate. Such operations are due to the fact that the neoplasm covers healthy brain systems.

Glomus neoplasms are removed by resection of the pyramidal part of the temporal bone, after which it is isolated into the cervical zone. In this case, the patient loses a large amount of blood, because glomus tumors cover the vascular trunk, which has a good blood supply. To prevent bleeding, embolization of vessels adjacent to the tumor is used.

Malignant formations are often not completely excised; palliative operations are used to alleviate the patient's condition. The neurosurgeon tries to remove the maximum allowable area of the affected bone. Along with it, the adjacent healthy bone tissue is excised, since it can hide tumor cells in itself. Such surgery is accompanied by radiation and chemotherapy. Metastatic tumors are removed if only one node is present, otherwise, the treatment will be ineffective.

After resection, plastic surgery of the defective zone is performed, if this is permissible by the clinical picture. Suturing is the final step in the removal of skull bone tumors. The sutures are removed after a week. The rehabilitation period includes antibiotics, chemical and radiation therapy (if necessary).

Contraindications for removal

With active tumor growth and strong metastases, removal is contraindicated. Surgery is also not recommended for:

advanced age of the patient;
severe somatic pathologies;
the impossibility of excision of the predominant area of the tumor (with strong ingrowth or coverage of vital brain systems).

Complications when removing a tumor of the bones of the skull

Relapse is one of the most serious complication. In this case, a great threat to the patient is that a benign neoplasm can turn into a malignant one. Malignancy is extremely dangerous and it is impossible to predict it.

Other complications:

damage to 9-12 cranial nerves;
throat cut;
development of liquorrhea;
hemorrhagic stroke;
meningitis;
ischemic stroke.

There are other negative consequences that are characteristic of surgical treatment of the brain and cranium.

Tumors in the base of the skull treatment in Rostov-on-Don: doctors of medical sciences, candidates of medical sciences, academicians, professors, corresponding members of the academy. Making an appointment, counseling, reviews, prices, addresses, detailed information. Make an appointment with the leading neurosurgeon in Rostov-on-Don without a queue at a convenient time for you.

Balyazin Viktor Alexandrovich

Balyazin Viktor Alexandrovich Doctor of Medical Sciences, Professor, Head of the Department of Neurosurgery, Rostov State Medical University

Moldovanov Vladimir Arkhipovich

Moldovanov Vladimir Arkhipovich Candidate of Medical Sciences, Doctor of the highest qualification category, 35 clinical experience

Efanov Vladimir Georgievich

Candidate of Medical Sciences, Head of the Neurosurgical Department of Rostov State Medical University, Efanov Vladimir Gergievich

How to make an appointment with a doctor?

1) Call the number 8-863-322-03-16 .

1.1) Or use the call from the site:

Request a call

call the doctor

1.2) Or use the contact form.

Inna Bereznikova

Reading time: 7 minutes

A A

Everyone knows what a skull is, but only a few understand where its base is located. Let's try to take a short anatomical course to clarify the situation. This is a very complex system, consisting of the posterior and anterior sections. The anterior, in turn, is characterized by a boundary location between the organs of the face and the brain, and the posterior - between the cervical region and the brain. In a more understandable language: the anterior part of the base of the skull is located in the region of the paranasal sinus, and the posterior part falls on the occipital part.

Tumors of the base of the skull are quite rare. It is very difficult and dangerous to treat such a disease, but a running process brings even more trouble. It is better to get rid of education, noticing the first symptoms.

Inner base of the skull

Varieties of benign tumors of the base of the skull:

papilloma inverted;
polyps;
meningioma;
fibroma;
osteoma;
schwannoma;
neurofibroma;
cementoma;
Thornwald bag.

Most often, benign occurs, since it is in this part that the maximum amount of adipose tissue is concentrated, which are constantly subjected to mechanical stress. Consider the most popular formations.

Inverted papilloma

This is a benign tumor of the base of the skull, which is located in or paranasal sinuses. It begins to develop at the age of 50, predominantly men suffer. Education has local aggressiveness. Under the influence of inverted papilloma, soft tissues suffer and the dense bone walls of the nose are partially destroyed. The main danger of inverted papillomas is the tendency to frequent relapses. Also, about 5% of the formations degenerate into cancer.

Diagnostics

Papillomas are diagnosed by assessing the symptoms of their manifestation. Let's consider the main ones:

shortness of breath in one of the sinuses or its complete absence;
with an enlarged tumor, it is possible to open it, as a result of which nosebleeds develop;
olfactory functions are disturbed;
, which gradually spread to the entire face;
constant heaviness in the nasal passage;
excessive tearing;
deformity of the external nasal cartilages.

After assessing the symptoms, they proceed to a hardware examination. Rhinoscopy or computed tomography is prescribed, which show the internal structure of the formation. It has a granular structure and is located in the area of the base of the skulls with peculiar lobules. On closer examination, papillary growths are found. The color of the tissue of the inverted papilloma is pink or purplish red.

Treatment

Inverted papilloma can be cured only through surgical intervention. The endoscopic method is often used. This is contact removal in a single block for less invasiveness. The main thing is not to destroy the surrounding mucous membranes. After the operation, it is very important to conduct an examination every six months in order to exclude the possibility of recurrence.

meningioma

This is a benign tumor of the base of the skull, capable of transforming into a malignant formation over time. It grows from the hard tissues of the meninges. It is characterized by slow growth and gradual growth. As a rule, it is very difficult to completely remove such a formation, therefore, all patients who have undergone surgery are advised to carry out regular diagnostics to exclude malignancy of the formation. Also like this. Meningiomas occur most often at the age of 35 years.

Stages of development of meningiomas:

benign first degree;
atypical second degree;
malignant third degree.

The main reason for the development of meningiomas is radiation exposure. Also, a similar tumor can develop after radiation therapy, used to treat many types of cancer.

Symptoms

The disease manifests itself depending on its location and size. In the first couple, a meningioma can grow asymptomatically, but with an increase it brings considerable discomfort.

Diagnostics

Diagnosis of the disease is impossible without a visual examination. The general condition, symptoms of meningioma, as well as reflex reactions, sensitivity of the skin are assessed. The patient also undergoes a consultation with an ENT and an ophthalmologist. MRI, computed tomography is performed. A biopsy helps to determine the benign origin of the tumor, but it can only be done during surgery.

Treatment

After a diagnostic examination, the treatment tactics are determined. As a rule, surgical intervention is prescribed. As preparation, the patient is given conservative treatment in order to reduce the tumor and slow down its development. Inflammatory processes are also removed with the help of corticosteroid drugs.

Schwannoma (neurinoma)

A benign formation that is formed from the peripheral and spinal nerves. It is the result of the growth of the myelin sheath in the cavity of the base of the skull. Occurs at the age of 50 years. Outwardly, it resembles a dense rounded formation with an outer framing shell. The growth rate is quite slow: 1-2 mm annually. With more intensive growth, a suspicion of a malignant formation arises.

The reasons

Reasons for development:

radiation exposure to which the body is exposed at an early age;
prolonged exposure to chemical fumes;
harmful working conditions;
genetic neurofibromatous heredity;

Symptoms

Symptoms of the disease appear depending on the location and size of the formation. The tumor can affect the optic nerves, the hearing aid, cause cerebellar disorders.

First symptoms:

if the auditory nerve is involved in the tumor process, a constant ringing occurs in the ears;
hearing is impaired;
coordination is disturbed and severe dizziness occurs.

Later manifestations:

when the formation grows up to 2 cm, the trigeminal nerve is compressed;
the sensitivity of the skin of the face is disturbed;
dull pain in the affected area. Often the patient is confused by her dental;
when the tumor grows up to 4 cm, the facial nerves begin to be compressed, causing loss of taste, profuse salivation, and strabismus.

Tumors of the posterior cranial fossa

These formations include pathological changes in the brain tissues, IV ventricle and medulla oblongata. There are meningiomas, astrocytomas, neuromas, gliomas. Such formations occur at an early age, develop slowly and can transform into cancer. If tumors of the posterior cranial fossa occur in old age, this is usually the result of the formation of metastases.

Symptoms

Symptoms of tumors of the posterior cranial fossa:

frequent nausea and unreasonable vomiting;
headache that does not go away after taking painkillers;
deterioration of hearing and vision;
numbness of the face and neck, pain in the same area;
damage to the central nervous system;
the appearance of unusual tics;
dizziness;
changes in the appearance of the face;
violation of the swallowing reflex.

Diagnostics

Diagnosis of a tumor of the posterior cranial fossa is carried out according to an assessment of the symptoms described by the patient, as well as using a hardware examination. Since education begins to show itself only at later stages with an increase in volume, one cannot do without X-rays, MRI and computed tomography.

x-ray is the simplest diagnostic method and shows the level of damage to the bone part of the skull;
computed tomography using X-ray radiation allows you to accurately determine the contours of the tumor and the level of penetration deep into the nervous system;
MRI is an important diagnostic procedure that provides qualitative information about pathological transformations of soft tissues;
puncture of the cerebrospinal fluid assesses the damage to the nervous system, as well as the degree of prevalence;
electroencephalography demonstrates the basic functionality of the nervous system;
genetic examination indicates that the patient has hereditary neurofibromatosis;
histology helps to establish an accurate diagnosis and prescribe effective treatment.

Surgery for skull base tumors

Treatment

The success of the treatment depends on the experience and skill of the neurosurgeon, since in most cases it is not possible to avoid surgical intervention. This is a radical method of getting rid of education. The main goal is not to hurt the central nervous system. In modern medicine, microsurgical instruments with a special optical system are used. Only in this way can the operation be carried out with particular accuracy. Doctors try to avoid damage to healthy tissue and the development of serious complications.

What are the stages in lymphoma?
(Read in 9 minutes)

What are the complications after removal of prostate adenoma?
(Read in 3 minutes)

Malignant neoplasms of the skeletal system in the head region occur both as primary and secondary tumors. This disease is characterized by rapid and aggressive growth of mutated tissues. skull cancer, mainly develops in the form of the initial lesion.

The reasons

The etiology of the disease is unknown. Among the risk factors, doctors consider:

the presence of a concomitant oncological disease;
genetic predisposition;
exposure to ionizing radiation;
systemic immunosuppression.

Cancer of the bones of the skull: types of tumors

Malignant neoplasms of this area are formed in the following variants:

- a tumor, which includes mutated elements of cartilage tissue.
- oncological formation, which is mainly localized in the temporal, occipital and frontal regions. This pathology is characterized by rapid and aggressive growth with early metastasis. Most patients are people of a younger age category, which is explained by the development of a mutation during the period of bone tissue growth.
- cancer of the base of the skull. It is dangerous for the spread of oncology into the nasopharyngeal space and damage to the nerve bundles. Because of these features of the topography among cancer patients with chordoma, there is a high mortality rate.
- cancerous pathology, which is located in the area of the cranial vault.
- in most cases, this tumor affects the bones of the limbs, and in the cranial tissues, the sarcoma is identified as a metastasis.

Symptoms and signs

The clinical picture is based on the following principles:

The early stages of the oncoprocess are mostly asymptomatic.
For Ewing's sarcoma, typical manifestations are: migraine attacks, subfebrile body temperature, an increase in the concentration of leukocytes and anemia.
Myeloma is accompanied by malaise and intense muscle pain.
Symptoms of osteosarcoma include the formation of an immovable hard tissue hard tissue lump and a local attack of pain.
Metastatic processes in the skull are manifested by symptoms of intoxication of the body.

Modern diagnostics

The definition of cancer diagnosis is based on x-rays of the head. Cancer compaction, in particular, requires a radiological examination in the lateral projection.

The radiologist identifies the tumor by atypical bone fusion, which may have clear or jagged edges. Depending on the form of pathology, the foci of mutation can be either single or multiple.

The final diagnosis is established in the laboratory, by microscopic examination of a small area of modified tissue (biopsy). This technique is called.

After determining the final diagnosis, specialists prescribe the patient to conduct computed and magnetic resonance imaging. Such examinations are necessary to clarify the prevalence and location of the tumor.

Cancer of the bones of the skull: how is it treated today?

The method of anticancer exposure in case of cranial cancer depends on the stage of malignant growth and the localization of the painful focus.

At the initial stage, the most effective method of treatment is a surgical operation, during which the neoplasm is excised in a radical way for a cancer patient. After resection, often, the patient undergoes a course of rehabilitation. He undergoes plastic surgery of a bone defect and endoprosthetics to restore cosmetics.

In the later phases of oncology development and in case of inoperable tumor, the patient is recommended to undergo the following treatment:

Chemotherapy

The systemic use of cytostatic agents causes the disintegration of the neoplasm in the first and second stages. Oncologists prescribe this therapy in several courses, the dosage is determined individually for each cancer patient.

Radiotherapy

Radiation irradiation of the tumor focus is indicated for Ewing's sarcoma as the only anticancer technique. And in the case of myeloma lesions, ionizing radiation contributes to a significant improvement in the quality of life.

Combined treatment

The bottom line is surgical removal and subsequent radiation therapy. This sequence of procedures minimizes the risk of postoperative complications and recurrence of the disease.

Palliative care

Metastatic cancer and cancer of the skull bone at the terminal stage are treated symptomatically. Medical care in such cases focuses on stopping pain attacks and maintaining the vital functions of the body.

Video: Gorodnichev versus CANCER 1 episode (craniotomy)

Sarcoma of the skull bones

Forecast and how long live?

To assess the consequences of such a diagnosis as " skull bone cancer”, in oncological practice, a 5-year survival rate is used. This index includes the total number of patients who survived to the five-year milestone from the date of the final diagnosis.

Video: BATTLE OF CASTLES Skull and Cancer. Evolution 1 and 2.

The prognosis for the life of patients on, as a rule, is favorable. About 80% of cancer patients live for 5 years or more. Further development of oncology and the spread of mutated cells outside the tumor aggravate the prognosis. The index of postoperative survival at is 60%. The terminal phase and metastasized neoplasm of cranial tissues has a negative result of treatment. The high mortality of patients is due to the aggressiveness of oncology and damage to nearby nerve centers.

skull cancer, like many other malignant oncological formations, requires detailed and timely diagnosis. Only adequate therapy at an early stage of the oncological process contributes to a complete cure and protects the patient from postoperative relapse. Such patients also additionally need to undergo annual preventive examinations by an oncologist.

Attention, only TODAY!

The first symptoms that make it possible to suspect a pathological process in the body are weakness, spontaneous rises in body temperature, weight loss and appetite. The most common symptom of bone tumors, occurring in 70% of patients, is pain. At first, the pain may be mild and disappear spontaneously. In the future, stubborn, constant pains that increase over time and at night are characteristic, which are poorly removed or not removed by painkillers. As a rule, from the moment the first pain sensations appear to the diagnosis, it takes from 6 to 12 months. Physiotherapy, often given before the diagnosis is made, may increase pain or reduce it only for a short time. The pain can be of varying intensity, but the faster the growth of the tumor, the stronger the pain syndrome. In addition, it is possible to detect a tumor formation of various sizes and limited mobility in the joint near which the tumor appeared. At the site of the tumor, the limb is enlarged in circumference, painful, the skin above it can be swollen and thinned, hot to the touch.