Renowned expertise from different specialists leads to personalized, comprehensive care for skull base tumors.
The “skull base” is the floor of the skull composed of five bones behind the eyes and nose that provides support to the bottom of the brain. Within the skull base are all the blood vessels that supply the brain with nutrients and oxygen, as well as nerves that are critical to several functions, including vision, smell, hearing, facial movement, and breathing.
Tumors in the skull base can be cancerous (malignant) or benign (noncancerous). Even when they aren’t malignant, they may cause health problems if they grow. Removing tumors that form in the skull base requires a high level of experience, technology, knowledge, and skill. In addition, treatment for these tumors often involve the help of specialists, including, ophthalmologists, nutritionists, speech language pathologists, physical and occupational therapists, and others who work alongside your surgeon as part of your care team.
At MedStar Health, we are committed to achieving the best outcomes for patients who have tumors at the base of the skull. Our center features skilled physicians trained in the latest neurosurgical techniques. We offer a unique combination of state-of-the-art tools and expertise that makes us one of the most comprehensive programs treating these types of tumors. We use cutting-edge technology, minimally invasive techniques, and a team approach to help our patients with skull base tumors live to the fullest, preserving their quality of life.
Symptoms and risk factors
Skull base tumors can impact vision, hearing, smell, and swallowing.
Sometimes skull base tumors are incidentally found before the patient has symptoms. Other times, people may notice symptoms as the tumor grows. Signs and symptoms of these tumors vary by location and may include:
- Numbness in face
- Nosebleeds
- Impaired vision
- Headaches
- Loss of smell
- Weakness of extremities
- Hearing changes
- Ringing in the ears (tinnitus)
- Dizziness or vertigo
- Difficulty swallowing
- Shortness of breath
Although having these symptoms may not mean you have a brain tumor, it’s important to speak with your primary care provider for further evaluation.
Screening and prevention
You can’t prevent skull base tumors.
Unlike other types of cancer, lifestyle factors don't affect a person's chances of developing a brain or spinal cord tumor. As a result, there's no way to prevent these types of lesions.
Therefore, if you have a history of cancer, it's important to follow your surveillance plan to minimize the risk of metastasis or recurrence and ensure it is caught early when it may be more easily treated. If you notice any warning signs of a tumor, seek care immediately.
Diagnosis
Each tumor requires a thorough evaluation involving imaging and/or biopsy.
If you have symptoms, a skull base tumor diagnosis involves a brain MRI scan, which will help your care team determine the size and location of your tumor. You may further undergo a biopsy prior to a more definitive procedure. This will provide information on the specific characteristics of your mass, including whether it is benign or malignant. There are several ways your doctor may collect a biopsy sample, including:
- Fine-needle aspiration, which involves inserting a thin needle into the mass
- Endoscopic endonasal approach, during which your doctor will insert a thin, lighted tube into the nasal cavity.
- Craniotomy, which is when a neurosurgeon will access the tumor through the skull
Depending on the pathology of your tumor, your doctor may order additional imaging to gather other necessary information, including if it has spread to other parts of the body.
In addition, functional tests can help determine the impact of your tumor on your daily life. These will vary person-to-person, but may include tests that evaluate:
- Hearing
- Vision
- Balance
- Memory
- Hormones
- Sense of smell
- Swallowing
What are the types of skull base tumors?
There are benign and malignant tumors.
Masses at the skull base can be cancerous (malignant) or noncancerous (benign) tumors. At MedStar Health, our neuropathologists are experts in evaluating tumor under the microscope. This allows us to determine the unique profile of your tumor, which helps us tailor treatment to your specific tumor type.
We provide diagnosis and treatment options for both rare and common types of skull base tumors. Common types of benign skull base tumors include:
- Meningioma: A meningioma is a tumor that grows from the membranes surrounding your brain and spinal cord, known as the meninges.
- Acoustic neuroma (Vestibular schwannoma): An acoustic neuroma is a benign brain tumor that grows on the vestibulocochlear nerve, influencing balance and hearing. Acoustic neuromas are rare and usually slow growing.
Pituitary tumor: A pituitary tumor arises from the pituitary gland, the gland primarily responsible for regulating your hormones. We work closely with endocrinologists and ophthalmologists at MedStar Health to treat the full range of pituitary tumors. Malignant tumors that can develop in the skull base include:
- Chondrosarcomas, a type of sarcoma that begins in the cartilage around the skull base bones
- Esthesioneuroblastoma, which arises in the olfactory nerves that control your sense of smell
- Nasopharyngeal carcinomas, which develop in the upper part behind the nose (nasopharynx)
- Metastases that spread from other parts of the body
- Sinus cancers
Learn More About Brain Tumors and Brain Cancer
Treatments
Exceptional expertise that delivers advanced, comprehensive treatment for tumors at the skull base.
Treating this part of the body requires expert knowledge and skill. The best outcomes can be achieved by well-equipped, experienced surgeons working as part of a multidisciplinary team.
Each patient at MedStar Health receives compassionate, individualized care. Experts in neurosurgery, head and neck surgery, radiation oncology, otolaryngology, interventional and neuroradiology, neuro-ophthalmology, and medical oncology work closely with other clinical specialists throughout MedStar Health. These specialists meet regularly in a Skull Base Tumor Board to review and plan personalized care for each patient, considering the size, type, and location of your tumor. This ensures your skull base tumor treatment is tailored to your unique needs, leveraging the latest evidence-based approaches.
Surgery
At MedStar Health, we have a team of surgeons who are trained in, and focused solely on, treating skull base tumors. We’re one of few teams in the region with a dedicated endoscopic skull base team with fellowship-trained neurosurgeons and otolaryngologists working together to maximize your outcomes.
Our team is equipped with the latest technology. We’re highly skilled at performing advanced lateral skull base surgery using endoscopy or microsurgery, as well as an open craniotomy, to operate on tumors in this part of the skull base.
Microsurgery
Microsurgery utilizes specialized tools and techniques to remove brain tumors. At MedStar Health, our surgeons are skilled in the use of sophisticated technologies that allow access and removal of complex skull base tumors. One such technology is neuro-navigation, a GPS-like tool that guides surgeons through critical brain structures and pathways before and during surgery.
Endoscopy
Endoscopy is a minimally invasive procedure using a specially designed endoscope (a long, tube equipped with a light at the end) with high-definition cameras and monitors to gain access to your tumor through your nose. This approach often leads to a quick recovery with few complications following surgery.
Chemotherapy
If you have a skull base tumor that is malignant, your neuro-oncology team may recommend chemotherapy to destroy cancer cells. Chemotherapy medications may be given orally via a pill, through an injection, or intravenously. A medical oncologist or neuro-oncologist may recommend chemotherapy in combination with other treatment options, depending on your unique needs.
Immunotherapy and targeted therapy
In addition to chemotherapy, there are other emerging drugs that can circulate throughout the body and target cells that affect tumor growth. We continue studying how immunotherapies and targeted therapies may be used to treat skull base tumors.
Learn More About Immunotherapy
Learn More About Targeted Therapy
Radiation therapy
At MedStar Health, our radiation oncologists are experts in using state-of-the-art technology to deliver radiation with unmatched precision, limiting side effects and improving effectiveness of treatment. Your multidisciplinary team will determine if you would benefit from this type of treatment, working closely with your surgeons and medical oncologists to plan the right course of action.
For some skull base tumors, proton therapy or stereotactic radiosurgery (SRS) can be standalone treatments or used in conjunction with surgical techniques, including microsurgery or endoscopy. We were one of the first to use both to treat brain tumors, making us one of the most advanced radiation teams in the area.
Proton therapy is a highly targeted form of radiation that administers high-energy beams in the exact shape and size of your tumor, causing less damage to nearby structures. SRS is a non-invasive radiation treatment utilizing high-powered x-rays, computers, robotics, and image-guidance technology to pinpoint and destroy small tumors. At MedStar Health, we use both CyberKnife® and Zap-X® Radiosurgery to accurately deliver radiation in fewer treatments than traditional radiation therapy. Both technologies are incredibly precise, sparing nearby healthy structures and preserving critical functions.
Looking for expert neuro-oncology care?
We're dedicated to making it as easy as possible to get the world-class neuro-oncology care you deserve. Our neurosurgeons and other specialists see patients at several convenient locations throughout the region, and we work quickly to begin treatment once you are referred to us. In addition, through our Comprehensive Brain Tumor Center, patients benefit from seeing multiple providers from their oncology team under the same roof in the same appointment. This reduces travel time for patients while allowing your care team to present one well-coordinated treatment plan, so everyone is on the same page.
Our providers
Location: Change location Enter your location
Neurosurgery
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Edward Fiore Aulisi, MBBS
Spine Surgery & Neurosurgery
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Zeena Dorai, MD
Spine Surgery & Neurosurgery
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Victor Du, MD
Spine Surgery & Neurosurgery
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Daniel Roque Felbaum, MD
Neurosurgery, Vascular Neurosurgery, Endovascular Neurosurgery & Spine Surgery
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John Lynes, MD
Spine Surgery, Brain and Tumor Neurosurgery & Neurosurgery
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Jeffrey Ching-Kwei Mai, MD, PhD
Skull Base Surgery, Neurosurgery, Vascular Neurosurgery, Endovascular Neurosurgery & Spine Surgery
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Kevin Michael McGrail, MD
Spine Surgery & Neurosurgery
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Charles A. Miller, MD
Neurosurgery
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Mani Nathan Nair, MD
Neurosurgery
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Faheem Akram Sandhu, MD
Spine Surgery & Neurosurgery
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Charles L Schnee, MD
Spine Surgery & Neurosurgery
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Jugal K Shah, MD
Spine Surgery & Neurosurgery
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Samir Sur, MD
Neurosurgery
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Jean-Marc Voyadzis, MD
Spine Surgery & Neurosurgery
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Joseph Watson, MD
Neurosurgery
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Teresa Wojtasiewicz, MD
Spine Surgery & Neurosurgery
Show All Neurosurgery
Medical Oncology
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Kevin Y. Chen, MD
Gastrointestinal Medical Oncology, Medical Oncology & Hematology Oncology
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Rumaisa Hameed, MD
Hematology Oncology
Show All Medical Oncology
Radiation Oncology
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Katherine S Chen, MD
Radiation Oncology
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Keith R. Unger, MD
Radiation Oncology
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Paul Byron Fowler, MD
Radiation Oncology
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Lester L. Greer, MD
Radiation Oncology
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Kelly Orwat, MD
Radiation Oncology
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Stephen Krystjan Ronson, MD
Radiation Oncology
Show All Radiation Oncology
Our locations
Distance from Change locationEnter your location
MedStar Franklin Square Cancer Center at Loch Raven Campus
5601 Loch Raven Blvd. Russell Morgan Building First Floor Baltimore, MD 21239
MedStar Georgetown Cancer Institute at MedStar Health Bel Air Medical Campus
12 MedStar Blvd. Ste. 180 Bel Air, MD 21015
MedStar Georgetown Cancer Institute at MedStar Washington Hospital Center
110 Irving Street, NW Washington, D.C., 20010
MedStar Health: Neurology at MedStar Washington Hospital Center
110 Irving St., NW East Building, Gamma Knife Ste. G019 Washington, D.C., 20010
MedStar Health: Neuroscience at MedStar Georgetown University Hospital
3800 Reservoir Road, NW Pasquerilla Healthcare Center 7th Floor Washington, D.C., 20007
MedStar Health: Neurosurgery at Chevy Chase
5454 Wisconsin Ave. Ste. 1225 Chevy Chase, MD 20815
MedStar Health: Neurosurgery at Clinton
10401 Hospital Dr. Ste.101 Clinton, MD 20735
MedStar Health: Neurosurgery at Olney
18109 Prince Philip Dr. Ste. 300 Olney, MD 20832
MedStar Health: Neuroscience at Baltimore
3304 Guilford Ave. Baurenschmidt Bldg Ste. 487 Baltimore, MD 21218
MedStar Health: Neurosurgery at MedStar Franklin Square Medical Center
9103 Franklin Square Dr. Ste. 301 Rosedale, MD 21237
MedStar Health: Neurosurgery at MedStar Washington Hospital Center
110 Irving St., NW Ste. 2B-10 Washington, D.C., 20010
MedStar Georgetown Cancer Institute at MedStar Franklin Square Medical Center
9103 Franklin Square Dr. The Harry and Jeanette Weinberg Cancer Institute Suite 220 Baltimore, MD 21237
Why choose us
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Our fellowship-trained surgeons care for more advanced skull base tumors than anyone else in the region.
Skull base surgery at MedStar Health often involves a team of surgeons specializing in neurosurgery, head and neck surgery, otolaryngology, reconstructive surgery, and other surgical specialties. Each are experts in their respective field, with unmatched skill and experience. Our surgeons have extensive experience in minimally invasive skull base surgery using sophisticated endoscopic techniques. -
Our radiation oncologists were among the first in the region to use advanced radiosurgery technology to treat brain tumors.
We were the first in the world to use proton beam therapy with pencil beam scanning technology, the latest advancement in this type of therapy. We were also among the first in the region to use CyberKnife to treat brain tumors without incisions and with shorter sessions than conventional therapy. This expertise makes us one of the most advanced radiation therapy teams in the region.
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Our entire team of experts work together to deliver comprehensive care from start to finish.
Maximizing your quality of life is our top priority, and our specialists work together to determine which treatments will be most effective in targeting your tumor while preserving function. In addition to surgeons, medical oncologists, and radiation oncologists, your care team may also include ophthalmologists, nutritionists, speech language pathologists, physical and occupational therapists, and others who work as part of your care team to help you to enjoy your life to the fullest extent possible.
Awards and recognition
Recipient of an Accreditation with Commendation, the highest level of approval, from the American College of Surgeons’ Commission on Cancer (CoC)
Numerous surgeons, medical oncologists, and surgical oncologists recognized as "Top Doctors" by both Baltimore Magazine and the Washingtonian
Magnet® designation from the American Nurses Credentialing Center (ANCC)
Clinical trials and research
Clinical trials
MedStar Health patients have access to promising clinical trials that offer new approaches to diagnosis or treatment of cancer of all types. We frequently collaborate with the National Institute of Health and other institutions to advance care for these types of tumors.
Research
The Georgetown Lombardi Comprehensive Cancer Center is our research engine, providing us with the ability to offer all of the latest treatment options backed by the most advanced research. Our doctors are often among first to pioneer new skull base treatment options using minimally invasive surgical techniques and state-of-the-art radiation therapies.
Support services
A tumor diagnosis can cause a mix of emotions and impact more than just your physical health. As a patient at MedStar Health, you'll benefit from seamless coordination with support groups, social work services, and specialists who can help you to navigate your diagnosis, treatment, and recovery.
Learn More About Cancer Support Services
Genetic counseling
Skull base tumors are rarely attributed to genetics; however, some may be related to inherited conditions. Our genetic counselors can help you and your family learn about any potential hereditary risks of developing these types of tumors.
Learn More About Genetic Counseling
Personalized rehabilitation
Skull base tumors can affect multiple important functions. We offer comprehensive rehabilitation services that leverage the expertise of speech language pathologists, physical therapists, occupational therapists, and neuropsychologists who will tailor treatment to help you address any needs that arise.
Learn More About Cancer Rehabilitation
Survivorship
Cancer care doesn't end after treatment. Our comprehensive survivorship program will give you a clear path for navigating any necessary follow-up care, including regular imaging to catch and address signs of recurrence. We can also help you manage any late side effects or impacts to your day-to-day living to ensure you can return to the things you love.