Tumors of the Skull and Cranial Nerves
Benign Tumors
Osteoma
Benign growth of mature dense cortical bone in paranasal sinuses, cranial vault, mandible, mastoid sinuses. Associated with Gardner syndrome (autosomal-dominant osteoma, colon polyps, soft tissue fibromas).
Usually asymptomatic with slow growth. Sometimes causes local pain, proptosis, headache, recurrent sinusitis.
CT: circumscribed homogeneous bone density.
Chondroma
Rare, slow-growing benign tumor; arises from cartilaginous portion of bones of skull base or paranasal sinuses. Often causes cranial nerve palsies.
CT: lytic lesion, sharp margins, erosion surrounding bone, stippled calcification.
Hemangioma
Benign vascular bone tumor of capillary or cavernous vascular channels. More common in vertebral column than cranium.
MRI: flow voids, suggesting vascular lesion.
Dermoid, Epidermoid
Cranial vault, paranasal sinuses, orbit, petrous bone. Common in children.
CT: round or ovoid lytic lesions with sharp sclerotic margins; involves all 3 layers of bone. Treatment rarely necessary.
Treatment
Treatment for all types (if symptomatic): surgical resection.
Malignant Tumors
Metastases to Skull Base
Most common: breast, lung, prostate; head-neck tumors; lymphoma. Local pain, cranial neuropathy.
Lesions usually readily demonstrated on MRI.
Differential diagnosis: leptomeningeal metastasis.
Treatment: palliative radiotherapy.
Extension of Malignant Tumors to Skull Base
Squamous cell carcinomas (nasal sinuses, temporal bone), carcinoma of salivary gland, olfactory mucosa, nasopharynx. Local pain, cranial neuropathy.
CT or MRI: soft tissue mass, erosion of skull base. Biopsy often diagnostic.
Related posts:
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
