Multimedia
 | Media file 1: Osteoma. CT scan with axial bone windows and coronal plane reconstruction that demonstrates a fibrous osteoma that involves the right orbit and the floor of the anterior cranial fossa. |
 | Media file 2: Intracranial plasmacytoma. Sagittal and axial T1-weighted MRI with contrast enhancement demonstrate a right-sided plasmacytoma of the petrous bone. This tumor was treated through a far lateral approach and suboccipital craniotomy following a superselective embolization of feeding arteries. |
 | Media file 3: Paraganglioma. Contrast-enhanced MRI scan of the axial (left) and coronal (right) planes that demonstrates a paraganglioma (glomus jugulare) at the right cerebellopontine angle. Extension out of the jugular foramen into the extracranial soft tissue is visible (right). |
 | Media file 4: Paraganglioma. Arterial phase external carotid artery angiograms of the patient in Image 3. Pre-embolization imaging (left) demonstrates the rich vascularity of the tumor. Postembolization imaging (right) demonstrates that the arterial feeding vessels have been significantly reduced. |
 | Media file 5: Esthesioneuroblastoma. A 39-year-old man presented with 1 month of decreased vision, left facial numbness, and swelling. Physical examination demonstrated left-sided exophthalmos and blindness. He was also unable to smell. Contrast-enhanced T1-weighted MRI demonstrated a large lesion that originated in the paranasal sinuses and extended through the cribriform plate into the anterior cranial fossa. He underwent a bifrontal craniotomy for resection of this tumor. |
 | Media file 6: Clival chondrosarcoma. Contrast-enhanced T1-weighted MRI in the coronal plane. This tumor involved the clivus and posterior clinoid and encroached on the optic chiasm in the suprasellar region. It was subtotally resected through a frontotemporal craniotomy with a zygomatic osteotomy. |
 | Media file 7: Chordoma. T1-weighted MRI with contrast that demonstrates an enhancing mass that replaced the clivus and invaded the right cavernous sinus. This lesion was subtotally resected using a sublabial approach. The patient was then treated with gamma knife radiosurgery (GKRS). |
 | Media file 8: Fibrous dysplasia. Coronal reconstruction of nonenhanced CT scan that demonstrates fibrous dysplasia of the right orbit with extension into the floor of the anterior fossa. This lesion was completely resected using a multidisciplinary team and a craniofacial approach that included a bifrontal craniotomy |
 | Media file 9: Vestibular schwannoma. T1-weighted MRI scan that demonstrates a large left-sided vestibular schwannoma in a 19-year-old woman with neurofibromatosis type II. Also present on the left is a vagal (tenth nerve) schwannoma. A residual tumor from a right-sided vestibular schwannoma, which was previously operated on, is visible. These lesions were resected through a retrosigmoid approach and suboccipital craniectomy. |
 | Media file 10: Hypoglossal schwannoma. Precontrast (left) and Postcontrast (right) T1-weighted MRI scans that demonstrate a right-sided schwannoma of the hypoglossal (XII) nerve. This tumor was completely resected using an extreme lateral approach and suboccipital craniectomy. |
 | Media file 11: Foramen magnum meningioma. Contrast-enhanced T1-weighted MRI scans that demonstrate a ventral, left-sided meningioma at the foramen magnum. This tumor was completely resected using a far lateral approach and suboccipital craniotomy with C1 laminectomy. |
 | Media file 12: Multiple skull base meningiomas. Contrast-enhanced T1-weighted MRI in the coronal (above) and sagittal (below) planes demonstrates a large left-sided petroclival meningioma and a right-sided meningioma at the foramen magnum. After shunt placement to treat hydrocephalus, the petroclival tumor was resected using a presigmoid approach. The foramen magnum tumor was subsequently resected. |
 | Media file 13: Right sphenoid wing meningioma with intraorbital involvement. Contrast-enhanced T1-weighted sagittal MRI scan. This tumor manifested as slowly progressive unilateral vision loss and mild proptosis on the right. It was resected using a frontotemporal craniotomy with orbitozygomatic osteotomy. Note the right sphenoid hyperostosis, which is best seen on the axial image (Image 14). |
 | Media file 14: Right sphenoid wing meningioma with intraorbital involvement. Contrast-enhanced T1-weighted axial MRI scan (same patient as Image 13). This tumor manifested as slowly progressive unilateral vision loss and mild proptosis on the right side. It was resected using a frontotemporal craniotomy with orbitozygomatic osteotomy. Note the right sphenoid hyperostosis. |
 | Media file 15: Meningioma of the tuberculum sella. Contrast-enhanced T1-weighted MRI scan that demonstrates a meningioma in a patient who presented with headaches and slowly progressive visual loss. Note the broad dural base, best appreciated on the sagittal image (right). This lesion was completely removed using a frontotemporal craniotomy with orbital osteotomy. |
 | Media file 16: Hemangiopericytoma. Contrast enhanced T1-weighted MRI scans that demonstrates a large hemangiopericytoma originating from the floor of the anterior fossa in a young man with progressive headaches, blurred vision, and papilledema. This tumor was subtotally resected through a frontotemporal craniotomy with orbital osteotomy. |
 | Media file 17: Adenoid cystic carcinoma. A T1-weighted image from an MRI scan that demonstrates a tumor (red arrow) that involves the ethmoid sinuses and cribriform plate. |
 | Media file 18: Adenoid cystic carcinoma. Extension of the tumor into the middle fossa anterior to the temporal lobe (blue arrow). |
 | Media file 19: Petroclival meningioma. Contrast-enhanced T1-weighted and a T2-weighted (upper right) MRI scan that demonstrates a large left-sided petroclival meningioma. This tumor was near totally resected using a presigmoid approach. The patient subsequently underwent gamma knife radiosurgery (GKRS) for the treatment of the residual tumor. |
 | Media file 20: Skull base tumors. Sagittal enhanced T1-weighted image from an MRI scan that shows a hypointense mass (blue arrow) anterior to the brainstem. |
 | Media file 21: Skull base tumors. Axial T2-weighted image from an MRI scan that demonstrates a hyperintense mass (blue arrow) anterior to and compressing the brainstem. |
 | Media file 22: Squamous cell carcinoma. Venous phase of a cerebral angiogram that demonstrates filling of the right transverse sinus (red arrow) but no filling of the left transverse sinus (blue arrow). |
 | Media file 23: Squamous cell carcinoma. Balloon test occlusion with the balloon inflated in the right transverse sinus (red arrow). |
 | Media file 24: Squamous cell carcinoma. Venous phase of a cerebral angiogram with the balloon occluding the right transverse sinus (red arrow). |
 | Media file 25: Gamma knife radiosurgery plan. This patient presented with adenoid cystic carcinoma of the right lacrimal gland. The tumor metastasized to the right middle fossa and cavernous sinus. |
 | Media file 26: Radiation necrosis. The same patient from Image 25 subsequently developed tumor recurrence and underwent right orbital exenteration and further gamma knife radiosurgery (GKRS). He presented 18 months later with new headaches and seizures. Contrast-enhanced T1-weighted and T2 FLAIR (center) MRI demonstrate radiation necrosis at the site of previous radiation therapy. |
 | Media file 27: Giant pituitary adenoma. Contrast-enhanced MRI scan that demonstrates a very large pituitary adenoma with significant suprasellar extension. Large tumors of the sellar and suprasellar region may require a combined craniotomy and trans-sphenoidal approach to achieve complete resection. |
More on Skull Base Tumors |
| Overview: Skull Base Tumors |
| Workup: Skull Base Tumors |
| Treatment: Skull Base Tumors |
| Follow-up: Skull Base Tumors |
 Multimedia: Skull Base Tumors |
| References |
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Further Reading
Keywords
skull base tumors, brain tumor, skull base surgery, skull-base tumor, skull-base surgery, brain surgery, skull-base mass, skull base mass, brain mass, meningioma, intracranial tumor, schwannoma, chondrosarcoma, chordoma, metastatic bone lesion, osteoma, en plaque tumor, en masse tumor, neurinoma, neurilemoma, acoustic neuroma, anterior cranial fossa tumor, juvenile angiofibroma, esthesioneuroblastoma, inverted papilloma, lymphomas, nasopharyngeal carcinoma, orbital glioma, orbital tumor, orbital mass, rhabdomyosarcoma, osteogenic sarcoma, ossifying fibroma, esthesioneuroblastoma, olfactory neuroblastoma, nasopharyngeal carcinoma, middle cranial base tumor, pituitary adenoma, craniopharyngioma, temporal bone tumor, cholesteatoma, enchondroma, posterior cranial fossa tumor, epidermoid tumor, dermoid tumor, chondroma, glomus tumor, paraganglioma
