Benign Skull Tumors Treatment & Management

Updated: Jan 16, 2019
  • Author: Draga Jichici, MD, FRCP, FAHA; Chief Editor: Tarakad S Ramachandran, MBBS, MBA, MPH, FAAN, FACP, FAHA, FRCP, FRCPC, FRS, LRCP, MRCP, MRCS  more...
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Treatment

Medical Care

Administer aspirin or NSAIDs for osteoid osteoma.

Provide pain control symptomatically.

No treatment is required for asymptomatic lesions unless diagnostic concerns exist.

Stereotactic radiosurgery should be considered as an alternative to surgical resection for benign meningiomas. [10]

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Surgical Care

Complete surgical excision when feasible is ideal for benign skull tumors for symptomatic relief, cosmetic reasons, or cranial nerve/neural decompression.

En bloc resection is the preferred intervention though this may not be possible for skull base lesions, especially those of a chondroid nature.

Curettage is also performed for lesions that cannot be resected completely. Careful removal of the cyst wall is critical in epidermoids and dermoids. Gamma Knife and CyberKnife are possible new ways of treating unresectable symptomatic lesions. [11]

Extended endonasal approaches to skull base lesions are now accepted methods of accessing hitherto difficult-to-access lesions. Endoscopy is also being used in simple osteoid osteomas of the forehead for cosmetic purposes.

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Consultations

See the list below:

  • Neurosurgeon

  • Plastic surgeon

  • Neurologist

  • Radiation oncologist: Radiation therapy is acceptable as an adjuvant treatment in some partially resected lesions, such as ossifying fibroma, hemangioma, and aneurysmal bone cyst because of their high recurrence rate. In addition, stereotactic neurosurical modalities such as the Gamma Knife and the CyberKnife are widely used now for inaccessible/ incompletely resected skull base lesions.

  • Ophthalmologist

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