Primary Malignant Skull Tumors Treatment & Management

Updated: Aug 09, 2017
  • 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

See the list below:

  • Analgesic medications can be used for painful lesions.

  • Aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) are used for osteoid osteoma.

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Surgical Care

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  • Whenever possible, complete surgical excision is the treatment of choice for primary tumors (except multiple myeloma).

  • Preoperative embolization is recommended for angiosarcomas to reduce intraoperative blood loss. If other means cannot control tumor expansion, surgery is still an option in metastatic disease.

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Consultations

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  • Neurosurgeon

  • Neurologist

  • Radiation oncologist

  • Hematologist/oncologist

  • Radiation therapist

  • Radiosurgery, including Gamma Knife and CyberKnife, can be useful for some tumors.

    • Osteosarcomas - Primary form of treatment for secondary osteosarcoma, especially in elderly patients

    • Ewing sarcoma

    • Giant cell tumor

    • Multiple myeloma, if chemotherapy fails

    • Chordoma

    • Radiosensitive metastatic tumors

    • Not indicated for angiosarcoma and fibrosarcoma

    • Use in chondrosarcoma controversial

  • Chemotherapy also may be indicated. Chemotherapy should be administered under the direction of a hematologist and/or oncologist. Combinations of various drugs are used, including cisplatin, cyclophosphamide, carmustine (BCNU), and lomustine (CCNU).

    • Osteosarcomas

    • Fibrosarcomas

    • Multiple myeloma (first choice of treatment)

    • Efficacy in chondrosarcoma unknown

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