Cancer of the bones that make up the skull is a cancer that occurs in people of different age groups. In this article we will look at the types of bone tissue of the skull, as well as symptoms, stages, diagnosis and treatment methods malignant tumors this localization.

Cancer of the skull bones can be a consequence of mutation of primary benign formations:

osteoma from the deep layers of the periostat. The outer and inner plates of the substance form a compact single or multiple osteoma, the spongy substance forms a spongy (spongy) osteoma or a mixed form.
hemangiomas of the spongy substance of the parietal and frontal ossicles (less often occipital) of capillary (spotty), cavernous or racemose forms;
enchondroma;
osteoid osteomas (cortical osteomas);
osteoblastoma;
chondromyxoid fibromas.

A primary tumor of the bones of the skull and soft tissues of the head with benign growth can secondary grow into the bones of the vault and destroy them. They can be located at both corners of the eye in the form of dermoid cysts, next to mastoid process, sagittal and coronal sutures.

Cholesteatomas of the soft tissues of the head form defects on the outer bone plate: scalloped edges and a band of osteosclerosis. Meningiomas grow into the bones along the osteon canals, and due to the proliferation of osteoblasts, the bone tissue is destroyed and thickened.

Types of malignant tumors of the skull bone

Skull bone cancer is represented by:

chondrosarcoma with mutated elements of cartilage tissue;
osteogenic sarcoma in the temple, occiput and forehead;
myeloma at the cranial vault;
Ewing's sarcoma in the tissues of the skull;
malignant fibrous histiocytoma.

This malignant tumor of the skull, growing from cartilage cells, damages the skull, trachea and larynx. It is rare in children; people aged 20-75 years are more likely to get sick. This type of cancer appears in the form bony prominence, covered with cartilage. Chondrosarcoma can result from malignancy of benign tumor processes. This type is classified according to its degree, reflecting the speed of its development. With slow growth, the severity and prevalence will be lower and the survival prognosis will be higher. If the degree of malignancy is high (3 or 4), then the formation grows and spreads quickly.

Features of some chondrosarcomas:

differentiated - aggressive behavior, they can change and acquire features of fibrosarcomas or osteosarcomas;
clear cell - slow growth, frequent local recurrence in the area of the initial oncological process;
mesenchymal - rapid growth, but good sensitivity to chemicals and radiation.

This osteogenic tumor of the skull bones is rarely primary and is formed from bone cells. Affects the temporal, occipital and frontal regions. More often, secondary sarcoma is diagnosed in the periosteum, dura mater, aponeurosis and paranasal sinuses. Education reaches large sizes, are prone to decay and rapid germination into the dura mater of the brain.

Metastases from cancer of the skull bones (osteosarcoma) occur early, the formation forms quickly and grows aggressively. When examining the x-ray, a lesion with uneven outlines and the presence of borderline osteosclerosis is noticed. If the lesion extends beyond the cortex, this leads to the appearance of radiant periostitis. In this case, the bone spicules diverge fan-shaped.

Primitive connective tissue, which gives rise to osteogenic sarcoma of the skull, is capable of forming tumor osteoid. Then CT scans record a combination of osteological and osteoblastic processes.

Children, due to mutations in bone tissue during growth, and young people aged 10-30 years are most often affected. Elderly people get sick in 10% of cases. Treatment is carried out surgically, antitumor drugs (and others) and radiation therapy.

The growth of this sarcoma of the skull in bone and soft tissues occurs from malignant neoplasms other zones. The tumor mass contains uniform round large cells with small nuclei, necrosis and hemorrhage may be present. Ewing's sarcoma of the head actively affects the human condition from the first months of development. Patients complain of high temperature, pain, their leukocyte level increases (up to 15,000), and secondary anemia develops. Children, adolescents and young adults are more likely to get sick. Ewing's sarcoma can be treated with radiation and Sarcolysin. X-ray therapy can prolong the life of patients up to 9 years or more.

A malignant tumor of the skull bone of these types initially originates in ligaments, tendons, fatty and muscle tissue. It then spreads to the bones, especially the jaws, and metastasizes to lymph nodes and important vital organs. Elderly and middle-aged people are more often affected.

Myeloma at the calvarium

Myeloma occurs in the flat cranial bones and ossicles facial area. It is characterized by a pronounced destructive process in the area of the cranial vault. The clinical and radiological type of myeloma (according to S. A. Reinberg) is:

multifocal;
diffuse-porotic;
isolated.

X-ray changes in bone in myeloma (according to A.A. Lemberg):

focal;
knotty;
osteolytic;
mesh;
osteoporotic;
mixed.

In the works of G.I. Volodina identified focal, osteoporotic, small-cell and mixed radiological variants of changes in bone tissue in myeloma. Focal changes include bone destruction: round or irregular shape. The diameter of the area can be 2-5 cm.

Chordoma at the base of the skull

Oncology of the skull bones is also represented by chordoma at its base. She's dangerous rapid spread into the nasopharynx and damage to nerve bundles. The location of the chordoma leads to high frequency mortality of patients, among whom there are more men after 30 years. With residual chordoma cells after surgery, local recurrence occurs.

Classification of bone cancer also includes:

giant cell primary tumor of benign and malignant forms without characteristic metastasis. Giant cell occurs as a local relapse after surgical excision bone tumor formation;
non-Hodgkin's lymphoma in the bones or lymph nodes;
plasmacytoma on the bones or bone marrow.

From the lymph nodes, cells can penetrate into the bones of the head and other organs. The tumor behaves like any other primary non-Hodgkin's tumor with the same subtype and stage. Therefore, treatment is carried out the same as for primary lymph nodes. The therapeutic regimen, as for osteogenic sarcoma of the skull, is not used.

Giant cell tumor of the skull (osteoblastoclastoma or osteoclastoma)

May occur due to hereditary predisposition in the population, from infancy to old age. The peak of the oncological process occurs at 20-30 years of age, due to the growth skeletal system. Benign tumors can transform into malignant ones. Osteoclastoma progresses slowly, pain and swelling of the bone appear on late stages diseases. Metastases reach surrounding and distant venous vessels.

In lytic forms of giant cell tumor, its cellular-trabecular structure is noticeable on the radiograph or the bone completely disappears under the influence of the oncological process. Pregnant women with this disease should terminate the pregnancy or begin treatment after childbirth if it is detected late.

Causes of skull bone cancer

The etiology and causes of cranial bone cancer have not yet been fully studied. It is believed that cancer formations in the lungs, mammary glands, sternum and other areas of the body during metastasis spread their cells through the blood and lymph vessels. When they reach the head, secondary cancer of the skull bones occurs. The formation of tumors, for example, at the base of the skull occurs when tumors grow from the neck and soft tissues. from the nasopharynx in later stages can also grow into the bones of the skull.

Risk factors or causes of skull tumors:

genetic predisposition;
related benign diseases(eg, retinoblastoma of the eye);
bone marrow transplant;
exostoses (bumps due to ossification cartilage tissue) with chondrosarcoma;
ionizing radiation, exposure to radiation for therapeutic purposes;
diseases and conditions that reduce immunity;
frequent bone injuries.

Skull bone cancer: symptoms and manifestations

Clinical symptoms of cranial bone cancer are divided into three groups. The first general infectious group includes:

increase in body temperature with chills and/or excessive sweating;
intermittent fever: a sharp rise in temperature above 40° and a fleeting decline to normal and subnormal levels, then a repetition of temperature jumps after 1-3 days;
increased leukocytes in the blood, ESR;
sudden weight loss, increasing weakness, appearance of pale skin on the face and body.

Symptoms of cranial bone cancer of the general cerebral group:

headaches with increased intracranial pressure, with nausea and vomiting, as well as changes in the fundus (this includes congestive discs, optic neuritis, etc.);
epileptic seizures (appear due to intracranial hypertension);
periodic (orthostatic) bradycardia up to 40-50 beats/min;
mental disorders;
slowness of thinking;
inertia, lethargy, “stupefaction”, drowsiness, even coma.

Focal (third group) symptoms and signs of cancer of the skull bones depend on the location of the pathological process. in some cases they do not appear for a long time.

Focal symptoms of skull bone tumors are complicated by swelling and compression of brain tissue, meningeal symptoms with cerebellar abscesses. This is characterized by the manifestation of pleocytosis with lymphocytes and polynuclear cells (multinuclear cells) in the cerebrospinal fluid. It increases the protein concentration (0.75-3 g/l) and pressure. But often such changes may not occur.

Osteogenic sarcoma of the skull bone is characterized by a fixed subcutaneous compaction and pain when the skin above it moves. The lymph nodes of the head and neck are enlarged. With metastases, hypercalcemia develops, accompanied by nausea, vomiting, dryness of the oral mucosa, excessive urination, and impaired consciousness.

With Ewing's sarcoma, patients have increased white blood cell levels and temperature, headaches, and anemia. With myeloma, patients sharply weaken, they develop secondary anemia, and excruciating pain aggravates their life.

Multiple myeloma can affect 40% of the bone tissue of the cranial vault. In this case, all detected lesions are considered primary with multifocal growth and do not belong to metastatic tumors.

Stages of skull cancer

Primary cancer of the skull bone is divided into stages of the malignant process, which is necessary to determine the extent of tumor spread, prescribe treatment and predict survival after it.

At the first stage, tumor formations have a low level of malignancy and do not extend beyond the bone. At stage IA, the size of the node does not exceed 8 cm, at stage IB it is >8 cm.

At the second stage, the oncological process is still in the bone, but the degree of cell differentiation decreases.

At the third stage, several bones or areas of bone are affected, and the oncological process spreads throughout the skull and its soft tissues. Metastasis occurs to the lymph nodes, lungs and other distant organs at stage 4.

Diagnosis of a skull bone tumor

Diagnosis of cranial bone cancer includes:

examination of the nasal cavity and ears using the endoscopic method;
radiography of frontal and lateral projections of the head;
CT and MRI with layer-by-layer radiological scanning of bone and soft tissue;
PET – positron emission tomography with the introduction of glucose, containing a radioactive atom, to identify the oncological process in any area of the body and distinguish between benign and malignant tumors;
PET-CT – for more rapid detection of sarcoma of the skull bone and other formations;
osteoscintigraphy – scanning bone skeleton using radionuclides;
histological examination of biopsy material after radical surgery (biopsy, puncture and/or surgical biopsy);
urine and blood tests, including a blood test for .

Diagnosis of a tumor of the skull bones is supported by collecting anamnesis and examining patients to establish all the symptoms of the disease and the general condition of the patient.

Skull bone cancer with metastases

Metastases in the bones of the skull appear mainly from a primary malignant process in the lungs, mammary, thyroid and prostate glands, as well as the kidneys. In 20% of patients, metastases from cancer of the skull bones spread from malignant melanoma of the mucous membranes of the nasopharynx and mouth, and the retina. Tumors spread to the brain through blood vessels. Metastasizes in adults with retinoblastoma and/or sympathoblastoma, in children - retinoblastoma and/or medulloblastoma. Destructive bone lesions damage the spongy substance. As the metastasis grows, a wide sclerotic zone moves outward from the bone.

With multiple lytic small-focal metastases, as in multiple myeloma, their configuration may be different in the bones of the calvarium, and the process will resemble malignant chromaffin tumor of the adrenal glands, liver and mediastinum. Metastases also affect the base of the skull and facial bones. Therefore, when identifying signs of skull cancer on radiographs, it is necessary to examine not only the primary tumor, but also the metastatic lesion.

If even one metastasis appears in the skull, all other major organs are fully examined to exclude metastases in them. First of all, the lungs are checked with an X-ray. In addition to hematogenous metastasis, the following tumors can also penetrate into the vault and base of the skull as they grow:

chordoma (it involves the bottom and back of the sella turcica, clivus and pyramidal apexes of the temple bones in the oncological process);
cancer of the nasopharynx (the tumor mass grows into the sphenoid sinus and the bottom of the sella turcica).

Metastases from the kidneys, mammary glands, adrenal glands reach the paranasal sinuses, upper and lower jaw, eye sockets. Then a retrobulbar tumor is detected on an x-ray. With radionuclide scanning, metastases are detected faster than with radiography.
Treatment for metastatic cancer of the skull bones is the same as for primary tumors.

Treatment of skull bone cancer

Surgical treatment

Various pathological processes that develop in the cranial bones and in its cavities require surgical intervention: craniotomy.

Treatment of a tumor of the skull bones is carried out:

resection trepanation with the formation of an unclosed bone defect;
osteoplastic trephination, in which a part of the bone and soft tissue flaps are cut out, and after the operation they are placed in place. Sometimes alloplastic material (protacryl) is used to close the defect or preserved homogeneity.

Treatment of cancer of the skull bones, which is complicated by osteomyelitis, is carried out by wide resection of the affected bone to stop the purulent process. Primary tumors (benign and malignant) are excised as much as possible within the healthy tissue and treatment is supplemented with radiation therapy. Ifosfamide (Ifosa).

Cyclophosphamide (Cytoxan).

Cisplatin or .

Cytostatic agents, when released into the blood, contribute to different stages. Courses, regimens, combinations of drugs and their dosage are selected individually for each patient. This determines how much it will be possible to minimize the development of complications (side effects) after chemotherapy.

Temporary health complications include nausea and vomiting, loss of appetite and hair, and the appearance of ulcerations on the mucous membranes of the mouth and nose. Chemicals damage bone marrow cells involved in hematopoiesis, as well as lymph nodes. At the same time, the number of blood cells decreases. If there is a blood disorder:

risk increases infectious diseases(with a decrease in the level of leukocytes);
bleeding or bruising occurs due to minor cuts or injuries (with a decrease in platelet levels);
shortness of breath and weakness appear (with a decrease in red blood cells).

TO specific complications include hematuria (hemorrhagic cystitis - blood particles in the urine), which appears due to damage bladder Ifosfamide and Cyclophosphamide. To eliminate this pathology, the drug Mesna is used.

Cisplatin damages nerves, and neuropathy occurs: nerve function is impaired. Patients feel numbness, tingling and pain in the limbs. The drug can damage the kidneys, so the patient is given a lot of fluid before/after the Cisplatin infusion. Hearing is often impaired, especially not perceived high sounds, therefore, before prescribing chemotherapy and dosing medications, hearing is examined (an audiogram is performed).

Doxorubicin damages the heart muscle, especially when high doses drug. Before chemotherapy with Doxorubicin, heart function is examined to minimize the harm caused. All side effects should be reported to doctors and nurses so that corrective measures can be taken.

During the chemistry period, blood and urine tests are examined in the laboratory to determine the functional functioning of the liver, kidneys and bone marrow.

Radiotherapy

Some bone tumors may respond to radiotherapy only at high doses. This can cause damage to healthy structures and nearby nerves. This type of treatment is used as the main treatment for Ewing's sarcoma. In myeloma, ionizing radiation significantly improves the quality of life of patients. When the tumor mass is partially removed, the edges of the wound are irradiated to damage/destroy the remaining malignant cells.

Intensity modulated radiation therapy (IMRT)) believe modern look external (local) radiological therapy, is carried out by computer adjusting beams of rays to the volume of the tumor and changing their intensity. The rays are directed to the epicenter at different angles in order to reduce the dose of radiation that passes through healthy tissues. At the same time, the radiation dose to the site of the oncological process remains high.

A new type of radiotherapy includes proton beam therapy. Here protons are replaced x-rays. The proton beam slightly damages healthy tissue, but reaches and destroys cancer cells. This type of radiation is effective for treating the base of the skull in chordomas and chondrosarcomas.

For metastases, surgery is performed followed by radiation therapy, which reduces postoperative complications and recurrence. Palliative therapy ( symptomatic treatment) are carried out for metastatic and bone cancer of the skull: pain attacks are stopped and vital functions of the body are supported.

Life prognosis for cancer of the skull bones

To assess the consequences of a diagnosis of skull bone cancer, oncologists use an indicator that includes the number of patients who lived 5 years from the date of confirmation of the diagnosis.

The life expectancy for cancer of the skull bones at the first stage is 80%. With the further development of cancer, cell mutations and their spread beyond the lesion, the prognosis becomes less optimistic. In the second and third stages, up to 60% of patients survive. In the terminal phase and with metastasis, treatment of cranial tissue formations may have a negative result. Aggressive behavior tumors and damage to the central nervous system lead to death.

Life expectancy for tumors of the skull bones is late stages after treatment lasts 6-12 months. The most disappointing prognosis is for multiple metastatic lesions. Neurological disorders persist in 30% of patients after treatment.

Informative video

Tumors in the base of the skull: description, treatment, appointment

Tumors in the base of the skull treatment in Rostov-on-Don: doctors of medical sciences, candidates of medical sciences, academicians, professors, corresponding members of the academy. Make an appointment, consultation, reviews, prices, addresses, detailed information. Make an appointment with a leading neurosurgeon in Rostov-on-Don without waiting in line at a time convenient for you.

Balyazin Viktor Alexandrovich

Balyazin Viktor Alexandrovich Doctor of Medical Sciences, Professor, Head of the Department of Neurosurgery, Rostov State Medical University

Moldovanov Vladimir Arkhipovich

Moldovanov Vladimir Arkhipovich Candidate of Medical Sciences, Doctor of Higher Education qualification category, 35 clinical experience

Efanov Vladimir Georgievich

Candidate of Medical Sciences, Head of the Neurosurgical Department of Rostov State Medical University, Efanov Vladimir Gergievich

How to make an appointment with a doctor?

1) Call the number 8-863-322-03-16 .

1.1) Or use the call from the site:

Request a call

Call the doctor

1.2) Or use the contact form.

Inna Bereznikova

Reading time: 7 minutes

A A

Everyone knows what a skull is, but only a few understand where its base is. Let's try a quick anatomy course to clear things up. This is very complex system, consisting of posterior and anterior sections. The anterior one, in turn, is characterized by a boundary location between the organs of the face and the brain, and the posterior one - between the cervical region and the brain. In more understandable language: the anterior section of the base of the skull is located in the area of the paranasal sinus, and the posterior section is located in the occipital part.

Tumors of the base of the skull are a fairly rare occurrence. It is very difficult and dangerous to treat such a disease, but the neglected process brings even more more trouble. It is better to get rid of the formation as soon as you notice the first symptoms.

Inner base of the skull

Types of benign tumors of the skull base:

inverted papilloma;
polyps;
meningioma;
fibroma;
osteoma;
schwannoma;
neurofibroma;
cementoma;
Thornwald's bag.

Most often, benign occurs, since it is in this part that the maximum quantity fatty tissues that are constantly exposed to mechanical stress. Let's look at the most popular formations.

Inverted papilloma

This is a benign tumor of the base of the skull, which is located in the paranasal sinuses. It begins to develop at the age of 50 and affects mainly men. Education has local aggressiveness. Under the influence of inverted papilloma they suffer soft fabrics and the dense bone walls of the nose are partially destroyed. The main danger of inverted papillomas is the tendency to frequent relapses. Also, about 5% of formations degenerate into cancer.

Diagnostics

Papillomas are diagnosed by assessing the symptoms of their manifestation. Let's consider the main ones:

difficulty breathing in one of the nasal sinuses or its complete absence;
if the tumor is enlarged, it may be opened, resulting in nosebleeds;
the functions of smell are impaired;
which gradually spread to the entire face;
constant heaviness in the nasal passage;
excessive tearing;
deformation of the external nasal cartilages.

After assessing the symptoms, they proceed to a hardware examination. Rhinoscopy or computed tomography is prescribed, which show internal structure education. It has a granular structure and is located in the area of the base of the skulls in peculiar lobules. Upon closer examination, papillary growths are revealed. The color of the inverted papilloma tissue is pink or purplish red.

Treatment

Inverted papilloma can only be cured through surgery. Often used endoscopic method. This is contact removal in a single block for less invasiveness. The main thing is not to destroy the surrounding mucous membranes. After surgery, it is very important to undergo examination every six months in order to exclude the possibility of relapse.

Meningioma

This is a benign tumor of the base of the skull that can transform into a malignant tumor over time. Grows from hard tissues meninges. Characterized by slow growth and gradual expansion. As a rule, it is very difficult to completely remove such a formation, so all patients who have undergone surgery are recommended to carry out regular diagnostics to exclude malignancy of the formation. Also like this. Meningiomas occur most often at the age of 35 years.

Degrees of development of meningiomas:

benign first degree;
atypical second degree;
malignant third degree.

The main cause of the development of meningiomas is radiation exposure. Also similar tumor may develop after radiation therapy used to treat many types of cancer.

Symptoms

The disease manifests itself depending on its location and size. At first, meningioma can grow asymptomatically, but as it grows it causes considerable discomfort.

Diagnostics

Diagnosis of the disease cannot be made without a visual examination. Evaluated general condition, symptoms of meningioma, as well as reflex reactions, sensitivity of the skin. The patient also undergoes consultation with an ENT specialist and an ophthalmologist. MRI and computed tomography are performed. A biopsy helps determine the benign origin of the tumor, but it can only be done during surgery.

Treatment

After a diagnostic examination, treatment tactics are determined. As a rule, surgical intervention is prescribed. As preparation, the patient is given conservative treatment in order to reduce the tumor and slow down its development. Inflammatory processes are also relieved with the help of corticosteroid drugs.

Schwannoma (neurinoma)

Benign formation, which is formed from peripheral and spinal nerves. It is the result of the proliferation of the myelin sheath in the cavity of the base of the skull. Occurs at the age of 50 years. Outwardly it resembles a dense round formation with an outer framing shell. The growth rate is quite slow: 1-2 mm annually. With more intensive growth, a suspicion arises about the malignancy of the formation.

Reasons

Reasons for development:

radiation exposure to which the body is exposed at an early age;
long-term influence of chemical fumes;
harmful working conditions;
genetic neurofibromatosis heredity;

Symptoms

Symptoms of the disease appear depending on the location and size of the formation. The tumor can affect the optic nerves, the hearing aid, and cause cerebellar disorders.

First symptoms:

if involved in the tumor process auditory nerve, there is a constant ringing in the ears;
hearing is impaired;
Coordination is impaired and severe dizziness occurs.

Later manifestations:

when the formation grows to 2 cm, the trigeminal nerve is compressed;
the sensitivity of the facial skin is impaired;
dull pain in the affected area. Often the patient confuses it with a tooth;
when the tumor grows to 4 cm, the facial nerves begin to be compressed, causing loss of taste, profuse salivation, strabismus.

Posterior fossa tumors

Such formations include pathological changes in brain tissue, the fourth ventricle and medulla oblongata. There are meningiomas, astrocytomas, neuromas, and gliomas. Such formations appear at an early age, develop slowly and can turn into cancer. If posterior fossa tumors occur in old age, this is usually the result of metastases.

Symptoms

Symptoms of tumors of the posterior cranial fossa:

frequent nausea and causeless vomiting;
headache that does not go away after taking painkillers;
deterioration of hearing and vision;
numbness of the face and neck, painful sensations to the same area;
central lesion nervous system;
the appearance of unusual tics;
dizziness;
changes in facial appearance;
violation of the swallowing reflex.

Diagnostics

Diagnosis of a tumor of the posterior cranial fossa is carried out according to the assessment of the symptoms described by the patient, as well as using hardware examination. Since the formation begins to manifest itself only at later stages with an increase in volume, it is impossible to do without X-rays, MRI and computed tomography.

X-ray is the simplest diagnostic method and shows the level of damage to the bone part of the skull;
computed tomography using X-ray radiation allows you to accurately determine the contours of the tumor and the level of penetration deep into the nervous system;
MRI is important diagnostic procedure, which provides high-quality information about pathological transformations of soft tissues;
cerebrospinal fluid puncture assesses damage to the nervous system, as well as the extent of its extent;
electroencephalography demonstrates the basic functionality of the nervous system;
genetic testing indicates that the patient has hereditary neurofibromatosis;
histology helps to establish accurate diagnosis and prescribe effective treatment.

Surgery for skull base tumors

Treatment

The success of treatment depends on the experience and dexterity of the neurosurgeon, since in most cases it is not possible to avoid surgical intervention. This is a radical method of getting rid of education. The main goal is not to affect the central nervous system. In modern medicine, microsurgical instruments with a special optical system are used. This is the only way to carry out the operation with extreme precision. Doctors try to avoid damage to healthy tissue and the development of serious complications.

Skull bone tumors

What are Skull Bone Tumors -

Brain abscess- limited accumulation of pus in the brain matter. The most common abscesses are intracerebral, less often - epidural or subdural.

What provokes / Causes of Swelling of the skull bones:

The cause of a brain abscess is the spread of infection caused by streptococci, staphylococci, pneumococci, and meningococci. E. coli, Proteus, and mixed flora are often found. The ways in which infection penetrates into the brain matter are different. In accordance with the etiology and pathogenesis, brain abscesses are divided into: 1) contact (associated with a nearby purulent focus); 2) metastatic; 3) traumatic.

Pathogenesis (what happens?) during tumors of the skull bones:

Most common contact abscesses caused by mastoiditis, otitis, purulent processes in the bones of the skull, paranasal sinuses nose, orbit, meninges. About half of all brain abscesses are of otogenic origin. Chronic purulent otitis are much more often complicated by an abscess than acute inflammatory processes in the ear. Infection in otitis media penetrates from the temporal bone through the roof of the tympanic cavity and the cavernous sinuses percontinuitate into the middle cranial fossa, causing an abscess of the temporal lobe of the brain. Otogenic infection can also spread into the posterior cranial fossa through the labyrinth and sigmoid sinus, leading to a cerebellar abscess. Rhinogenic abscesses are localized in the frontal lobes of the brain. First, local pachymeningitis develops, then adhesive limited meningitis, and finally inflammatory process spreads to the brain substance with the formation of limited purulent encephalitis. In more in rare cases Oto- and rhinogenic abscesses can occur hematogenously due to thrombosis of veins, sinuses, and septic arteritis. Abscesses are localized in the deep parts of the brain, far from the primary focus.

Metastatic abscesses brain diseases are most often associated with lung diseases: pneumonia, bronchiectasis, abscess, empyema. Metastatic abscesses can also complicate septic ulcerative endocarditis, osteomyelitis, abscesses internal organs. The mechanism of infection entering the brain is septic embolism. In 25-30% of cases, metastatic abscesses are multiple and are usually localized in the deep parts of the white matter of the brain.

Traumatic abscesses arise as a result of open (extremely rarely closed) skull injuries. When the dura mater is damaged, the infection penetrates through the perivascular fissures into the brain tissue, which is preceded by the development of limited or diffuse inflammation of the membranes. In cases of penetration into the brain foreign body the infection comes with it. An abscess forms along the wound canal or directly in the area of a foreign body. Peacetime traumatic abscesses account for up to 15% of all brain abscesses; their percentage increases sharply during the war and in the post-war period.

Pathomorphology. The formation of a brain abscess goes through a number of stages. Initially, the reaction to the introduction of infection is expressed in a picture of limited inflammation of the brain tissue - purulent encephalitis. In the future, healing through scarring is possible. In other cases, as a result of the melting of brain tissue, a cavity filled with pus appears - the stage of a limited abscess. A rather dense connective tissue capsule forms around the cavity - the stage of an encapsulated abscess. It is believed that capsule formation begins after 2-3 weeks and ends after 4-6 weeks. With a decrease in the body's immune reactivity, encapsulation occurs extremely slowly, and sometimes the purulent focus in the brain remains in the stage of melting of the brain tissue.

Symptoms of Skull Tumors:

In the clinical picture of a brain abscess, 3 groups of symptoms can be distinguished:

1) general infectious diseases- increased temperature (sometimes intermittent), chills, leukocytosis in the blood, increased ESR, signs of a chronic infectious process (pallor, weakness, weight loss); 2) cerebral, appearing as a result of an increase intracranial pressure caused by the formation of an abscess. Most persistent symptom- headaches. Cerebral vomiting, fundus changes (congestive discs or optic neuritis), periodic (orthostatic) bradycardia up to 40-50 beats/min, and mental disorders are often observed. The inertia, lethargy of the patient, and the slowness of his thinking are noteworthy. Stupefaction, drowsiness, and in severe cases without treatment, coma may gradually develop. As a consequence intracranial hypertension general epileptic seizures may be observed; 3) focal, depending on the location of the abscess in the frontal, temporal lobes, and cerebellum. Abscesses located deep in the hemispheres outside the motor zone can occur without local symptoms. Otogenic abscesses sometimes form not on the side of otitis media, but on the opposite side, giving the corresponding clinical picture. Along with focal symptoms, symptoms associated with swelling and compression of brain tissue may be observed. When the abscess is close to the membranes and with a cerebellar abscess, meningeal symptoms are detected.

In the cerebrospinal fluid, pleocytosis is observed, consisting of lymphocytes and polynuclear cells, an increase in protein levels (0.75-3 g/l) and pressure. However, often no changes are found in the cerebrospinal fluid.

Flow. The onset of the disease is usually acute, with rapid manifestations of hypertension and focal symptoms against the backdrop of rising temperatures. In other cases, the onset of the disease is less defined, then the clinical picture resembles the course general infection or meningitis. Rarely initial stage abscess occurs latently, with minimally expressed symptoms and low fever. After the initial manifestations, after 5-30 days, the disease enters the latent stage, corresponding to the encystation of the abscess. This stage is asymptomatic or manifests itself with moderate symptoms of intracranial hypertension - frequent headache, vomiting, mental retardation. The latent stage can last from several days to several years. In the future, gender is influenced by any external factor(infection), and more often without obvious reasons, cerebral and focal symptoms begin to progress rapidly. Fatal outcome with a brain abscess it occurs due to its swelling and sharp increase intracranial pressure. An extremely serious complication of an abscess, possible at any stage, is its rupture into the ventricular system or subarachnoid space, which also usually ends in death.

Diagnosis of tumors of the skull bones:

Recognition of a brain abscess is based on medical history ( chronic otitis media, bronchiectasis, other foci of purulent infection, trauma), the presence of focal, cerebral symptoms, signs of increased intracranial pressure, onset of the disease with elevated temperature and its characteristic progressive course. To make a diagnosis, repeated echoencephalography is important, revealing displacement of the midline structures of the brain during abscesses of the hemispheres. X-rays of the skull (signs of increased intracranial pressure), radiography of the paranasal sinuses, temporal bones, fundus examination (congestive discs or a picture of optic neuritis), and lumbar puncture are also necessary.

The decisive role in recognizing abscesses, especially multiple ones, belongs to computed tomography and magnetic resonance imaging, which reveals a characteristic round formation, usually limited to the capsule.

When conducting a study at the stage of abscess formation, the capsule may be absent, and around the formed cavity there are signs of inflammation of the brain tissue and accompanying edema.

In the presence of hypertension syndrome lumbar puncture should be carried out carefully, and if the patient’s condition is serious, refrain from it, since with increasing intracranial hypertension, extraction of cerebrospinal fluid can cause pinching of the cerebellar tonsils in the foramen magnum (with a cerebellar abscess) or the medial parts in the temporal lobes in the foramen of the tentorium of the cerebellum (with abscess of the temporal lobe) with compression of the trunk, which can lead to the death of the patient.

Differential diagnosis depends on the stage of the abscess. In the initial acute period of the disease, an abscess should be distinguished from purulent meningitis, the cause of which may be the same as the abscess. The greater severity of rigidity should be taken into account neck muscles and Kernig's sign in purulent meningitis, persistence high temperature(with an abscess the temperature is often hectic), large neutrophilic pleocytosis in the cerebrospinal fluid, absence of focal symptoms.

The course and symptoms of an abscess and a brain tumor have much in common. Differential diagnosis is difficult, since a malignant tumor may cause leukocytosis in the blood and an increase in body temperature. In these cases, the anamnesis data is of particular importance, i.e. the presence of factors that cause the development of an abscess. It should be borne in mind that by the time the abscess forms, the primary purulent focus may have already been eliminated.

Treatment of Skull Tumors:

With a brain abscess, the prognosis is always serious. With untimely and inadequate treatment, primarily surgical, mortality reaches 40-60%. The worst prognosis is in patients with multiple metastatic abscesses. In 30% of those who have recovered, residual neurological symptoms, most often focal seizures.

Which doctors should you contact if you have a tumor of the skull bones:

Is something bothering you? Do you want to know more detailed information about tumors of the skull bones, its causes, symptoms, methods of treatment and prevention, the course of the disease and diet after it? Or do you need an inspection? You can make an appointment with a doctor– clinic Eurolab always at your service! The best doctors they will examine you and study you external signs and will help you identify the disease by symptoms, advise you and provide necessary help and make a diagnosis. You can also call a doctor at home. Clinic Eurolab open for you around the clock.

How to contact the clinic:
Phone number of our clinic in Kyiv: (+38 044) 206-20-00 (multi-channel). The clinic secretary will select a convenient day and time for you to visit the doctor. Our coordinates and directions are indicated. Look in more detail about all the clinic’s services on it.

(+38 044) 206-20-00

If you have previously performed any research, Be sure to take their results to a doctor for consultation. If the studies have not been performed, we will do everything necessary in our clinic or with our colleagues in other clinics.

At yours? It is necessary to take a very careful approach to your overall health. People don't pay enough attention symptoms of diseases and do not realize that these diseases can be life-threatening. There are many diseases that at first do not manifest themselves in our body, but in the end it turns out that, unfortunately, it is too late to treat them. Each disease has its own specific signs, characteristic external manifestations - the so-called symptoms of the disease. Identifying symptoms is the first step in diagnosing diseases in general. To do this, you just need to do it several times a year. be examined by a doctor to not only prevent terrible disease, but also to maintain a healthy spirit in the body and the organism as a whole.

If you want to ask a doctor a question, use the online consultation section, perhaps you will find answers to your questions there and read self care tips. If you are interested in reviews about clinics and doctors, try to find the information you need in the section. Also register on the medical portal Eurolab to be constantly aware of the latest news and information updates on the site, which will be automatically sent to you by email.

Other diseases from the group Diseases of the nervous system:

Absence epilepsy Kalpa

Brain abscess

Australian encephalitis

Angioneuroses

Arachnoiditis

Arterial aneurysms

Arteriovenous aneurysms

Arteriosinus anastomosis

Bacterial meningitis

Amyotrophic lateral sclerosis

Meniere's disease

Parkinson's disease

Friedreich's disease

Venezuelan equine encephalitis

Vibration disease

Viral meningitis

Exposure to ultra-high frequency electromagnetic fields

Effects of noise on the nervous system

Eastern equine encephalomyelitis

Congenital myotonia

Secondary purulent meningitis

Hemorrhagic stroke

Generalized idiopathic epilepsy and epileptic syndromes

Hepatocerebral dystrophy

Herpes zoster

Herpetic encephalitis

Hydrocephalus

Hyperkalemic form of paroxysmal myoplegia

Hypokalemic form of paroxysmal myoplegia

Hypothalamic syndrome

Fungal meningitis

Influenza encephalitis

Decompression sickness

Childhood epilepsy with paroxysmal activity on EEG in the occipital region

Cerebral palsy

Diabetic polyneuropathy

Dystrophic myotonia Rossolimo–Steinert–Kurshman

Benign childhood epilepsy with EEG peaks in the central temporal region

Benign familial idiopathic neonatal seizures

Benign recurrent serous meningitis of Mollare

Closed injuries of the spine and spinal cord

Western equine encephalomyelitis (encephalitis)

Infectious exanthema (Boston exanthema)

Hysterical neurosis

Ischemic stroke

California encephalitis

Candidal meningitis

Oxygen starvation

Tick-borne encephalitis

Coma

Mosquito viral encephalitis

Measles encephalitis

Cryptococcal meningitis

Lymphocytic choriomeningitis

Meningitis caused by Pseudomonas aeruginosa (pseudomonas meningitis)

Meningitis

Meningococcal meningitis

Myasthenia gravis

Migraine

Myelitis

Multifocal neuropathy

Disorders of the venous circulation of the brain

Spinal circulatory disorders

Hereditary distal spinal amyotrophy

Trigeminal neuralgia

Neurasthenia

Obsessive-compulsive disorder

Neuroses

Femoral nerve neuropathy

Neuropathy of the tibial and peroneal nerves

Facial nerve neuropathy

Ulnar nerve neuropathy

Radial nerve neuropathy

Median nerve neuropathy

Nonfusion of vertebral arches and spina bifida

Neuroborreliosis

Neurobrucellosis

neuroAIDS

Normokalemic paralysis

General cooling

Burn disease

Opportunistic diseases of the nervous system in HIV infection

Tumors of the cerebral hemispheres

Acute lymphocytic choriomeningitis

Acute myelitis

Acute disseminated encephalomyelitis

Brain swelling

Primary reading epilepsy

Primary damage to the nervous system in HIV infection

Fractures of the skull bones

Landouzy-Dejerine scapulohumeral-facial form

Pneumococcal meningitis

Subacute sclerosing leukoencephalitis

Subacute sclerosing panencephalitis

Late neurosyphilis

Polio

Poliomyelitis-like diseases

Malformations of the nervous system

Transient cerebrovascular accidents

Progressive paralysis

Progressive multifocal leukoencephalopathy

Becker's progressive muscular dystrophy

Progressive Dreyfus muscular dystrophy

Progressive Duchenne muscular dystrophy

Progressive muscular dystrophy Erb-Roth

Tumors of the skull base are neoplasms that have a different histological structure and can be localized in the cranial cavity or in the area of the facial skeleton. Most often, tumors of the skull base are metastases of other malignant neoplasms.

The base of the skull is the bottom brain skull, formed by several bones (basal, occipital, frontal and temporal). The base of the skull appears in the human embryo already in the second month of its embryonic life. The definition of “tumor of the skull base” is collective and combines various pathological processes that affect this anatomical formation.

Anatomy

Inner base of the skull- This is the surface of the skull that faces the medulla. The inner base of the skull follows the contours of the adjacent brain. It is permeated with holes and channels - through them pass blood vessels and cranial nerves.

The surface has three depressions - the anterior, middle and posterior cranial fossae. In the anterior and middle fossa is placed big brain, the cerebellum is located in the back. The anterior and middle fossae are separated by the posterior edges of the small wings of the sphenoid bone, the middle fossa is separated from the posterior dorsum of the sella turcica and the upper edge of the pyramids of the temporal bones.

The anterior cranial fossa contains frontal lobes brain. It communicates with the nasal cavity and is located in the area of the frontal and ethmoid bones.
The middle one is located in the area of the sella turcica and communicates with the orbits through the optic canals. The pituitary gland is located in the central part of the middle cranial fossa, and the temporal lobes of the hemispheres are located in the lateral parts. In front of the sella turcica lies the optic chiasm.
The posterior cranial fossa is located in the region of the temporal and occipital bones and communicates with the spinal canal through the large foramen.

External base of the skull has a large number of openings - nerves and vessels (arteries, veins) pass through them. In front it is covered with bones facial section skulls The posterior section of the outer base of the skull is formed from the outer surfaces of the temporal, sphenoid and occipital bones.

Since there is both an external and internal base of the skull, we include not only pathological processes in the internal base, but also formations located in the structures that make up the external base of the skull as tumors of the skull base. Major advances in the treatment of tumors of the skull base have occurred due to the discovery of new diagnostic methods - computed tomography and MRI (magnetic resonance imaging). Without the use of these examination methods, the likelihood of a clinical error is very high: small tumors that occur without symptoms can immediately affect the base of the skull and, accordingly, create a significant threat to the patient’s life. Tumors that produce much more severe symptoms may not spread directly to the base of the skull and have a much better prognosis.

Etiology and pathogenesis

Tumors of the skull base are most often of a metastatic nature. Most often, the primary sources of metastases are malignant breast tumors, lung cancer, myeloma and cancer prostate gland. Damage to the base of the skull can result from contact spread of nasopharyngeal cancer, osteosarcoma, squamous cell carcinoma, glomus tumors, and chordoma. All of these tumors can spread to the base of the skull. Separately, we can highlight formations that are within the competence of otoneurologists, otolaryngologists and rhinologists: tumors localized in the nasal cavity, nasopharynx and sinuses.

Tumors affecting the base of the skull can be either malignant or benign. Example benign tumor With such localization, meningioma can serve.

Symptoms and course

A tumor of the base of the skull is a rare and complex pathology. For the most part, tumors of the skull base are represented by metastases of malignant tumors in other parts of the body - mammary glands, lungs, prostate gland. Another reason for the development of this condition is a tumor process in the paranasal sinuses.

Tumors of the skull base are accompanied by symptoms organic damage brain - headache, fainting, epileptic seizures and other neurological symptoms. When the tumor spreads into the cranial cavity and orbit, in addition to neurological disorders, ophthalmological disorders also appear - vision problems.

An even less common occurrence is the development of a primary tumor directly from the bones that make up the base of the skull. Due to the rarity of the pathology and blurring clinical picture The disease is extremely rarely detected in a timely manner. Possibility of radical surgical intervention with such data it is very difficult, since:

The tumor often spreads into the cranial cavity
The pathological process involves the brain and cranial nerves
Several anatomical zones are affected at once

If the formation is located in the area of the nose or nasopharynx, then it causes the following clinical picture:

Headache
Facial pain
Nasal breathing problems
The appearance of mucous or bloody discharge from the nose
Symptoms of sinusitis

From the appearance of the first signs of the disease to the full clinical picture, it can take from six months to a year - in each case the disease develops individually. If the complaints listed above occur, the patient should immediately consult a doctor, because if there is a delay, his health may be seriously affected (tumors of the base of the skull can be fatal).

Diagnostics

Initial examination by a doctor

The doctor listens to the patient’s complaints, finds out how the disease manifests itself clinically, and collects anamnesis.

Instrumental diagnostic methods

Endoscopic examination of the nasal cavity
X-ray computed tomography (CT)
Magnetic resonance imaging (MRI)

However, despite the high level of modern devices, the likelihood diagnostic error still remains quite high.

Listed below are specific diagnostic methods that allow you to eliminate doubts and make the correct diagnosis.

Neurosurgical biopsy
Tumor resection followed by histological examination

Treatment

Advanced combined operations, which are indicated for such complex pathologies, can lead to serious complications and sometimes fatal outcomes. Therefore, an important task of modern medicine is to find effective, and at the same time, organ-preserving methods of treating tumors of the skull base.

Radiation therapy is recommended for patients with a tumor at the base of the skull. An innovative method of treating such formations is stereotoxic radiosurgery and the CyberKnife installation. "Cyber Knife" is a high-precision treatment method equipped with a moving arm, a manipulator and robotics. Treatment with the installation does not require hospitalization; procedures can be performed on an outpatient basis.