Skull cancer symptoms and treatment. Where in Russia is surgery performed to remove skull bone cancer? Types of malignant tumors of the skull bone

Malignant neoplasms of the skeletal system in the head region occur both as primary and secondary tumors. This disease is characterized by rapid and aggressive growth of mutated tissues. skull cancer, mainly develops in the form of the initial lesion.

The reasons

The etiology of the disease is unknown. Among the risk factors, doctors consider:

• the presence of a concomitant oncological disease;
• genetic predisposition;
• exposure to ionizing radiation;
• systemic immunosuppression.

Cancer of the bones of the skull: types of tumors

Malignant neoplasms of this area are formed in the following variants:

1. - a tumor, which includes mutated elements of cartilage tissue.
2. - oncological formation, which is mainly localized in the temporal, occipital and frontal regions. This pathology is characterized by rapid and aggressive growth with early metastasis. Most patients are people of a younger age category, which is explained by the development of a mutation during the period of bone tissue growth.
3. - cancer of the base of the skull. It is dangerous for the spread of oncology into the nasopharyngeal space and damage to the nerve bundles. Because of these features of the topography among cancer patients with chordoma, there is a high mortality rate.
4. - cancerous pathology, which is located in the area of ​​​​the cranial vault.
5. - in most cases, this tumor affects the bones of the limbs, and in the cranial tissues, the sarcoma is identified as a metastasis.

Symptoms and signs

The clinical picture is based on the following principles:

• The early stages of the oncoprocess are mostly asymptomatic.
• For Ewing's sarcoma, typical manifestations are: migraine attacks, subfebrile body temperature, an increase in the concentration of leukocytes and anemia.
• Myeloma is accompanied by malaise and intense muscle pain.
• Symptoms of osteosarcoma include the formation of an immovable hard tissue hard tissue lump and a local attack of pain.
• Metastatic processes in the skull are manifested by symptoms of intoxication of the body.

Modern diagnostics

The definition of cancer diagnosis is based on x-rays of the head. Cancer compaction, in particular, requires a radiological examination in the lateral projection.

The radiologist identifies the tumor by atypical bone fusion, which may have clear or jagged edges. Depending on the form of pathology, the foci of mutation can be either single or multiple.

The final diagnosis is established in the laboratory, by microscopic examination of a small area of ​​modified tissue (biopsy). This technique is called.

After determining the final diagnosis, specialists prescribe the patient to conduct computed and magnetic resonance imaging. Such examinations are necessary to clarify the prevalence and location of the tumor.

Cancer of the bones of the skull: how is it treated today?

The method of anticancer exposure in case of cranial cancer depends on the stage of malignant growth and the localization of the painful focus.

At the initial stage, the most effective method of treatment is a surgical operation, during which the neoplasm is excised in a radical way for a cancer patient. After resection, often, the patient undergoes a course of rehabilitation. He undergoes plastic surgery of a bone defect and endoprosthetics to restore cosmetics.

In the later phases of oncology development and in case of inoperable tumor, the patient is recommended to undergo the following treatment:

Chemotherapy

The systemic use of cytostatic agents causes the disintegration of the neoplasm in the first and second stages. Oncologists prescribe this therapy in several courses, the dosage is determined individually for each cancer patient.

Radiotherapy

Radiation irradiation of the tumor focus is indicated for Ewing's sarcoma as the only anticancer technique. And in the case of myeloma lesions, ionizing radiation contributes to a significant improvement in the quality of life.

Combined treatment

The bottom line is surgical removal and subsequent radiation therapy. This sequence of procedures minimizes the risk of postoperative complications and recurrence of the disease.

Palliative care

Metastatic cancer and cancer of the skull bone at the terminal stage are treated symptomatically. Medical care in such cases focuses on stopping pain attacks and maintaining the vital functions of the body.

Video: Gorodnichev versus CANCER 1 episode (craniotomy)

Forecast and how long live?

To assess the consequences of such a diagnosis as " skull bone cancer”, in oncological practice, a 5-year survival rate is used. This index includes the total number of patients who survived to the five-year milestone from the date of the final diagnosis.

Video: BATTLE OF CASTLES Skull and Cancer. Evolution 1 and 2.

The prognosis for the life of patients on, as a rule, is favorable. About 80% of cancer patients live for 5 years or more. Further development of oncology and the spread of mutated cells outside the tumor aggravate the prognosis. The index of postoperative survival at is 60%. The terminal phase and metastasized neoplasm of cranial tissues has a negative result of treatment. The high mortality of patients is due to the aggressiveness of oncology and damage to nearby nerve centers.

skull cancer, like many other malignant oncological formations, requires detailed and timely diagnosis. Only adequate therapy at an early stage of the oncological process contributes to a complete cure and protects the patient from postoperative relapse. Such patients also additionally need to undergo annual preventive examinations by an oncologist.

Tumors of the skull bones

What is Skull Tumors?

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

What provokes / Causes of Tumors of the bones of the skull:

The cause of a brain abscess is the spread of infection caused by streptococci, staphylococci, pneumococci, meningococci. Often found Escherichia coli, Proteus, mixed flora. Ways of penetration of infection into the substance of the brain are different. In accordance with the etiology and pathogenesis, brain abscesses are divided into: 1) contact (associated with a closely located purulent focus); 2) metastatic; 3) traumatic.

Pathogenesis (what happens?) during Skull Tumors:

Most common contact abscesses caused by mastoiditis, otitis, purulent processes in the bones of the skull, paranasal sinuses, eye socket, meninges. About half of all brain abscesses are of otogenic origin. Chronic purulent otitis is 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 percontinuitatem 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 the inflammatory process spreads to the substance of the brain with the formation of limited purulent encephalitis. In more rare cases, oto- and rhinogenic abscesses can occur hematogenously due to thrombosis of veins, sinuses, septic arteritis. Abscesses in this case are localized in the deep parts of the brain, far from the primary focus.

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

Traumatic abscesses arise as a result of open (extremely rarely closed) injuries of the skull. 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 of a foreign body, the infection enters along with it. An abscess is formed along the wound channel or directly in the area of ​​a foreign body. Peacetime traumatic abscesses account for up to 15% of all brain abscesses; their percentage rises 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 the picture of limited inflammation of the brain tissue - purulent encephalitis. In the future, healing by scarring is possible. In other cases, as a result of the melting of the brain tissue, a cavity filled with pus appears - the stage of a limited abscess. A rather dense connective tissue capsule is formed around the cavity - the stage of an encapsulated abscess. It is believed that the formation of the capsule 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 a purulent focus in the brain remains in the stage of brain tissue melting.

Symptoms of tumors of the bones of the skull:

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

1) general infectious- fever (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 increased intracranial pressure due to the formation of an abscess. The most constant symptom is headaches. Vomiting of a cerebral nature, changes in the fundus of the eye (congestive discs or optic neuritis), periodic (orthostatic) bradycardia up to 40-50 beats / min, and mental disorders are often noted. Attention is drawn to the inertia, lethargy of the patient, the slowness of his thinking. Stupefaction, drowsiness may gradually develop, in severe cases without treatment - coma. As a consequence of intracranial hypertension, general epileptic seizures may occur; 3) focal depending on the localization of the abscess in the frontal, temporal lobes, cerebellum. Abscesses located in the depths of the hemispheres outside the motor zone can occur without local symptoms. Otogenic abscesses are sometimes formed not on the side of otitis media, but on the opposite side, giving an appropriate clinical picture. Along with focal symptoms, there may be symptoms associated with edema and compression of the brain tissue. With the proximity of the abscess to the membranes and with an abscess of the cerebellum, meningeal symptoms are detected.

In the cerebrospinal fluid, pleocytosis is noted, consisting of lymphocytes and polynuclear cells, an increase in the level of protein (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 manifestation of hypertensive and focal symptoms against the background of fever. In other cases, the onset of the disease is less defined, then the clinical picture resembles the course of a general infection or meningitis. Rarely, the initial stage of an abscess proceeds latently, with minimally severe symptoms and low temperature. After the initial manifestations, after 5-30 days, the disease passes into a latent stage, corresponding to the encapsulation of the abscess. This stage is asymptomatic or is manifested by moderately severe symptoms of intracranial hypertension - frequent headache, vomiting, mental lethargy. The latent stage can last from several days to several years. In the future, under the influence of some external factor (infection), and more often without obvious reasons, cerebral and focal symptoms begin to progress rapidly. A lethal outcome in a brain abscess occurs due to its edema and a sharp increase in intracranial pressure. An extremely severe complication of an abscess, possible at any stage, is its breakthrough into the ventricular system or subarachnoid space, which also usually ends in death.

Diagnosis of tumors of the bones of the skull:

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

A decisive role in the recognition of abscesses, especially multiple ones, belongs to computed and magnetic resonance imaging, which reveals a characteristic rounded formation, usually limited to a 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 hypertensive syndrome, lumbar puncture should be performed carefully, and in a serious condition of the patient - refrain from it, since with increasing intracranial hypertension, extraction of cerebrospinal fluid can cause infringement of the cerebellar tonsils in the large occipital foramen (with cerebellar abscess) or the medial department in the temporal lobes in the foramen of the cerebellum (with an abscess of the temporal lobe) with compression of the trunk, which can lead to the death of the patient.

The 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. Consideration should be given to the greater severity of stiffness of the cervical muscles and Kernig's symptom in purulent meningitis, the constancy of high temperature (with an abscess, the temperature is often hectic), large neutrophilic pleocytosis in the cerebrospinal fluid, and the absence of focal symptoms.

The course and symptoms of abscess and brain tumors have much in common. In this case, differential diagnosis is difficult, since with a malignant tumor, leukocytosis in the blood and an increase in body temperature are possible. Of particular importance in these cases are the data of the anamnesis, 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 is formed, the primary purulent focus may already be eliminated.

Treatment of tumors of the skull bones:

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. Residual neurological symptoms persist in 30% of those who recover, most often focal seizures.

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Other diseases from the group Diseases of the nervous system:

Inna Bereznikova

Reading time: 7 minutes

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Everyone knows what a skull is, but only a few understand where its base is located. Let's try to take a short anatomical course to clarify the situation. This is a very complex system, consisting of the posterior and anterior sections. The anterior, in turn, is characterized by a boundary location between the organs of the face and the brain, and the posterior - between the cervical region and the brain. In a more understandable language: the anterior part of the base of the skull is located in the region of the paranasal sinus, and the posterior part falls on the occipital part.

Tumors of the base of the skull are quite rare. It is very difficult and dangerous to treat such a disease, but a running process brings even more trouble. It is better to get rid of education, noticing the first symptoms.

Inner base of the skull

Varieties of benign tumors of the base of the skull:

1. papilloma inverted;
2. polyps;
3. meningioma;
4. fibroma;
5. osteoma;
6. schwannoma;
7. neurofibroma;
8. cementoma;
9. Thornwald bag.

Most often, benign occurs, since it is in this part that the maximum amount of adipose tissue is concentrated, which are constantly subjected to mechanical stress. Consider the most popular formations.

Inverted papilloma

This is a benign tumor of the base of the skull, which is located in or paranasal sinuses. It begins to develop at the age of 50, predominantly men suffer. Education has local aggressiveness. Under the influence of inverted papilloma, soft tissues suffer 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 the formations degenerate into cancer.

Diagnostics

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

• shortness of breath in one of the sinuses or its complete absence;
• with an enlarged tumor, it is possible to open it, as a result of which nosebleeds develop;
• olfactory functions are disturbed;
• , which gradually spread to the entire face;
• constant heaviness in the nasal passage;
• excessive tearing;
• deformity of the external nasal cartilages.

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

Treatment

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

meningioma

This is a benign tumor of the base of the skull, capable of transforming into a malignant formation over time. It grows from the hard tissues of the meninges. It is characterized by slow growth and gradual growth. As a rule, it is very difficult to completely remove such a formation, therefore, 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.

Stages of development of meningiomas:

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

The main reason for the development of meningiomas is radiation exposure. Also, a similar tumor can develop after radiation therapy, used to treat many types of cancer.

Symptoms

The disease manifests itself depending on its location and size. In the first couple, a meningioma can grow asymptomatically, but with an increase it brings considerable discomfort.

Diagnostics

Diagnosis of the disease is impossible without a visual examination. The general condition, symptoms of meningioma, as well as reflex reactions, sensitivity of the skin are assessed. The patient also undergoes a consultation with an ENT and an ophthalmologist. MRI, computed tomography is performed. A biopsy helps to determine the benign origin of the tumor, but it can only be done during surgery.

Treatment

After a diagnostic examination, the 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 removed with the help of corticosteroid drugs.

Schwannoma (neurinoma)

A benign formation that is formed from the peripheral and spinal nerves. It is the result of the growth 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 rounded formation with an outer framing shell. The growth rate is quite slow: 1-2 mm annually. With more intensive growth, a suspicion of a malignant formation arises.

The reasons

Reasons for development:

1. radiation exposure to which the body is exposed at an early age;
2. prolonged exposure to chemical fumes;
3. harmful working conditions;
4. genetic neurofibromatous 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, cause cerebellar disorders.

First symptoms:

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

Later manifestations:

1. when the formation grows up to 2 cm, the trigeminal nerve is compressed;
2. the sensitivity of the skin of the face is disturbed;
3. dull pain in the affected area. Often the patient is confused by her dental;
4. when the tumor grows up to 4 cm, the facial nerves begin to be compressed, causing loss of taste, profuse salivation, and strabismus.

Tumors of the posterior cranial fossa

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

Symptoms

Symptoms of tumors of the posterior cranial fossa:

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

Diagnostics

Diagnosis of a tumor of the posterior cranial fossa is carried out according to an assessment of the symptoms described by the patient, as well as using a hardware examination. Since education begins to show itself only at later stages with an increase in volume, one cannot do without X-rays, MRI and computed tomography.

1. x-ray is the simplest diagnostic method and shows the level of damage to the bone part of the skull;
2. 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;
3. MRI is an important diagnostic procedure that provides qualitative information about pathological transformations of soft tissues;
4. puncture of the cerebrospinal fluid assesses the damage to the nervous system, as well as the degree of prevalence;
5. electroencephalography demonstrates the basic functionality of the nervous system;
6. genetic examination indicates that the patient has hereditary neurofibromatosis;
7. histology helps to establish an accurate diagnosis and prescribe effective treatment.

Surgery for skull base tumors

Treatment

The success of the treatment depends on the experience and skill 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 hurt the central nervous system. In modern medicine, microsurgical instruments with a special optical system are used. Only in this way can the operation be carried out with particular accuracy. Doctors try to avoid damage to healthy tissue and the development of serious complications.

Tumors of the bones of the skull can be divided into two large groups: primary, i.e. started their growth in the place of their localization; and secondary, which are the result of tumors that originated in other organs.

In addition, both groups according to the nature of tumors can be divided into benign and malignant.

Primary benign tumors include:

• osteomas;
• hemangiomas;
• cholesteatoma;
• dermoid cysts.

Secondary benign neoplasms include meningiomas (arachnoid endotheliomas).

For primary malignant tumors include osteogenic sarcoma. BUT to secondary- tumors that have developed in other organs and systems of the body - the mammary gland, kidneys, lungs, prostate gland, etc., metastasized to the brain. Such metastasis is also characteristic of melanoma, a skin cancer characterized by a high degree of malignancy.

2. Benign tumors

Osteoma, according to doctors, is a consequence of a failure of the body at the stage of embryonic development of the fetus. Osteomas can be either single or multiple. These tumors grow very slowly and almost do not detect themselves - in most cases they are detected during an x-ray or MRI examination. Such a tumor needs to be removed only if it poses a threat to the patient's health.

Hemangioma- a rather rare tumor, which is also mainly determined by chance, during the examination, due to the absence of any symptoms. Usually surgeons offer to remove it surgically. The prognosis of such an operation is favorable.

cholesteatoma- a neoplasm localized in soft tissues, while provoking the development of extensive defects in the bone plates of the skull. Such a tumor needs to be removed surgically. With the help of the operation, the health of the patient is completely restored.

Favorite location dermoid cyst- inner and outer corners of the eyes, mastoid segment, sagittal suture area, etc. The main danger of such a cyst is that it can gradually destroy the bones of the cranial vault. The neoplasm is removed if it disrupts the functioning of neighboring organs.

meningioma- a benign tumor that is formed by the tissues of the arachnoid membrane of the brain. It can give clinical manifestations, provided that it reaches a solid size. This tumor is usually removed. To reduce the risk of recurrence, a surgical operation to remove a meningioma is performed in combination with radiation therapy, which makes the prognosis absolutely favorable.

3. Malignant tumors

Osteogenic sarcoma- usually develops in young patients, grows rapidly, reaching large sizes, tends to grow into the dura mater and metastasize to the bones of the skeleton - ribs, pelvis, spine, sternum.

Secondary osteosarcoma develops in the opposite direction when metastases spread from tumors of the breast, lungs, thyroid gland, etc.

The main symptom of osteogenic sarcoma is severe, sometimes unbearable pain in the bones. In some cases, the patient may undergo surgery, but the main method of treating this disease is radiotherapy. Unfortunately, not in all cases the onset of a cure is possible, but it is unacceptable to delay treatment.

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. Making an appointment, counseling, reviews, prices, addresses, detailed information. Make an appointment with the leading neurosurgeon in Rostov-on-Don without a queue at a convenient time 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 the highest 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

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