Skull Base Tumors in Children

Although rare, skull base tumors in children are often complex and life-threatening. Duke’s specially trained pediatric neurosurgeons collaborate with experts in otolaryngology, oncology, endocrinology, neuro-ophthalmology, and more to address every aspect of your child’s tumor. That means your child benefits from the experience of a team of specialists.

To learn more about your child’s skull base tumor, doctors may order the following tests:

Imaging Scans
A CT or an MRI scan produces detailed images of your child’s brain, skull, and tissues inside their head and neck. Some scans may require contrast dye, given via an injection. Results are reviewed by neuroradiologists who specialize in interpreting these images.

Nasal Endoscopy
When tumors are in or near the nasal cavity, an otolaryngologist may insert an endoscope -- a thin, flexible, lighted tube with a camera on the end -- into your child’s nose to see inside the nasal passages. A numbing spray makes this more comfortable for your child.

Biopsy
A surgeon uses a needle to remove a small piece of the tumor. The sample is sent to a specialized head and neck pathologist, who examines the tissue to determine whether it is cancerous, its grade (how it compares to normal tissue), the type of tumor, and other factors. A biopsy may be performed in a doctor’s office with local numbing or in an operating room with general anesthesia. This will depend on the tumor’s location. Certain tumors may not be reachable for biopsy without surgery.

Most pediatric skull base tumors are surgically removed. Duke surgeons offer several approaches to reach and remove the tumor in the least-invasive way. We carefully balance the risks of surgery with the benefits of removing as much of the tumor as possible.

Endoscopic Endonasal 
If the tumor isn’t deep inside the skull, surgeons may be able to reach it through the nostrils using an endoscope. Because this technique requires no external incisions, it leaves little or no visible scarring and significantly speeds recovery time.

Craniotomy
If the tumor can’t be reached through the nostrils, your surgeons may need to cut through the skull. This is called a craniotomy.

Combination Approach
Some children may benefit from a combination approach. Surgeons remove part of the tumor through the nostrils endoscopically, and the rest is removed through a craniotomy.

Duke Team Offers Expertise and Experience
Our pediatric skull base tumor experts include surgeons who are specially trained in pediatric neurosurgery, skull base neurosurgery, sinus surgery, and head and neck surgery. We also collaborate with Duke’s adult skull base tumor team, which is recognized by the North American Skull Base Society. Duke is one of the few centers in the Southeast equipped to treat skull base tumors in children.

Advanced Technology
From diagnostic imaging scans to surgical navigation systems, we use the latest technology to accurately identify and safely remove your child’s tumor.

Leading Cancer Center
Duke Cancer Institute focuses on treating your child’s cancer and improving their quality of life. We deliver the best-possible outcomes, and we work to reduce cancer treatment side effects that could affect your child’s future health.

Clinical Trials
At Duke, your child may be eligible to participate in clinical trials studying new and improved ways to treat pediatric skull base tumors. This means they could access new treatments before they are available elsewhere.

Patient Navigators Coordinate Your Child’s Care
Our patient navigators become your one-stop shop for scheduling appointments, coordinating visits, communicating test results, and planning surgery. It’s their job to make skull base tumor treatment journey easier by guiding you through it step by step. And they are more than willing to answer all of your questions along the way.