Skull Base Tumor Diagnosis

MD Anderson patients with tumors of the skull base receive a complete diagnostic evaluation, treatment and follow-up care with the latest techniques and equipment. 

Because of the unique characteristics of each tumor type and each patient, experts on the skull base team carefully tailor the diagnostic methods and treatment regimens in each case to provide the best care for each patient. 

Skull base tumor diagnostic tests

If you have symptoms that may signal a skull base tumor, your doctor will examine you and ask you questions about your health and symptoms. Our team of experts carefully chooses the tests that are best for each specific tumor.

Radiologists and pathologists who have special expertise in tumors of the head, neck and brain work closely with your doctor to determine the tumor type based on your diagnostic test results.

One or more of the following tests may be used to find out if you have a skull base tumor and if it has spread.

Imaging exams

Imaging exams allow doctors to identify the presence and location of tumors. The following imaging exams can be used for skull base tumors:

• CT or CAT (computed axial tomography) scans: A CT scan uses an x-ray machine to take several pictures from different angles, providing a highly detailed image.
• MRI (magnetic resonance imaging) scans: Magnetic Resonance Imaging, or MRI, uses magnetic fields and radio waves to generate pictures of the body’s soft tissue and organs. 
• PET (positron emission tomography) scans: During a positron emission tomography scan, or PET scan, a small dose of radioactive sugar is injected into a patient. A scanner shows where the body distributes the sugar, allowing for the creation of an image. This image can help radiologists find cancer cells in the body.
• Angiogram: Angiograms create detailed images of the body’s blood flow and blood vessels

Biopsy

During a biopsy, a small tissue sample is removed and examined under a microscope for the presence of cancer cells. Depending on tumor location, some biopsies can be done on an outpatient basis with only local anesthesia. Other times patients must undergo a surgical biopsy under general anesthesia. The following biopsies can be used for skull based tumors:

• Fine-needle aspiration (FNA): The removal of suspected cancer cells with a thin needle
• Endoscopic biopsy: A thin long tube with a camera and another tool on the end is inserted through the nose and sinuses. The doctor then locates the tumor and removes a piece for examination.
• From the ear using a microscope
• Surgical biopsy

Functional testing 

Functional testing shows how certain parts of the brain, head and neck are working. These tests are chosen based on your symptoms and the tumor’s location in the skull base. They may include:

• Hearing tests: audiogram, auditory brainstem response (ABR)
• Balance tests (videonystagmography, rotary chair testing)
• Vision tests
• Videostroboscopy of vocal cord function
• Swallowing tests, including a modified barium swallow
• Neurocognitive evaluation to test for memory and cognition changes
• Hormone testing
• Smell testing

Some cases of skull base tumors can be passed down from one generation to the next. Genetic counseling may be right for you. Learn more about the risk to you and your family on our genetic testing page.