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Journal of Neuro-Oncology

, Volume 75, Issue 1, pp 63–69 | Cite as

Skull-base metastases

  • Florence Laigle-Donadey
  • Sophie Taillibert
  • Nadine Martin-Duverneuil
  • Jerzy Hildebrand
  • Jean-Yves Delattre
Article

Summary

Metastasis to the skull-base particularly affects patients with carcinoma of the breast and prostate. Clinically, the key feature is progressive ipsilateral involvement of cranial nerves. Five syndromes have been described according to the metastatic site including the orbital, parasellar, middle-fossa, jugular foramen and occipital condyle syndromes. Magnetic resonance imaging (MRI) is nowadays the most useful examination to establish the diagnosis but plain films, CT scans with bone windows and isotope bone scans remain helpful to demonstrate bone erosion. Normal imaging studies do not exclude the diagnosis. The treatment depends on the nature of the underlying tumor. Radiotherapy is generally the standard treatment, while some patients with chemosensitive or hormonosensitive lesions benefit from chemotherapy or hormonotherapy and selected patients from surgical removal. Gamma Knife radiosurgery is sometimes a useful alternative, particularly for previously irradiated skull-base regions, and for small tumors (diameter < 30 mm). The overall prognosis is poor, with an overall median survival of about 2.5 years, probably because skull-base metastases appear late in the course of the disease.

Keywords

base of skull cranial nerves metastasis palsy improvement radiotherapy 

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Copyright information

© Springer 2005

Authors and Affiliations

  • Florence Laigle-Donadey
    • 1
  • Sophie Taillibert
    • 1
  • Nadine Martin-Duverneuil
    • 2
  • Jerzy Hildebrand
    • 1
  • Jean-Yves Delattre
    • 1
  1. 1.Fédération de Neurologie MazarinGroupe Hospitalier Pitié-SalpêtrièreParis Cedex 13France
  2. 2.Service de NeuroradiologieGroupe Hospitalier Pitié-SalpêtrièreParisFrance

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