Osteosarcoma is the most common primary bone cancer. Cancer may form in the bone or spread to the bone from another site in the body. When cancer starts in bone tissue, it is called primary bone cancer. When cancer cells travel to the bone from elsewhere, it is called secondary or metastatic bone cancer.
Symptoms of osteosarcomas of the skull base can include deep bone pain, swelling or lumps, and fatigue.
The preferred surgical treatment at UPMC for osteosarcoma in the skull base is the Endoscopic Endonasal Approach (EEA) to remove the tumor. This innovative, minimally invasive technique uses the nose and nasal cavities as natural corridors to access hard-to-reach or previously inoperable tumors. EEA offers the benefits of no incisions to heal, no disfigurement to the patient, and a faster recovery time. If complementary treatments such as radiation therapy are needed, those therapies can begin soon after surgery.
Your doctor will perform a physical exam and ask about any symptoms you are experiencing. Symptoms may include:
- deep bone pain that wakes you up
- swelling or a lump where the tumor is
- unexplained weight loss
- trouble breathing
- fevers or night sweats
Your doctor also will want to run various tests to confirm the osteosarcoma. Those tests will include:
- blood tests to check the level of the enzyme alkaline phosphatase (an increased amount of this enzyme is released in patients with bone tumors)
- bone, CT, and MRI scans
The sooner osteosarcoma is found and treated, the more favorable the outcome. Once the tumor is found, staging tests are performed to find out if the cancer has spread and, if so, to what extent.
Treatment depends on the type, stage, and location of the cancer, and your overall health. Surgery for osteosarcomas of the skull base involves the removal of the cancerous tumor and nearby tissues.
Osteosarcoma of the skull base may be approached directly by using the Endoscopic Endonasal Approach (EEA). This approach allows surgeons to see the tumor well without making incisions to the face or skull. The tumor is removed through the nose and nasal cavities, and recovery time is faster than with the traditional approach. Patients who received surgery with the Endoscopic Endonasal Approach may be able to begin chemotherapy or radiation therapy soon after surgery.
At UPMC, we take a 360° Approach to treatment when evaluating each patient—looking at their conditions from every direction—to find the path that is least disruptive to the patient's brain, critical nerves, and ability to return to normal functioning. Our neurosurgical team may recommend a combination of surgical and non-surgical approaches to maximize the benefits of surgery while minimizing risks.
If the tumor is large, aggressive, or the risk of spread is high, chemotherapy and radiation therapy may be added to help prevent a recurrence at the site of surgery, and also to prevent spread to other organs.
Chemotherapy given before and after surgery will often cure osteosarcoma.