Imaging of Skull Base Tumors

A Multidisciplinary Skull Base Board for Tumour and Non-Tumour Diseases: Initial Experiences

The skull base is the area where various cancerous and non-cancerous diseases occur and represents the intersection of several medical fields. The key is an integrated treatment by specialists of multiple disciplines. We prospectively analysed patients with a skull base disease between August 2022 and 2023 and presented to the Multidisciplinary Skull Base Board (MDT-SB), which takes place once a month hybridly (in-person and remotely). Thirty-nine patients (median age of 58.2 years) were included, of which twelve (30.8%) had a benign tumour, twelve (30.8%) had a malignant tumour, five had an infection (12.8%), and ten (25.6%) had other diseases. For each patient, at least two otorhinolaryngologists, a neurosurgeon, and a neuroradiologist, as well as an infectious disease specialist, a paediatrician, an oculoplastic surgeon, a maxillofacial surgeon, and a pathologist were involved in 10%, 8%, 8%, 3%, and 3% of cases, respectively. In fifteen patients (38%), the MDT-SB suggested surgical treatment; in fourteen (36%), radiological follow-ups; in five (13%), non-surgical treatments; in two, conservative treatments (5%); in two (5%), surgical and conservative treatments; and in one (3%), a biopsy. Non-cancerous and cancerous diseases of the skull base in adults and children should be presented to the MDT-SB, which consists of at least an otolaryngologist, a neurosurgeon, and a neuroradiologist.

A Rare Case of Benign Long-Standing Ecchordosis Physaliphora

Ecchordosis physaliphora (EP) is a rare benign lesion arising from embryonic notochordal remnants, typically located in the retroclival region. This case report presents a 46-year-old male patient experiencing intermittent headaches and occipital pain. Imaging revealed a well-defined, smoothly corticated bony lesion on the left side of the clivus, accompanied by a characteristic bony stalk devoid of any aggressive features. A review of the patient's medical records indicated stable imaging findings of the lesion over six years. Clinicians and radiologists should be familiar with EP as a benign entity and differentiate it from aggressive pathologies.