Malignant Lesions of the Central and Posterior Skull Base

Abstract

Imaging interpretation of skull base lesions can be challenging because of their infrequent occurrence, the complex nature of the skull base and the ability of normal anatomical variations to mimic pathology. Since the majority of skull base lesions are accidentally detected and inaccessible for biopsy, the clinicians heavily rely upon the accurate image interpretation by the radiologist. The main goals of the image analysis are to distinguish normal anatomical variations form true pathology, recognize medically treatable conditions and to differentiate benign “do-not-touch” lesions from malignant processes that might require aggressive treatment. The imaging features and preferential location of the different malignant skull base lesions and their benign counterparts will be discussed in this chapter. After the diagnosis of a malignancy is established, the radiologist’s main role is the delineation of the extent of the suspected malignant skull base lesion for treatment planning.