Challenging Skull Base Lesions: A Neurosurgical Perspective
Abstract
Harsh Patel, Preeti Singh and Abhaya Kumar
Lesions in the skull base represent a significant diagnostic and therapeutic challenge due to the complex anatomy of the area. Their close proximity to critical neural and vascular structures makes them potentially life-threatening, and their deep location complicates both diagnosis and treatment. Most skull base lesions are benign and don’t spread to other parts of the body. We present 2 challenging cases we faced first case is 62 year old immunocompetent male, radiological investigation suggestive of skull base lesion but upon further investigation it was found to be high grade intracranial glioma invading skull base and second case is of young 19 year female who was diagnosed with primary extraosseous intracranial Ewing's sarcoma, also known as a peripheral primitive neuroectodermal tumor or "small round blue cell tumor," is an extremely rare entity with only 9 cases reported in the literature till date. Early detection, careful planning, and a multidisciplinary approach are essential for effective management, with the goal of maximizing the patient's functional outcomes and quality of life. Histopathological misdiagnosis can lead to devastating consequences of late treatment and disease progression therefore close follow up and reviewing of tissue blocks may be required as sometimes key histopathological features get masked by extensive fibrosis. therefore continuous reevaluation of the pathology, especially in the case of unexpected changes in the patient’s condition is crucial.