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Complex Cases

When a 14-year-old boy was found to have a large tumor in the right side of his head at the base of the cranium, he was referred to Cedars-Sinai Medical Center, where his case was reviewed by a team of specialists. The patient had gradually lost all hearing in his right ear and was experiencing facial weakness because several major nerves were damaged by the tumor.

Sophisticated diagnostic studies, including magnetic resonance imaging (MRI), 3D computed tomography (CT) and CT angiography showed that the tumor had invaded a large area, destroyed bone and compressed critical brain structures as it grew. It also had developed its own blood supply from the carotid arteries.

The physicians and surgeons evaluating the boy’s condition devised a three-step approach to be completed over several days. 

In the first phase, a specialist in endovascular neurosurgery performed a minimally invasive procedure using a catheter threaded through blood vessels to block the tumor’s blood supply.

The second phase was an open surgery performed by a pediatric neurosurgeon and a surgeon specializing in cranial base surgery and neurotology (treatment of the ears, balance system, nerves and other structures at the base of the skull and in the head and neck.) They entered the skull base and meticulously removed sections of the tumor that were pressing on nerves and other structures.

In the final phase, the pediatric neurosurgeon and a neurosurgeon specializing in adult brain tumors completed the tumor removal and rebuilt damaged bones and structures.

At Cedars-Sinai's Brain Tumor Center, specialists from many disciplines work together to plan and provide every patient’s care. Treatment recommendations are made after careful review and discussion in weekly Tumor Board meetings, where every option is considered, including medical, surgical and radiation therapies or inclusion in a clinical trial. Care is provided by physicians, surgeons and numerous other health care professionals, many of whom work behind the scenes in laboratories, imaging facilities, operating rooms, and therapy centers.

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