Malignant skull base tumours

Malignant skull base tumours are a rare and diverse group of histological entities that cross the skull base. Their management requires a multidisciplinary approach that aims to achieve microscopically clear margins, dural reconstitution to avoid cerebrospinal fluid (CSF) leak, soft tissue reconstruction and where possible, an en bloc resection. Both traditional craniofacial and more modern endoscopic techniques can be utilized, if the surgical and management goals can be achieved successfully. This is then combined with adjuvant therapy, typically radiotherapy, to maximize prognosis. We discuss both anterior and lateral skull base tumours as well as consider the special case of perineural spread as an example of complex disease at the skull base.