Primary bone cancer isn’t common, but it can sometimes be diagnosed in the skull. Symptoms may include headaches, vision problems, or a lump on the head that grows larger over time.

Cancer that starts in your bones, called primary bone cancer, is uncommon. The American Cancer Society estimates that only 3,970 new diagnoses of primary bone cancer will be made in 2023.

Primary bone cancer can start in many parts of your skeleton. One of these is your skull. In this article, we review the different bone cancers of the skull, their symptoms, and how they’re treated.

There are several different types of bone cancer that can affect your skull.

Chordoma

Chordomas are a rare type of bone cancer. At the same time, it’s one of the more common bone cancers of the skull. About 35% of chordomas happen at the base of your skull. They’re typically slow growing and aren’t likely to spread to other areas.

Chordomas form when cells from early spinal tissue aren’t replaced by bone during development. Sometimes, these cells get genetic changes and begin to grow uncontrollably.

Chondrosarcoma

Chondrosarcomas happen in cells that form cartilage (connective tissue). Most chondrosarcomas typically grow slowly, although some can be more aggressive. They’re also another more common type of bone cancer affecting your skull.

This type of bone cancer can develop in any part of your body where cartilage is present, including your skull. When chondrosarcomas affect your skull, they’re typically found at your skull base.

Osteosarcoma

Osteosarcomas are the most common type of primary bone cancer overall, but they’re less common in your skull. They develop from early forms of bone cells. Osteosarcomas can grow and spread quickly.

It’s possible for osteosarcoma to develop in any part of your skull. A 2017 review notes that the top part of your skull, which includes several skull bones, and your skull base are more common locations.

Ewing sarcoma

Ewing sarcoma typically forms from bone tissue, although it can also develop from soft tissue as well. It’s an aggressive type of bone cancer that mainly affects children and adolescents.

According to a 2016 case study, Ewing sarcoma can start in several different skull bones, including your frontal, parietal, and temporal bones. It can also begin in your skull base.

Metastatic (secondary) cancer of the skull

Metastatic skull cancer is a secondary bone cancer. It occurs when cancer cells break away from a primary cancer — such as prostate cancer, multiple myeloma, or renal cell carcinoma — and metastasize or spread to bone tissue in your skull.

According to the National Cancer Institute (NCI), the most common symptom of bone cancer is pain in or around the affected bone.

Bone cancers of the skull can begin to press on nerves and other tissues in your head and neck. As such, the potential symptoms of these cancers can depend on the exact type of tumor and where it’s located.

Some potential symptoms of bone cancer of the skull include:

Primary bone cancer happens when cells in your bone begin to grow and divide uncontrollably. This happens due to genetic changes that occur in these cells. These changes can either be present from birth or happen during your lifetime.

While the exact cause of primary bone cancers remains unknown, some factors can increase a person’s risk of developing them. These include:

Treatment for bone cancer of the skull can depend on many factors. These include:

  • the type of cancer
  • the extent, or stage, of the cancer
  • how fast the cancer is growing
  • the location and size of the cancer
  • your age and overall health
  • your personal preference

Potential treatment options for bone cancers of the skull can include one or a combination of the following:

  • Surgery: For some bone cancers of the skull, surgery is done to remove as much of the cancer as possible. Based on the location of the cancer, surgery may not always be possible, as it could lead to serious side effects.
  • Radiation therapy: Radiation therapy can be used when surgery isn’t possible. It may also be done following surgery to help destroy any remaining cancer cells.
  • Chemotherapy: Generally speaking, chemotherapy for bone cancers of the skull is typically used before surgery to reduce the size of a tumor (neoadjuvant) or after surgery to lower your risk of the tumor returning (adjuvant).

According to the Surveillance, Epidemiology, and End Results (SEER) database of the NCI, the average 5-year survival rate for all types of primary bone cancer is 67.4%. This is the percentage of people with primary bone cancer that are alive 5 years after receiving a diagnosis of it.

As with all cancers, the specific outlook for someone with bone cancers of the skull can depend on many factors, such as:

  • the type of cancer
  • the stage of the cancer
  • the location and size of the cancer
  • the type of treatment that’s used
  • how the cancer responds to treatment
  • if the cancer has spread to other parts of your body
  • if you’re being treated for a recurrence of cancer
  • your age and overall health

Bone cancers of the skull can also come back (recur) after treatment. Recurrence rates can vary based on your type of cancer. It’s also possible for some more aggressive cancers to spread to other parts of your body (metastasize).

Because of the complex web of factors involved, it’s important to talk with a healthcare team about your outlook. They can give you a better idea of what to expect.

While primary bone cancer isn’t common, it can sometimes be diagnosed in your skull. These cancers can be caused by several different types of primary bone cancer, including chordoma, chondrosarcoma, and osteosarcoma.

In addition, cancers that start elsewhere in your body can metastasize to your skull bone. This is called secondary bone cancer.

The treatment for bone cancer of the skull and the outlook for people who have it can vary based on factors such as their type of cancer as well as its location and stage.

To get a better idea of your individual treatment options and outlook, be sure to talk with a healthcare team.