Multidisciplinary team performs a life-changing tumor removal surgery for one local patient

(SACRAMENTO) When Nishica Cervantes started experiencing headaches and neck pain, she never imagined that her discomfort might be caused by a tumor. 

“I was experiencing headaches and an odd ache and pain in my neck for quite some time and thought it may have been related to sleep apnea,” said the 45-year-old resident of Elk Grove, California. “Sensing that something else was at play, my UC Davis primary care physician ordered an X-ray and MRI in August 2020. The MRI revealed a tumor at the base of my skull, near my brain stem and spinal cord.” 

Cervantes went to the emergency department the same day she was diagnosed with the tumor. She spent the night in the hospital for observation and saw UC Davis Health surgeon Kiarash Shahlaie the next day. 

“He suspected that the tumor had been growing for five to 10 years, and that it was likely benign,” Cervantes said. “He said it was operable with a less invasive surgery, which would be less risky and painful compared to traditional surgery." 

Shahlaie is the director of the UC Davis Center for Skull Base Surgery, which provides state-of-the-art care for patients with a variety of skull base, brain, head and neck tumors. The center also treats other diseases that affect the skull base, which is the area behind the eyes and nose that slopes down to the back of the head and forms the base of the skull. 

The center has been recognized by the North American Skull Base Society (NASBS) as an NASBS Multidisciplinary Team of Distinction. It’s the only center in Northern California, and one of only two centers in the state, to receive this recognition. 

“We’ve brought together a unique group of highly skilled, fellowship-trained individuals that are focused on treating skull base disorders,” said Shahlaie, who is also a professor in the Departments of Neurology and Neurological Surgery. “Our entire team is simply world-class, and I’m so excited that they have all been honored by this recognition. I’d especially like to acknowledge Marianne Abouyared for her leadership as our ENT Director of Skull Base Surgery. Her partnership, along with leaders from other disciplines, has been key in helping us obtain this NASBS designation.”  

A multidisciplinary team

The multidisciplinary group includes faculty from the following areas:

• Department of Neurological Surgery
• Department of Otolaryngology (Head and Neck Surgery Division)
• UC Davis Eye Center (Neuro-Ophthalmology Service)
• Department of Internal Medicine (Endocrinology Division)
• UC Davis Comprehensive Cancer Center (Medical Oncology)
• Department of Radiation Oncology
• Department of Pathology and Laboratory Medicine
• Department of Radiology (Neuroradiology) 

The UC Davis Center for Skull Base Surgery has been a leader in this field for many decades. Skull base tumors are among the most challenging conditions to treat. They can affect critical blood vessels and nerves that are responsible for vision, speech, swallowing, hearing, facial sensation and movement, and brain stem function. 

“These operations can be very long, technically challenging, and carry significant risks,” Shahlaie said. “Our team of experts works together to treat these very complex conditions and meets monthly to review our patients. We work closely together to develop customized surgical, medical and radiation treatment plans. Over the years, procedures have become less invasive, with greater use of endoscopy and keyhole craniotomy approaches for both benign and cancerous tumors.” 

Life-changing surgery

For Cervantes, the less invasive surgical procedure was life changing. Shahlaie and Toby Steele removed the tumor using an endoscopic endonasal approach, which goes through the nasal cavity and sinuses to operate on areas at the front of the brain and the top of the spine. The surgery was successful, and Cervantes said she feels fortunate to have such a great care team. 

“Dr. Shahlaie and Dr. Steele are exceptional surgeons, with an impeccable bedside manner,” said Cervantes, who works in real estate. “Their dedication to their profession and patient care is unparalleled. I was impressed by the knowledge and professionalism of all the doctors, surgeons and nursing staff at UC Davis Medical Center.” 

Cervantes experienced an additional benefit after surgery: Her blood pressure, which was high for nearly 10 years, was suddenly under control. The tumor was growing in the area that controls blood pressure and after it was removed, she was able to stop taking one blood pressure medication and reduce the dosage of another medication. 

Today, Cervantes sees Steele for maintenance care and gets an annual MRI to make sure the tumor doesn’t return. “I feel fortunate to receive such world-class care,” Cervantes said. “I’m blessed that everything went so well. The less invasive surgery wasn’t as painful and let me go home faster. I’m grateful that I get to spend more time with my family.” 

Shahlaie said it’s this outstanding patient care that sets the UC Davis Center for Skull Base Surgery apart. “To provide state-of-the-art skull base care, it’s imperative to have a coordinated team of physicians from different disciplines all focused on skull base disorders,” he said. “This is something we uniquely offer, and it’s important for patients and physicians to know that our NASBS-recognized center can serve as a referral center for all of Northern California.”