Ramin Morshed Brings Surgical Skull Base Expertise to the Brain Tumor Center
Neurosurgeon Ramin Morshed, MD, recently joined the UCSF Brain Tumor Center, specializing in skull base tumors, meningiomas, vestibular schwannomas, pituitary tumors, brain metastases, gliomas, and minimally invasive endoscopic surgery. He attended Pritzker School of Medicine at the University of Chicago and completed neurosurgical residency at UCSF, where he developed a clinical and research interest in treating brain tumors. He also completed a skull base oncology fellowship at Mayo Clinic, where he received extensive training with open and endoscopic surgical techniques.
Specializing in Brain Tumor Surgery
During residency, I trained with Michael McDermott and Philip Theodosopoulos and found I really enjoyed performing skull base surgery. Following the rise of endoscopic surgery, we had more minimally invasive techniques, like keyhole eyebrow craniotomies and other smaller approaches, for skull base lesions. I wanted to implement these new techniques and be able to offer that to patients, in addition to the more traditional, transcranial approaches when needed. It’s a field in which you can make a significant impact on someone’s function for the rest of their life.
But I also provide care for other types of brain tumors, and I find that as a complex cranial tumor neurosurgeon who is able to do both skull base and intra-axial tumor surgery, I can be a little bit more comprehensive in what I can offer patients.
Multidisciplinary Management
Having trained at UCSF and Mayo Clinic, I developed a good understanding of the multidisciplinary care that's needed to treat patients with complex tumors. The appropriate treatment of these patients involves collaboration and discussion with radiation oncology, neuro-oncology and OHNS – that’s really a cornerstone of skull base patient care. Making decisions in a vacuum, only from a surgical perspective, is not in the best interest of the patient.
That’s why it’s also critical for us to have good communication with the providers we partner with in the community. It’s often in the patient’s best interest to receive part of their care locally, so I want referring doctors to feel comfortable reaching out to me by phone or email when a patient returns to their healthcare system. I’m always available to answer questions or provide input on management and remain involved in the patient’s care.
A New Meningioma Clinic
For meningioma patients specifically, we have a new specialized clinic that tailors care for these patients and a multidisciplinary tumor board to review cases. Each patient has their tumor sequenced, and there is a lot of exciting work being done to stratify patients based on the genomics of their tumor, as well as several new clinical trials in development.
Favorite Procedure
Endoscopic surgery for a variety of anterior skull base lesions.
Understanding the Genomics of Brain Metastases
During residency, I developed an interest in studying brain metastases and correlating their genomic changes with clinical outcomes after surgery. It is an especially important topic as precision medicine becomes more of a reality. Patients may get a systemic chemotherapy for their primary cancer that targets a specific receptor, but then the receptor is not there in the brain metastasis, or vice versa. For example, the primary tumor may not have an EGFR mutation, but then all of a sudden it pops up in the brain metastasis. This may mean that they're eligible for a therapy that they weren't eligible for before.
I think in the next 10 years our understanding of the genomic changes that occur in tumors will be a cornerstone of how we stratify patient risk. The next big hurdle will be to identify imaging biomarkers that correlate with these genetic findings. We could then use these imaging biomarkers to predict what kind of genomic changes are present to help guide decision-making even before proceeding with surgery.
The Best Part of UCSF
The people. Everyone here is very excited about taking care of patients and providing the best care that they can.