Difficult medical journey Only age 18 months old child was found by his parents 1 month ago the child in a quiet state right eye to the side of the nose deviation, in the local city children’s hospital, MRI suggests saddle dorsal occupancy, may be chordoma. Imaging showed that the tumor grew to the right through the cavernous sinus to the middle cranial fossa, grew forward to the posterior nasal cavity, and squeezed the pituitary gland upward. The receiving doctor told the family that the child was small in age, the tumor was extensive, the possibility of malignancy was high, the complexity of the surgery was high, the risk was high, and the family was advised to give up the treatment. With an unwillingness to give up, the parents took the child to Beijing to seek medical treatment, and the specialists at a major hospital in Beijing told the family that no matter whether it was surgical treatment or radiotherapy or chemotherapy, it would be very limited to improve the child’s survival rate. The child was too young for surgical treatment, firstly, it would be difficult to remove the tumor completely, and secondly, it would be difficult for the child to withstand prolonged surgical operation and resist postoperative complications such as infection, so the family was advised to give up. The family was still unwilling to give up, and traveled south to Guangzhou to consult the ENT department of our hospital. Director Qiu Qianhui asked about the patient’s medical history in detail, and initially diagnosed a malignant tumor at the base of the skull. After discussion with several specialists from ENT, radiotherapy and head and neck cancer, it was unanimously proposed to take a biopsy first to make a clear diagnosis. Director Qiu Qianhui pointed out that due to the child’s young age, the estimated systemic blood volume was about 600ml~800ml, the bleeding volume of the skull base surgery was large, and the surgical operation was close to the internal carotid artery, which made the technical operation complicated and risky, so the goal of the temporary surgery was to make a clear diagnosis, adjust the treatment plan according to the intra-operative pathology, and make good preoperative preparations for the surgical resection of the tumor. Surgical removal of the tumor would require the collaboration of multiple departments, especially the anesthesiology department and PICU. After many twists and turns, the surgery was finally completed On July 8, the child developed an upper respiratory tract infection, and a review of the routine blood test reported a mild increase in leukocytes, which, in combination with the child’s young age, made the surgery risky, so the anesthesiologist recommended that the surgical treatment be canceled for the time being. On the 14th, the tumor was finally removed under general anesthesia by Director Qiu Qianhui, and the anesthesia was performed by a strong team consisting of Director Wang Sheng, Director Sun Qiang, and Director Yu Wei. After the intraoperative pathology report came out, Director Qiu informed the family that the tumor was diagnosed as a small round cell malignant tumor, which is prevalent in children and has a low cure rate as reported in the literature. The tumor is so extensive that it may be difficult to completely remove the tumor, and the patient’s life may be in danger at any time during the operation. After the operation, the patient may also suffer from fatal infections and other complications, and require chemotherapy and other follow-up treatments. The patient’s family expressed their understanding, but still insisted on surgery. After Qiu Qianhui director p Dr. Su Xiaomei and anesthesiologists four hours of struggle, finally successfully completed the surgical treatment. About 2200ml of blood was transfused during the operation, which was equivalent to three times of the patient’s total blood volume. After the operation, the patient was sent to PICU for further monitoring and treatment. On the second day after the operation, the patient was in good condition and was transferred from PICU to ENT department. The perfect interpretation of the spirit of multi-disciplinary solidarity Director Qiu Qianhui introduced that the child was the youngest case of surgical resection of malignant tumor at the base of the skull in the Department of Otorhinolaryngology of the hospital, which is a high-risk operation and difficult to operate. Although the operation did not completely remove the tumor tissue, and the possibility of recurrence is high, there are cases in the past that have been survived by radiotherapy after the operation. Director Qiu hoped that the surgery would prolong the life of the child and that he could even grow up like a normal child after comprehensive treatment. The multidisciplinary collaboration in completing the surgical resection of the youngest skull base tumor in the ENT department not only shows that the ENT department is in the leading position in skull base surgery, but also is a perfect interpretation of the multidisciplinary collaboration in our hospital.