Malignant Tumors of the Anterolateral Skull Base

Hentschel, Stephen J.; Vora, Yashil; Suki, Dima; Hanna, Ehab Y.; DeMonte, Franco

doi:10.1227/01.neu.0000362033.38035.25

Cited by 23 publications

(30 citation statements)

References 22 publications

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“…This aspect was shown to be a significant negative prognostic factor of overall survival, and it may be explained by the presence of a more aggressive disease. Our 68% rate of negative resection margins is in accordance with previous reported series . However, it was not found to be a significant prognostic factor in the 32% of patients with positive margins.…”

Section: Discussionsupporting

confidence: 92%

“…The pathologic processes and lesions that may involve the ITF are variable, thus the outcome of treatment varies accordingly. There are only few published studies that selectively investigated tumors involving the ITF . Givi et al reported 43 patients who underwent tumor resection from the ITF using a combination of a pterional craniotomy with craniofacial resection or a bifrontal craniotomy.…”

Section: Discussionmentioning

confidence: 99%

“…There are only few published studies and paucity of data regarding the characteristics, general epidemiology and management approaches of ITF neoplasms . The most common malignant pathologies reported are squamous cell carcinoma (SCC), sarcoma, adenoid cystic carcinoma (ACC), adenocarcinoma and nasopharyngeal carcinoma (NPC).…”

Section: Introductionmentioning

confidence: 99%

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Surgical approaches for infratemporal fossa tumor resection: Fifteen years' experience of a single center

et al. 2019

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Background The aims of this study were to report our center's experience with infratemporal fossa (ITF) tumors, to review the treatment modalities and outcomes. Methods Data of patients that underwent resection of ITF tumors in a single tertiary referral medical center were collected and analyzed. Results Sixty‐three patients were included. Sarcoma was the most common pathology (18; 29%). The most common surgical approach was the preauricular‐orbitozygomatic approach (24; 38%), followed by endoscopic, craniofacial resection, and combined approaches. Forty‐seven patients (75%) required reconstruction, 23 (49%) involving free tissue transfer. Thirty‐five patients (76%) with malignant lesions required adjuvant therapy consisting of radiotherapy, chemotherapy, or both. Thirty‐three patients suffered from complications related to surgery or adjuvant therapy. The three‐ and five‐years survival rates for malignancy were 82% and 66%, respectively. Conclusion Complete surgical resection of ITF involving tumors is feasible, providing good long‐term survival. Multidisciplinary approach is the key for success.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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Surgical approaches for infratemporal fossa tumor resection: Fifteen years' experience of a single center

et al. 2019

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“…A tendency of spread through perineural spaces is a common characteristic of some malignant tumors of the head and neck origin, including but not limited to, sarcomas, squamous cell carcinomas, and adenoid cystic carcinomas . The trigeminal nerve involvement at the floor of the middle cranial fossa is not uncommon.…”

Section: Discussionmentioning

confidence: 99%

Anatomic characteristics of the dural sheath of the trigeminal nerve

Zhang

2015

Head & Neck

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“…3,4,27,43,45 Standard therapy for this malignancy has most commonly included a strategy of local resection followed by adjuvant radiation therapy. 6,13,16,17,23,24,28,30,35,38,39,43,46,47,52 Chemotherapy using agents such as carboplatinum and paclitaxel has been used, but with limited results. 2,11,12,15,26,27,36,41,44,[48][49][50] ACC can arise in any salivary gland, both major and minor.…”

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confidence: 99%

Adenoid cystic carcinoma of the skull base: results with an aggressive multidisciplinary approach

Ramakrishna¹,

Raza²,

Kupferman

et al. 2016

JNS

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A denoid cystic carcinoma (ACC) is a locally aggressive salivary gland malignancy prone to perineural invasion and metastasis. Local recurrences often involve the skull base, whereas distant metastases most frequently involve the lung, bones, and liver. 3,4,27,43,45 Standard therapy for this malignancy has most commonly included a strategy of local resection followed by adjuvant radiation therapy. 6,13,16,17,23,24,28,30,35,38,39,43,46,47,52 Chemotherapy using agents such as carboplatinum and paclitaxel has been used, but with limited results. 2,11,12,15,26,27,36,41,44,[48][49][50] ACC can arise in any salivary gland, both major and minor. Consequently, these tumors can be located in the tongue, trachea, palate, larynx, and paranasal sinuses. 27Tumors in the sinonasal cavity can remain undetected for long periods of time with minimal symptoms. Only after sufficient soft-tissue involvement, bone destruction, or cranial nerve involvement does the malignancy become manifest. Therefore, a strategy of maximal resection with minimal morbidity often presents a substantial therapeutic challenge given the complex anatomy of lesions that involve the paranasal sinuses and extend intracranially into the anterior or middle fossa.abbreviatioNs ACC = adenoid cystic carcinoma; EGFR = epidermal growth factor receptor; ICA = internal carotid artery; OS = overall survival; PFS = progression-free survival; VEGF = vascular endothelial growth factor. submitted October 28, 2014. accepted January 5, 2015. iNclude wheN citiNg Published online August 7, 2015; DOI: 10.3171/2015.1.JNS142462. disclosure The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper. results Median follow-up for study patients was 6.75 years. The 5- and 10-year overall survival (OS) rates were 78% and 50%, respectively. Sixty-six percent of patients had progression of their disease. The 5- and 10-year progressionfree survival (PFS) rates were 46.7% and 21.0%, respectively. Gross-total resection was achieved in 75% of patients, with 49% having microscopically negative margins at the time of first operation. On univariate analysis, resections with microscopically negative margins were associated with a significant OS advantage (20.1 ± 3.3 years) compared with resections that left residual disease, even if microscopic (10.3 ± 1.6 years, p = 0.035). In patients who underwent reoperation, the effect persisted, with improved OS in those with negative margins (21.4 ± 0.0 vs 16.7 ± 4.0 years, p = 0.06). The use of adjuvant radiotherapy was associated with an OS advantage (16.2 ± 2.5 vs 5.5 ± 2.2 years, p = 0.03) at initial diagnosis and improved PFS (7.8 ± 1.0 vs 2.1 ± 0.62 years, p = 0.005), whereas repeat irradiation provided no benefit. The use of adjuvant chemotherapy at diagnosis or at recurrence was not associated with any significant advantage. Multivariate analysis revealed margin-negative resection at initial operation and at recurrence retained OS significance, even after controlling...

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Malignant Tumors of the Anterolateral Skull Base

Cited by 23 publications

References 22 publications

Surgical approaches for infratemporal fossa tumor resection: Fifteen years' experience of a single center

Surgical approaches for infratemporal fossa tumor resection: Fifteen years' experience of a single center

Anatomic characteristics of the dural sheath of the trigeminal nerve

Adenoid cystic carcinoma of the skull base: results with an aggressive multidisciplinary approach

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