Recurrence of Ventral Skull Base Lesions Attributed to Tumor Seeding: A Systematic Review

Nguyen, Brandon; Blasco, Michael A.; Svider, Peter F.; Lin, Ho‐Sheng; Liu, James K.; Eloy, Jean Anderson; Folbe, Adam J.

doi:10.1016/j.wneu.2018.12.104

Cited by 4 publications

(3 citation statements)

References 64 publications

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“…It was unexpected that 94% of the ectopic recurrences were related to the surgical tract, with no preferable tissue type (subcutis, bone, muscle, or fibrous tissue) for ectopic recurrence. Even though recurrences in the surgical tract in skull base chordoma have been described in the literature as case reports [13][14][15][16][17][18][19] and systematic reviews [12,20], it remains under-evaluated. In our hospital, a total of 16 skull base chordoma patients received proton therapy after surgery, and five patients (32%) showed ectopic recurrence.…”

Section: Discussionmentioning

confidence: 99%

Ectopic Recurrence of Skull Base Chordoma after Proton Therapy

et al. 2022

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Background: Chordoma are rare tumors of the axial skeleton. The treatment gold standard is surgery, followed by particle radiotherapy. Total resection is usually not achievable in skull base chordoma (SBC) and high recurrence rates are reported. Ectopic recurrence as a first sign of treatment failure is considered rare. Favorable sites of these ectopic recurrences remain unknown. Methods: Five out of 16 SBC patients treated with proton therapy and surgical resection developed ectopic recurrence as a first sign of treatment failure were critically analyzed regarding prior surgery, radiotherapy, and recurrences at follow-up imaging. Results: Eighteen recurrences were defined in five patients. A total of 31 surgeries were performed for primary tumors and recurrences. Seventeen out of eighteen (94%) ectopic recurrences could be related to prior surgical tracts, outside the therapeutic radiation dose. Follow-up imaging showed that tumor recurrence was difficult to distinguish from radiation necrosis and anatomical changes due to surgery. Conclusions: In our cohort, we found uncommon ectopic recurrences in the surgical tract. Our theory is that these recurrences are due to microscopic tumor spill during surgery. These cells did not receive a therapeutic radiation dose. Advances in surgical possibilities and adjusted radiotherapy target volumes might improve local control and survival.

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Section: Discussionmentioning

confidence: 99%

Ectopic Recurrence of Skull Base Chordoma after Proton Therapy

et al. 2022

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“…Nguyen et al. conducted a systematic review of recurrence attributed to tumor seeding of all skull base lesions 143 . Of the 69 reported cases, three (4%) were sinonasal tumors.…”

Section: Principles Of Surgical Treatmentmentioning

confidence: 99%

International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors

Kuan

Wang

Adappa

et al. 2024

Int Forum Allergy Rhinol

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BackgroundSinonasal neoplasms, whether benign and malignant, pose a significant challenge to clinicians and represents a model area for multidisciplinary collaboration in order to optimize patient care. The International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors (ICSNT) aims to summarize the best available evidence and presents 48 thematic and histopathology‐based topics spanning the field.MethodsIn accordance with prior ICAR documents, ICSNT assigned each topic as an Evidence‐Based Review with Recommendations, Evidence‐Based Review, and Literature Review based on level of evidence. An international group of multidisciplinary author teams were assembled for the topic reviews using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses format, and completed sections underwent a thorough and iterative consensus‐building process. The final document underwent rigorous synthesis and review prior to publication.ResultsThe ICNST document consists of 4 major sections: general principles, benign neoplasms and lesions, malignant neoplasms, and quality of life and surveillance. It covers 48 conceptual and/or histopathology‐based topics relevant to sinonasal neoplasms and masses. Topics with a high level of evidence provided specific recommendations, while other areas summarized the current state of evidence. A final section highlights research opportunities and future directions, contributing to advancing knowledge and community intervention.ConclusionAs an embodiment of the multidisciplinary and collaborative model of care in sinonasal neoplasms and masses, ICSNT was designed as a comprehensive, international, and multidisciplinary collaborative endeavor. Its primary objective is to summarize the existing evidence in the field of sinonasal neoplasms and masses.This article is protected by copyright. All rights reserved

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“…3,5,[9][10][11][12] Most recurrences are local, with estimates ranging from 19 to 54%; however, surgical tract dissemination and distant metastases have also been reported. 9,[12][13][14][15] The rate of metastasis varies greatly in the literature, with some estimates reported to be as low as 3 to 5% and others as high as 42%. [3][4][5]11,12,16,17 Most metastases originate from primary sacrococcygeal chordomas, 18,19 although cervical chordomas also show metastatic spread.…”

Section: Introductionmentioning

confidence: 99%

Multifocal Ectopic Recurrence of a C2 Chordoma

Reyes,

Kayne,

Collopy

et al. 2023

J Neurol Surg Rep

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Background Chordomas are histologically benign but locally aggressive tumors with a high propensity to recur. Our case highlights the importance of long-term vigilance in patients who have undergone chordoma resection. Case Report We report the case of a 47-year-old man with a cervical chordoma who developed multiple musculoskeletal ectopic recurrences in the left supraclavicular region, the proximal right bicep, and the left submandibular region without recurrence in the primary tumor site. Primary tumor resection was achieved via a combination of surgery, adjuvant radiation therapy, and imatinib. All recurrences were successfully resected and confirmed via pathology to be ectopic chordoma. Discussion Ectopic recurrence of cervical chordoma is rare and lung is the most common site of distant spread. Chordoma recurrence in skeletal muscle is particularly rare, with only 10 cases described in the literature. A plausible mechanism of distant metastatic disease in chordoma patients suggests that tumor cells escape the surgical tract via a combination of cytokine release, vasodilation, and microtrauma induced during resection. Conclusion Cervical chordoma with ectopic recurrence in skeletal muscle has not been previously described in the literature. Skull base surgeons should be aware of the phenomenon of chordoma ectopic recurrence in the absence of local recurrence.

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Recurrence of Ventral Skull Base Lesions Attributed to Tumor Seeding: A Systematic Review

Cited by 4 publications

References 64 publications

Ectopic Recurrence of Skull Base Chordoma after Proton Therapy

Ectopic Recurrence of Skull Base Chordoma after Proton Therapy

International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors

Multifocal Ectopic Recurrence of a C2 Chordoma

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