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J Neurol Surg B Skull Base 2017; 78(03): 210-214
DOI: 10.1055/s-0036-1597279
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Minimally Invasive Approach for Resection of Parameningeal Rhabdomyosarcoma

Aileen Wertz
1   Department of Otolaryngology - Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan, United States
,
Brittny N. Tillman
1   Department of Otolaryngology - Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan, United States
,
Jennifer V. Brinkmeier
3   Department of Otolaryngology, Saint Louis University, Saint Louis, Missouri, United States
,
Tiffany A. Glazer
1   Department of Otolaryngology - Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan, United States
,
Andrew D. Kroeker
4   Department of Otolaryngology, Kaiser Permanente Health Northwest, Portland, Oregon, United States
,
Steven E. Sullivan
2   Department of Neurosurgery, University of Michigan Health System, Ann Arbor, Michigan, United States
,
Erin L. McKean
1   Department of Otolaryngology - Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan, United States
2   Department of Neurosurgery, University of Michigan Health System, Ann Arbor, Michigan, United States
› Author Affiliations
Further Information

Publication History

02 April 2016

24 October 2016

Publication Date:
12 December 2016 (online)

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Abstract

Background About one-third of rhabdomyosarcomas arise in the head and neck, with parameningeal primaries accounting for half of these. Principles of management involve chemotherapy, radiation, or both, in addition to surgical biopsy, debulking, and complete or near-complete resection. In the head and neck, diagnostic biopsies have historically been performed without attempt at resection due to proximity to critical structures and cosmetic considerations.

Methods Retrospective chart review of three cases of rhabdomyosarcoma at the cranial base managed through minimally invasive endoscopic surgical resection and adjuvant therapy.

Results Three patients were identified as having undergone endoscopic surgical debulking or margin-negative resection of a rhabdomyosarcoma of the cranial base. Two of three patients had complete resection based on intraoperative margin control. All three patients underwent adjuvant therapy within 1 month of diagnosis. Follow-up time ranged from 5 months to 3 years with all patients disease-free at last follow-up.

Conclusion Skull base surgeons should routinely be involved in multidisciplinary treatment planning for parameningeal rhabdomyosarcomas, as surgical options have evolved to allow for potential endoscopic resection with low morbidity and no or minimal delay in additional treatment options.

Keywords

rhabdomyosarcoma - parameningeal - endoscopic - minimally invasive
 

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