Singh G, Nakaji P, Chen F, Garrett M, Little A, Milligan J
Division of Neurological Surgery , Barrow Neurological Institute , St. Joseph’s Hospital and Medical Center , Phoenix, Arizona 85013 , USA.
Minim Invasive Neurosurg. 2011 Jun;54(3):135-7. doi: 10.1055/s-0031-1283128. Epub 2011 Aug 23.
Clival chordomas are difficult tumors to treat, particularly when they have already grown beyond the confines of the clivus.
We report the case of a 52-year-old man with a clival mass consistent with a chordoma with a prominent extension into the right middle fossa. At the patient's request, he underwent a simple endonasal biopsy to confirm the diagnosis. A second debulking procedure was planned to debulk the remnant tumor. However, follow-up magnetic resonance imaging showed that much of the middle fossa tumor had decompressed itself through the clival defect into the patient's pharynx.
The patient underwent additional clival debulking and proton-beam therapy. After 44 months of follow-up, he had no clinical or radiographic progression of disease.
It is intriguing to think that leaving a path for easy egress for a chordoma from the clivus may prevent it from building up in the bone and spreading.
斜坡脊索瘤是难以治疗的肿瘤，尤其是当它们已经生长到超出斜坡范围时。
我们报告一例52岁男性，其斜坡肿物符合脊索瘤，并有明显延伸至右侧中颅窝。应患者要求，他接受了单纯鼻内镜活检以确诊。计划进行第二次减瘤手术以切除残余肿瘤。然而，后续磁共振成像显示，大部分中颅窝肿瘤已通过斜坡缺损自行减压进入患者咽部。
患者接受了额外的斜坡减瘤手术和质子束治疗。经过44个月的随访，他没有疾病的临床或影像学进展。
认为为脊索瘤从斜坡留出一条容易排出的通道可能会防止其在骨内积聚和扩散，这一想法很有意思。
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