Moyer Kelly F, Maxwell Jessica H, Lumley Catherine, Manning JoAnn C, Gutt Ruchika
University of Maryland School of Medicine, Baltimore.
Georgetown University School of Medicine Washington, DC.
Fed Pract. 2022 May;39(Suppl 2):S26-S30. doi: 10.12788/fp.0254. Epub 2022 May 9.
Advanced cases of nasopharyngal carcinoma can present with skull base invasion. Treatment of these advanced cases with radiotherapy poses a challenge given proximity of tumor to critical neural structures as well as concern that a skull base defect and associated complications could develop with tumor regression.
A 34-year-old male patient presented with a 7-cm nasopharyngeal tumor invading the skull base with destruction of the clivus and intracranial extension. He underwent a course of definitive chemoradiation, requiring use of adaptive radiotherapy, that resulted in complete tumor regression and is free of disease 5 years posttreatment. Imaging done during treatment demonstrated that significant regeneration of bone occurred simultaneously with tumor regression.
This case demonstrates that it is possible for bony regeneration to occur simultaneously with tumor regression in a patient with skull base invasion by tumor, precluding the need for neurosurgical intervention.
晚期鼻咽癌可出现颅底侵犯。鉴于肿瘤与关键神经结构相邻，以及担心随着肿瘤消退可能会出现颅底缺损和相关并发症，对这些晚期病例进行放射治疗具有挑战性。
一名34岁男性患者，患有一个7厘米的鼻咽肿瘤，侵犯颅底，斜坡破坏并向颅内扩展。他接受了一个疗程的确定性放化疗，需要使用自适应放疗，结果肿瘤完全消退，治疗后5年无疾病。治疗期间进行的影像学检查表明，骨的显著再生与肿瘤消退同时发生。
该病例表明，肿瘤侵犯颅底的患者骨再生有可能与肿瘤消退同时发生，从而无需神经外科干预。
