Skull base surgery for pediatric parameningeal sarcomas

Head Neck. 2012 Aug;34(8):1057-63. doi: 10.1002/hed.21865. Epub 2011 Aug 30.

Abstract

Background: Localized pediatric parameningeal sarcomas are usually treated exclusively by chemotherapy and radiotherapy. In this location, surgery is complicated but sometimes attempted to improve local control.

Methods: A retrospective bicentric study was conducted to examine its place with particular reference to acute and long-term morbidity. Fifteen patients under the age of 20 years with parameningeal sarcoma underwent surgery between 2000 and 2007.

Results: Surgery was performed for 8 primary sarcomas and 7 radiation-induced sarcomas, mainly in infratemporal fossa. Three children had intracranial extension, 3 had metastases, and 1 had both. Median follow-up was 46 months (16-154 months). Five children experienced local relapse. Eight presented sequelae. Eleven children are alive with no evidence of disease, and 4 died.

Conclusion: Skull base surgery should be considered as a possible treatment in pediatric parameningeal sarcomas. Surgery is the only option in radiation-induced sarcoma. Larger studies are necessary to more clearly define surgical indications.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Follow-Up Studies
  • Humans
  • Infant
  • Meningeal Neoplasms / mortality
  • Meningeal Neoplasms / therapy*
  • Neoadjuvant Therapy
  • Neoplasm Recurrence, Local
  • Neoplasms, Radiation-Induced / surgery
  • Radiotherapy, Adjuvant
  • Retrospective Studies
  • Sarcoma / mortality
  • Sarcoma / therapy*
  • Skull Base / surgery*
  • Young Adult