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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
 

  • References

  • 1 Dasgupta R, Rodeberg DA. Update on rhabdomyosarcoma. Semin Pediatr Surg 2012; 21 (01) 68-78
    CrossrefPubMedGoogle Scholar
  • 2 Wexler L, Meyer W, Helman L. Rhabdomyosarcoma. . In: Pizzo P, Poplack D. , eds. Principles and Practice of Pediatric Oncology. 6th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2010: 923-953
    Google Scholar
  • 3 Daya H, Chan HSL, Sirkin W, Forte V. Pediatric rhabdomyosarcoma of the head and neck: is there a place for surgical management?. Arch Otolaryngol Head Neck Surg 2000; 126 (04) 468-472
    CrossrefPubMedGoogle Scholar
  • 4 Zevallos JP, Jain K, Roberts D. , et al. Modern multimodality therapy for pediatric nonorbital parameningeal sarcomas. Head Neck 2010; 32 (11) 1501-1505
    CrossrefPubMedGoogle Scholar
  • 5 Reilly BK, Kim A, Peña MT. , et al. Rhabdomyosarcoma of the head and neck in children: review and update. Int J Pediatr Otorhinolaryngol 2015; 79 (09) 1477-1483
    CrossrefPubMedGoogle Scholar
  • 6 Gradoni P, Giordano D, Oretti G, Fantoni M, Ferri T. The role of surgery in children with head and neck rhabdomyosarcoma and Ewing's sarcoma. Surg Oncol 2010; 19 (04) e103-e109
    CrossrefPubMedGoogle Scholar
  • 7 Gillespie MB, Marshall DT, Day TA, Mitchell AO, White DR, Barredo JC. Pediatric rhabdomyosarcoma of the head and neck. Curr Treat Options Oncol 2006; 7 (01) 13-22
    CrossrefPubMedGoogle Scholar
  • 8 National Cancer Institute. Childhood Rhabdomyosarcoma Treatment (PDQ®)–Health Professional Version. http://www.cancer.gov/cancertopics/pdq/treatment/childrhabdomyosarcoma/HealthProfessional . Accessed February 16, 2016
    PubMedGoogle Scholar
  • 9 Crist W, Gehan EA, Ragab AH. , et al. The Third Intergroup Rhabdomyosarcoma Study. J Clin Oncol 1995; 13 (03) 610-630
    CrossrefPubMedGoogle Scholar