Other Malignant Skull Base Tumors

There is, at present, little evidence that the endoscope is of benefit in resecting other malignant tumors affecting the skull base or paranasal sinuses, for example, adenocarcinoma (Fig. 15.58a-f), squamous cell carcinoma (Fig. 15.59 a-c), nasopharyngeal carcinoma, neuroendocrine tumors other than olfactory neuro-blastomas, lymphoma (Quraishi et al., 2000), undifferentiated carcinoma (Fig. 15.60a-d), small-cell carcinoma, adenoid cystic carcinoma, sarcomas, and metastases. However, some malignant tumors can be resected with as wide a margin as can be obtained using other techniques in the hands of an experienced endonasal surgeon. This should only be done in conjunction with a multidisciplinary team.

Fig. 15.58 a Preoperative coronal and b axial CT scans of > adenocarcinoma of the posterior skull base. c Postoperative coronal and d axial CT scans of adenocarcinoma of the posterior skull baseā€”the patient also received radiotherapy. e Endoscopic appearance at 5 years of the posterior nasal cavity and f close-up view with recess above the pituitary gland (*).

Pituitary Surgery Skull Base Squamous Cell

Fig. 15.59 a Preoperative MR image and b CT scan after endoscopic resection and radiotherapy in a moderately differentiated squamous cell carcinoma of the left paranasal sinuses. c Four year follow-up appearance after endoscopic resection and radiotherapy for squamous cell carcinoma.

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