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 base—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 (*).
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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