1
|
Meier L, Rajan G. Chondrosarcoma of the petrous apex with nerve abducens involvement in a woman with pre-existing contralateral amblyopia. BMJ Case Rep 2023; 16:e256273. [PMID: 37730429 PMCID: PMC10514603 DOI: 10.1136/bcr-2023-256273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2023] [Indexed: 09/22/2023] Open
Abstract
We report about a case of a woman in her 50s with a chondrosarcoma of the petrous apex. She has a strabism due to a right-sided amblyopia since childhood and noticed a slowly progressive squint angle in the last months. Her general practitioner (GP) referred her to an ophthalmologist who diagnosed a left abducens paresis and initiated an MRI demonstrating a mass in the left petrous apex. A transnasal endoscopic transsphenoidal biopsy revealed a grade I chondrosarcoma. The patient underwent an endoscopic transsphenoidal anterior petrosectomy approach with complete removal of the tumour. After surgery the squint angle gradually improved to previous levels, so that the patient was able to resume her work. This report demonstrates that even slight changes of a squint angle without diplopia, in this case because of pre-existing amblyopia, could be a hallmark of an intracranial process.
Collapse
Affiliation(s)
- Letizia Meier
- Klinik für Hals-, Nasen-, Ohren- und Gesichtschirurgie, Luzerner Kantonsspital, Luzern, Switzerland
| | - Gunesh Rajan
- Klinik für Hals-, Nasen-, Ohren- und Gesichtschirurgie, Luzerner Kantonsspital, Luzern, Switzerland
| |
Collapse
|
2
|
Gendreau JL, Hameed NUF, Jimenez A, Chakravarti S, Mehkri Y, Mukherjee D. Fractionated Radiotherapy After Gross Total Resection of Clival Chordoma: A Systematic Review of Survival Outcomes. Neurosurgery 2023; 93:257-266. [PMID: 36826997 DOI: 10.1227/neu.0000000000002418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 12/21/2022] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Current treatment guidelines for clival chordomas recommend surgical resection followed by high-dose radiotherapy (RT). However, in patients in whom gross total resection (GTR) is achieved, the benefits of additional RT remain unclear. OBJECTIVE To investigate whether RT offers any benefit to progression-free survival (PFS) in patients undergoing GTR of clival chordoma by performing a systematic review of all currently published literature. METHODS A total of 5 databases were searched to include all studies providing data on GTR ± RT for clival chordomas (January 1990-June 2021). Qualitative assessment was performed with Newcastle-Ottawa Scale guidelines for assessing quality of nonrandomized studies. Statistical analysis using individualized patient data of PFS was performed. RESULTS The systematic search yielded 2979 studies, weaned to 22 full-text articles containing 108 patients. All patients underwent GTR of clival chordoma, with 46 (43%) patients receiving adjuvant RT. Mean PFS for RT patients was 31.09 months (IQR: 12.25-37.75) vs 54.92 months (IQR: 14.00-85.75) in non-RT patients. Overall, RT did not increase PFS (HR 0.320, P = .069) to a value that achieved statistical significance. Stratifying by photon therapy vs particle beam therapy yielded no statistically significant benefit for particle beam therapy for PFS ( P = .300). Of patients with age ≥65 years, RT did not improve outcomes to statistical significance for PFS (HR 0.450, P = .481). Patients age ≥65 years had lower PFS on both bivariate analysis (HR 3.708, P = .007) and multivariate analysis (HR 3.322, P = .018). CONCLUSION After achieving GTR of clival chordoma, fractionated RT offers unclear benefit upon survival outcomes.
Collapse
Affiliation(s)
- Julian L Gendreau
- Department of Neurosurgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - N U Farrukh Hameed
- Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Adrian Jimenez
- Department of Neurosurgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Sachiv Chakravarti
- Department of Neurosurgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Yusuf Mehkri
- Department of Neurosurgery, University of Florida School of Medicine, Jacksonville, Florida, USA
| | - Debraj Mukherjee
- Department of Neurosurgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| |
Collapse
|
3
|
A Computed Tomography Radiomics Nomogram in Differentiating Chordoma From Giant Cell Tumor in the Axial Skeleton. J Comput Assist Tomogr 2023; 47:453-459. [PMID: 36728104 DOI: 10.1097/rct.0000000000001436] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The aim of the study is to develop and validate a computed tomography (CT) radiomics nomogram for preoperatively differentiating chordoma from giant cell tumor (GCT) in the axial skeleton. METHODS Seventy-three chordomas and 38 GCTs in axial skeleton were retrospectively included and were divided into a training cohort (n = 63) and a test cohort (n = 48). The radiomics features were extracted from CT images. A radiomics signature was developed by using the least absolute shrinkage and selection operator model, and a radiomics score (Rad-score) was acquired. By combining the Rad-score with independent clinical risk factors using multivariate logistic regression model, a radiomics nomogram was established. Calibration and receiver operator characteristic curves were used to assess the performance of the nomogram. RESULTS Five features were selected to construct the radiomics signature. The radiomics signature showed favorable discrimination in the training cohort (area under the curve [AUC], 0.860; 95% confidence interval [CI], 0.760-0.960) and the test cohort (AUC, 0.830; 95% CI, 0.710-0.950). Age and location were the independent clinical factors. The radiomics nomogram combining the Rad-score with independent clinical factors showed good discrimination capability in the training cohort (AUC, 0.930; 95% CI, 0.880-0.990) and the test cohort (AUC, 0.980; 95% CI, 0.940-1.000) and outperformed the radiomics signature (z = 2.768, P = 0.006) in the test cohort. CONCLUSIONS The CT radiomics nomogram shows good predictive efficacy in differentiating chordoma from GCT in the axial skeleton, which might facilitate clinical decision making.
Collapse
|
4
|
Clinical Characteristics and Prognostic Risk Factors of Parasellar Chondrosarcoma. Brain Sci 2022; 12:brainsci12101353. [PMID: 36291287 PMCID: PMC9599124 DOI: 10.3390/brainsci12101353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 09/30/2022] [Accepted: 10/04/2022] [Indexed: 11/18/2022] Open
Abstract
Background: Parasellar chondrosarcomas are extremely rare. This study describes the characteristics of parasellar chondrosarcoma and analyzes the risk factors and prognosis based on the resection degree. Methods: Fifteen patients with pathologically diagnosed parasellar chondrosarcoma were retrospectively analyzed for the clinical data, surgical methods, and prognosis to identify relationships between the surgical resection degree, tumor recurrence, and imaging characteristics. Results: Twelve patients had eye dysfunction and ptosis. Differentiation from other parasellar tumors by imaging is difficult. The preoperative Karnofsky Performance Scale (KPS) score positively correlated with the tumor resection degree (p = 0.026) and negatively correlated with the maximum tumor diameter (p = 0.001). Tumor recurrence negatively correlated with the resection degree (p = 0.009). The postoperative KPS score positively correlated with the preoperative KPS score (p < 0.001) and tumor resection degree (p = 0.026), and negatively correlated with the maximum tumor diameter (p = 0.016) and age (p = 0.047). An improved KPS score positively correlated with the tumor resection degree (p = 0.039). Patients who underwent total resection of the chondrosarcoma had longer progression-free survival than those who underwent partial resection (p = 0.0322). Conclusion: Parasellar chondrosarcomas are difficult to resect completely. Preoperative KPS score is an important factor for the degree of resection. KPS score, age, maximum tumor diameter, and resection degree may be important prognostic factors.
Collapse
|
5
|
Yamazawa E, Takahashi S, Shin M, Tanaka S, Takahashi W, Nakamoto T, Suzuki Y, Takami H, Saito N. MRI-Based Radiomics Differentiates Skull Base Chordoma and Chondrosarcoma: A Preliminary Study. Cancers (Basel) 2022; 14:cancers14133264. [PMID: 35805036 PMCID: PMC9265125 DOI: 10.3390/cancers14133264] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/25/2022] [Accepted: 06/27/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary In this study, we created a novel MRI-based machine learning model to differentiate skull base chordoma and chondrosarcoma with multiparametric signatures. While these tumors share common radiographic characteristics, clinical behavior is distinct. Therefore, distinguishing these tumors before initial surgical intervention would be useful, potentially impacting the surgical strategy. Although there are some limitations, such as the risk of overfitting and the lack of an extramural cohort for truly independent final validation, our machine learning model distinguishing chordoma from chondrosarcoma yielded superior diagnostic accuracy to that achieved by 20 board-certified neurosurgeons. Abstract Chordoma and chondrosarcoma share common radiographic characteristics yet are distinct clinically. A radiomic machine learning model differentiating these tumors preoperatively would help plan surgery. MR images were acquired from 57 consecutive patients with chordoma (N = 32) or chondrosarcoma (N = 25) treated at the University of Tokyo Hospital between September 2012 and February 2020. Preoperative T1-weighted images with gadolinium enhancement (GdT1) and T2-weighted images were analyzed. Datasets from the first 47 cases were used for model creation, and those from the subsequent 10 cases were used for validation. Feature extraction was performed semi-automatically, and 2438 features were obtained per image sequence. Machine learning models with logistic regression and a support vector machine were created. The model with the highest accuracy incorporated seven features extracted from GdT1 in the logistic regression. The average area under the curve was 0.93 ± 0.06, and accuracy was 0.90 (9/10) in the validation dataset. The same validation dataset was assessed by 20 board-certified neurosurgeons. Diagnostic accuracy ranged from 0.50 to 0.80 (median 0.60, 95% confidence interval 0.60 ± 0.06%), which was inferior to that of the machine learning model (p = 0.03), although there are some limitations, such as the risk of overfitting and the lack of an extramural cohort for truly independent final validation. In summary, we created a novel MRI-based machine learning model to differentiate skull base chordoma and chondrosarcoma from multiparametric signatures.
Collapse
Affiliation(s)
- Erika Yamazawa
- Department of Neurosurgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; (E.Y.); (H.T.); (N.S.)
| | - Satoshi Takahashi
- RIKEN Center for Advanced Intelligence Project, 2-1 Hirosawa, Wako 351-0198, Japan;
- Division of Medical AI Research and Development, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Masahiro Shin
- Department of Neurosurgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; (E.Y.); (H.T.); (N.S.)
- Department of Neurosurgery, University of Teikyo Hospital, 2-11-1 Kaga, Itabashi-Ku, Tokyo 173-8606, Japan
- Correspondence: (M.S.); (S.T.); Tel.: +81-3-3964-1211 (M.S.); +81-3-3815-5411 (S.T.)
| | - Shota Tanaka
- Department of Neurosurgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; (E.Y.); (H.T.); (N.S.)
- Correspondence: (M.S.); (S.T.); Tel.: +81-3-3964-1211 (M.S.); +81-3-3815-5411 (S.T.)
| | - Wataru Takahashi
- Department of Radiology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; (W.T.); (T.N.); (Y.S.)
| | - Takahiro Nakamoto
- Department of Radiology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; (W.T.); (T.N.); (Y.S.)
- Department of Biological Science and Engineering, Faculty of Health Sciences, Hokkaido University Kita 12, Nishi 5, Kita-ku, Sapporo-shi 060-0808, Japan
| | - Yuichi Suzuki
- Department of Radiology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; (W.T.); (T.N.); (Y.S.)
| | - Hirokazu Takami
- Department of Neurosurgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; (E.Y.); (H.T.); (N.S.)
| | - Nobuhito Saito
- Department of Neurosurgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; (E.Y.); (H.T.); (N.S.)
| |
Collapse
|
6
|
Wangaryattawanich P, Agarwal M, Rath T. Imaging features of cartilaginous tumors of the head and neck. J Clin Imaging Sci 2022; 11:66. [PMID: 34992942 PMCID: PMC8720426 DOI: 10.25259/jcis_186_2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 11/18/2021] [Indexed: 11/29/2022] Open
Abstract
There is a wide spectrum of head and neck cartilaginous lesions which include both neoplastic and nonneoplastic processes. Cartilaginous tumors of the head and neck are uncommon, posing a diagnostic challenge. Benign cartilaginous tumors that may occur in the head and neck include chondroma, chondroblastoma, chondromyxoid fibroma, osteochondroma, and synovial chondromatosis. Chondromesenchymal hamartoma is a rare non-neoplastic cartilaginous lesion that is included for the 1first time in the new WHO classification and radiologically can mimic a tumor. Malignant cartilaginous tumors include chondrosarcoma and chondroid variant of chordoma. Characteristic tumor locations, internal chondroid matrix calcification, and typical T2 hyperintense signal secondary to high-water content within the extracellular matrix of the hyaline cartilage are useful imaging features that narrow the differential diagnosis and help in diagnosing these diseases. This article presents a narrative review of the anatomy of the head and neck cartilaginous structures, discusses the current knowledge and imaging spectrum of benign and malignant cartilaginous tumors and tumor-like lesions of the head and neck.
Collapse
Affiliation(s)
- Pattana Wangaryattawanich
- Department of Radiology, Division of Neuroradiology, University of Washington School of Medicine, Seattle, Washington, United States
| | - Mohit Agarwal
- Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Tanya Rath
- Department of Radiology, Mayo Clinic Arizona, Phoenix, Arizona, United States
| |
Collapse
|
7
|
Kayahara T, Kurita H, Irie K, Nakahara I, Sasaki T. Intracranial chondrosarcoma located in the region of the posterior clinoid process: a case report. Radiol Case Rep 2021; 17:115-118. [PMID: 34777675 PMCID: PMC8577103 DOI: 10.1016/j.radcr.2021.09.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 09/29/2021] [Indexed: 11/30/2022] Open
Abstract
Intracranial chondrosarcomas located in the region of the posterior clinoid process have not been focused on. Here, we report the case of a 29-year-old woman with a skull base tumor in that region. Seven years after the diagnosis, the tumor had grown and showed calcification and tumor stain; chondrosarcoma, posterior clinoid meningioma, and chordoma were suspected. The patient underwent subtotal tumor resection, and the histopathological study revealed that the tumor was a low-grade chondrosarcoma. Chondrosarcomas can be located in the region of the posterior clinoid process, and not only chordomas but also posterior clinoid meningiomas should be considered as a differential diagnosis of tumors located in that region, especially when the tumor has calcification or receives a vascular supply.
Collapse
Affiliation(s)
- Tomomichi Kayahara
- Department of Neurosurgery, Nagoya Kyoritsu Hospital, 1-172 Hokke, Nakagawaku, Nagoya, Aichi 454-0933, Japan
- Corresponding author: T. Kayahara
| | - Hiroki Kurita
- Department of Cerebrovascular Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Keiko Irie
- Department of Neurosurgery, Nagoya Kyoritsu Hospital, 1-172 Hokke, Nakagawaku, Nagoya, Aichi 454-0933, Japan
| | - Ichiro Nakahara
- Department of Comprehensive Strokology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Tomio Sasaki
- Department of Neurosurgery, Nagoya Kyoritsu Hospital, 1-172 Hokke, Nakagawaku, Nagoya, Aichi 454-0933, Japan
| |
Collapse
|
8
|
El Sayed I, Trifiletti DM, Lehrer EJ, Showalter TN, Dutta SW. Protons versus photons for the treatment of chordoma. Cochrane Database Syst Rev 2021; 7:CD013224. [PMID: 34196007 PMCID: PMC8245311 DOI: 10.1002/14651858.cd013224.pub2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Chordoma is a rare primary bone tumour with a high propensity for local recurrence. Surgical resection is the mainstay of treatment, but complete resection is often morbid due to tumour location. Similarly, the dose of radiotherapy (RT) that surrounding healthy organs can tolerate is frequently below that required to provide effective tumour control. Therefore, clinicians have investigated different radiation delivery techniques, often in combination with surgery, aimed to improve the therapeutic ratio. OBJECTIVES To assess the effects and toxicity of proton and photon adjuvant radiotherapy (RT) in people with biopsy-confirmed chordoma. SEARCH METHODS We searched CENTRAL (2021, Issue 4); MEDLINE Ovid (1946 to April 2021); Embase Ovid (1980 to April 2021) and online registers of clinical trials, and abstracts of scientific meetings up until April 2021. SELECTION CRITERIA We included adults with pathologically confirmed primary chordoma, who were irradiated with curative intent, with protons or photons in the form of fractionated RT, SRS (stereotactic radiosurgery), SBRT (stereotactic body radiotherapy), or IMRT (intensity modulated radiation therapy). We limited analysis to studies that included outcomes of participants treated with both protons and photons. DATA COLLECTION AND ANALYSIS The primary outcomes were local control, mortality, recurrence, and treatment-related toxicity. We followed current standard Cochrane methodological procedures for data extraction, management, and analysis. We used the ROBINS-I tool to assess risk of bias, and GRADE to assess the certainty of the evidence. MAIN RESULTS We included six observational studies with 187 adult participants. We judged all studies to be at high risk of bias. Four studies were included in meta-analysis. We are uncertain if proton compared to photon therapy worsens or has no effect on local control (hazard ratio (HR) 5.34, 95% confidence interval (CI) 0.66 to 43.43; 2 observational studies, 39 participants; very low-certainty evidence). Median survival time ranged between 45.5 months and 66 months. We are uncertain if proton compared to photon therapy reduces or has no effect on mortality (HR 0.44, 95% CI 0.13 to 1.57; 4 observational studies, 65 participants; very low-certainty evidence). Median recurrence-free survival ranged between 3 and 10 years. We are uncertain whether proton compared to photon therapy reduces or has no effect on recurrence (HR 0.34, 95% CI 0.10 to 1.17; 4 observational studies, 94 participants; very low-certainty evidence). One study assessed treatment-related toxicity and reported that four participants on proton therapy developed radiation-induced necrosis in the temporal bone, radiation-induced damage to the brainstem, and chronic mastoiditis; one participant on photon therapy developed hearing loss, worsening of the seventh cranial nerve paresis, and ulcerative keratitis (risk ratio (RR) 1.28, 95% CI 0.17 to 9.86; 1 observational study, 33 participants; very low-certainty evidence). There is no evidence that protons led to reduced toxicity. There is very low-certainty evidence to show an advantage for proton therapy in comparison to photon therapy with respect to local control, mortality, recurrence, and treatment related toxicity. AUTHORS' CONCLUSIONS There is a lack of published evidence to confirm a clinical difference in effect with either proton or photon therapy for the treatment of chordoma. As radiation techniques evolve, multi-institutional data should be collected prospectively and published, to help identify persons that would most benefit from the available radiation treatment techniques.
Collapse
Affiliation(s)
- Iman El Sayed
- Department of Biomedical Informatics and Medical Statistics, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | | | - Eric J Lehrer
- Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, USA
| | | | - Sunil W Dutta
- Department of Radiation Oncology, Emory University, Atlanta, USA
| |
Collapse
|
9
|
Emanuelli E, Zanotti C, Munari S, Baldovin M, Schiavo G, Denaro L. Sellar and parasellar lesions: multidisciplinary management. ACTA OTORHINOLARYNGOLOGICA ITALICA 2021; 41:S30-S41. [PMID: 34060518 PMCID: PMC8172107 DOI: 10.14639/0392-100x-suppl.1-41-2021-03] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 02/18/2021] [Indexed: 11/23/2022]
Abstract
Introduction The endoscopic endonasal transsphenoidal approach to the sella and parasellar regions is now increasingly used for removal of a variety of lesions localized in the ventral skull base. The advantage of the endoscope is enhanced visualization and improved panoramic view that can result in more complete removal of the tumor. An extensive knowledge of the anatomy is mandatory to approach this region. Materials and methods From February 2009 to March 2020, the endoscopic endonasal approach was used in 153 patients with sellar and parasellar lesions, at our Institution: 136 pituitary adenomas, 7 craniopharyngiomas, 3 Rathke’s cysts, a tuberculum sellae meningioma, an aneurysm of the internal carotid artery (ICA), a clivus chordoma, a papillary glioneuronal tumor, an histiocytosis, a pituitary metastasis from breast cancer and a chondrosarcoma. Results The most common surgical complications were cerebral spinal fluid leak (9), bleeding (2), pituitary abscess (2). Among endocrinological complications, the most important were diabete insipidus (23) and panhypopituitarism (3). Two patients complicated with meningitis. There were no visual worsening and no operative mortality. We had persistence of disease in 20 cases. Twelve patients underwent surgical revision for recurrence of the disease. Conclusions Pre-operative planning and collaboration with several specialists are necessary in order to offer the patient the best treatment, minimizing complications.
Collapse
Affiliation(s)
- Enzo Emanuelli
- Department of Neurosciences DNS, Otolaryngology Section, Padua University, Padua, Italy
| | - Claudia Zanotti
- Department of Neurosciences DNS, Otolaryngology Section, Padua University, Padua, Italy
| | - Sara Munari
- Department of Neurosciences DNS, Otolaryngology Section, Padua University, Padua, Italy
| | - Maria Baldovin
- Department of Neurosciences DNS, Otolaryngology Section, Padua University, Padua, Italy
| | - Gloria Schiavo
- Department of Neurosciences DNS, Otolaryngology Section, Padua University, Padua, Italy
| | - Luca Denaro
- Department of Neurosciences DNS, Neurosurgery Section, Padua University, Padua, Italy
| |
Collapse
|
10
|
Cahill J, Ibrahim R, Mezey G, Yianni J, Bhattacharyya D, Walton L, Grainger A, Radatz MWR. Gamma Knife Stereotactic Radiosurgery for the treatment of chordomas and chondrosarcomas. Acta Neurochir (Wien) 2021; 163:1003-1011. [PMID: 33608764 DOI: 10.1007/s00701-021-04768-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 02/10/2021] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Primary chordomas and chondrosarcomas of the skull base are difficult tumours to treat successfully. Despite advances in surgical techniques, a gross total resection is often impossible to achieve. In addition, some patients may be deemed unsuitable or not wish to undergo extensive surgery for these conditions. This study examines the role of Gamma Knife Stereotactic Radiosurgery (GKRS) in the treatment of these difficult cases. METHODS All patients harbouring either a chordoma or chondrosarcoma treated at the National Centre for Stereotactic Radiosurgery, Royal Hallamshire Hospital, Sheffield, UK, between 1985 and 2018, were reviewed with regard to their clinical presentations, pre- and post-treatment imaging, GKRS prescriptions and outcomes. RESULTS In total, 24 patients with a mean tumour volume of 13 cm3 in the chordoma group (n=15) and 12 cm3 in the chondrosarcoma group (n=9) underwent GKRS. The 5- and 10-year overall survival rates for the chordoma group were 67% and 53% respectively, while for the chondrosarcoma group, they were 78% at both time points. The tumour control rates at 5 and 10 years in the chordoma group were 67% and 49% and for the chondrosarcoma group 78% at both time points. Patients with tumour volumes of less than 7 cm3 before GKRS treatment demonstrated a statistically significant longer overall survival rate (p=0.03). CONCLUSIONS GKRS offers a comparable option to proton beam therapy for the treatment of these tumours. Early intervention for tumour volumes of less than 7 cm3 gives the best long-term survival rates.
Collapse
|
11
|
Palmer JD, Gamez ME, Ranta K, Ruiz-Garcia H, Peterson JL, Blakaj DM, Prevedello D, Carrau R, Mahajan A, Chaichana KL, Trifiletti DM. Radiation therapy strategies for skull-base malignancies. J Neurooncol 2020; 150:445-462. [PMID: 32785868 DOI: 10.1007/s11060-020-03569-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 06/22/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION The management of skull base malignancies continues to evolve with improvements in surgical technique, advances in radiation delivery and novel systemic agents. METHODS In this review, we aim to discuss in detail the management of common skull base pathologies which typically require multimodality therapy, focusing on the radiotherapeutic aspects of care. RESULTS Technological advances in the administration of radiation therapy have led to a wide variety of different treatment strategies for the treatment of skull base malignances, with outcomes summarized herein. CONCLUSION Radiation treatment plays a key and critical role in the management of patients with skull base tumors. Recent advancements continue to improve the risk/benefit ratio for radiotherapy in this setting.
Collapse
Affiliation(s)
- J D Palmer
- Department of Radiation Oncology, The James Cancer Hospital at the Ohio State University Wexner Medical Center, Columbus, OH, USA.,Department of Neurosurgery, The James Cancer Hospital at the Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - M E Gamez
- Department of Radiation Oncology, The James Cancer Hospital at the Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - K Ranta
- Department of Radiation Oncology, The James Cancer Hospital at the Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - H Ruiz-Garcia
- Department of Radiation Oncology, Mayo Clinic, 4500 San Pablo Road S, Jacksonville, FL, 32224, USA
| | - J L Peterson
- Department of Radiation Oncology, Mayo Clinic, 4500 San Pablo Road S, Jacksonville, FL, 32224, USA.,Department of Neurological Surgery, Mayo Clinic, Jacksonville, FL, USA
| | - D M Blakaj
- Department of Radiation Oncology, The James Cancer Hospital at the Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - D Prevedello
- Department of Neurosurgery, The James Cancer Hospital at the Ohio State University Wexner Medical Center, Columbus, OH, USA.,Department of Otolaryngology - Head and Neck Surgery at the Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - R Carrau
- Department of Neurosurgery, The James Cancer Hospital at the Ohio State University Wexner Medical Center, Columbus, OH, USA.,Department of Otolaryngology - Head and Neck Surgery at the Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - A Mahajan
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA
| | - K L Chaichana
- Department of Neurological Surgery, Mayo Clinic, Jacksonville, FL, USA
| | - D M Trifiletti
- Department of Radiation Oncology, Mayo Clinic, 4500 San Pablo Road S, Jacksonville, FL, 32224, USA. .,Department of Neurological Surgery, Mayo Clinic, Jacksonville, FL, USA.
| |
Collapse
|
12
|
Chiaramonte C, Jacquesson T, Jouanneau E. Extra-intradural extracavernous subtemporal approach for chondrosarcomas: technical note and case report. Acta Neurochir (Wien) 2019; 161:2349-2352. [PMID: 31273444 DOI: 10.1007/s00701-019-03989-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 06/25/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Skull base chondrosarcomas are rare tumors often invading the petrous apex and cavernous sinus, and many surgical approaches have been described. For most of them, these tumors grow slowly and their partial removal can be a first option before complementary radiotherapy. We described herein a minimally invasive approach that could be useful for soft non-calcified chondrosarcomas. METHOD AND RESULTS We report a case of right parasellar chondrosarcoma, for which an extra-intradural extracavernous subtemporal approach allowed a safe effective partial removal. CONCLUSION This surgical approach is indicated in selected cases to obtain good decompression or partial removal of lesions involving the parasellar space and the petrous apex.
Collapse
Affiliation(s)
- Carmela Chiaramonte
- Division of Neurosurgery, Department of Neurosciences and Reproductive and Odontostomatological Sciences, School of Medicine and Surgery, University of Naples Federico II, Via Vincenzo Lombardi, 44 Gragnano, Naples, Italy.
| | - Timothée Jacquesson
- Skull Base Surgery Unit, Department of Neurosurgery B, Hospices Civils de Lyon, University Hospital of Lyon, Lyon, France
| | - Emmanuel Jouanneau
- Skull Base Surgery Unit, Department of Neurosurgery B, Hospices Civils de Lyon, University Hospital of Lyon, Lyon, France
| |
Collapse
|
13
|
Rinaldo L, Priemer DS, Vortmeyer AO, Cohen-Gadol AA, Brat DJ, Mahajan A, Giannini C, Burns TC. Chordoma of the corpus callosum: case report. J Neurosurg 2019; 131:1380-1386. [PMID: 30497142 DOI: 10.3171/2018.6.jns181028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 06/11/2018] [Indexed: 11/06/2022]
Abstract
Chordomas are neoplasms that typically arise from midline skeletal structures and rarely originate within the intradural compartment of the CNS. A chordoma arising from the corpus callosum has not been previously described. The authors report the surgical management of a chordoma originating within the splenium of the corpus callosum. To determine the incidence and distribution of intracranial intradural chordoma, a literature search for additional cases was performed. MEDLINE was searched using the MeSH keyword "chordoma," yielding 2010 articles. These articles were screened for cases of primary intradural chordoma rostral to the craniocervical junction, which led to the identification of 46 relevant articles. The authors report the case of a 69-year-old man who initially presented with nonspecific neurological symptoms including spatial disorientation and cognitive decline. These symptoms eventually prompted intracranial imaging, including MRI, which revealed a ring-enhancing, heterogeneous, cystic mass localized within the splenium of the corpus callosum and extending into the bilateral ventricles. The lesion was believed to represent a high-grade glioma and the patient underwent a left interhemispheric approach and subtotal resection. After pathologic evaluation confirmed a diagnosis of an anaplastic chordoma, the patient underwent further resection. A gross-total resection (GTR) was achieved with a transfalcine approach to the contralateral portion of the tumor. Postoperatively, the patient had a partial left homonymous quadrantanopsia, but was otherwise at his neurological baseline. Proton beam radiotherapy was performed to the resection cavity but diffuse intraventricular disease ensued. The results of a literature search suggest that a chordoma arising in the corpus callosum has not been previously described. The present case demonstrates that chordomas can occur in the corpus callosum, and illustrates the utility of a transfalcine approach for GTR of lesions in this location, as well as the need for improved strategies to prevent intraventricular dissemination.
Collapse
Affiliation(s)
| | - David S Priemer
- 2Department of Anatomic Pathology and Neuropathology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Alexander O Vortmeyer
- 2Department of Anatomic Pathology and Neuropathology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Aaron A Cohen-Gadol
- 3Goodman Campbell Brain and Spine, Indiana University Department of Neurological Surgery, Indianapolis, Indiana; and
| | - Daniel J Brat
- 4Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | - Caterina Giannini
- Departments of1Neurosurgery
- 6Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | | |
Collapse
|
14
|
Li L, Wang K, Ma X, Liu Z, Wang S, Du J, Tian K, Zhou X, Wei W, Sun K, Lin Y, Wu Z, Tian J. Radiomic analysis of multiparametric magnetic resonance imaging for differentiating skull base chordoma and chondrosarcoma. Eur J Radiol 2019; 118:81-87. [PMID: 31439263 DOI: 10.1016/j.ejrad.2019.07.006] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 06/25/2019] [Accepted: 07/04/2019] [Indexed: 12/29/2022]
Abstract
PURPOSE Patients with skull base chordoma and chondrosarcoma have different prognoses and are not readily differentiated preoperatively on imaging. Multiparametric magnetic resonance imaging (MRI) is a routine diagnostic tool that can noninvasively characterize the salient characteristics of tumors. In the present study, we developed and validated a preoperative multiparametric MRI-based radiomic signature for differentiating these tumors. METHOD This retrospective study enrolled 210 patients and consecutively divided them into the primary and validation cohorts. A total of 1941 radiomic features were acquired from preoperative T1-weighted imaging, T2-weighted imaging and contrast-enhanced T1-weighted imaging for each patient. The most discriminative features were selected by minimum-redundancy maximum-relevancy and recursive feature elimination algorithms in the primary cohort. The multiparametric and single-sequence MRI signatures were constructed with the selected features using a support vector machine model in the primary cohort. The ability of the novel radiomic signatures to differentiate chordoma from chondrosarcoma were assessed using receiver operating characteristic curve analysis in the validation cohort. RESULTS The multiparametric radiomic signature, which consisted of 11 selected features, reached an area under the receiver operating characteristic curve of 0.9745 and 0.8720 in the primary and validation cohorts, respectively. Moreover, compared with each single-sequence MRI signature, the multiparametric radiomic signature exhibited better classification performance with significant improvement (p < 0.05, Delong's test) in the primary cohorts. CONCLUSION By combining features from three MRI sequences, the multiparametric radiomics signature can accurately and robustly differentiate skull base chordoma from chondrosarcoma.
Collapse
Affiliation(s)
- Longfei Li
- Collaborative Innovation Center for Internet Healthcare, Zhengzhou University, Zhengzhou, Henan, 450052, China; CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
| | - Ke Wang
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100050, China
| | - Xiujian Ma
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100050, China
| | - Zhenyu Liu
- CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China; University of Chinese Academy of Sciences, Beijing, 100080, China
| | - Shuo Wang
- CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
| | - Jiang Du
- Department of Neuropathology, Beijing Neurosurgical Institute, Beijing, Dongcheng Distract, 100050, China
| | - Kaibing Tian
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100050, China
| | - Xuezhi Zhou
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710071, China
| | - Wei Wei
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710071, China
| | - Kai Sun
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710071, China
| | - Yusong Lin
- Collaborative Innovation Center for Internet Healthcare, Zhengzhou University, Zhengzhou, Henan, 450052, China; School of Software, Zhengzhou University, Zhengzhou, Henan, 450003, China.
| | - Zhen Wu
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100050, China.
| | - Jie Tian
- CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China; University of Chinese Academy of Sciences, Beijing, 100080, China; School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710071, China; Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Medicine, Beihang University, Beijing, China.
| |
Collapse
|
15
|
Zanoletti E, Mazzoni A, Martini A, Abbritti RV, Albertini R, Alexandre E, Baro V, Bartolini S, Bernardeschi D, Bivona R, Bonali M, Borghesi I, Borsetto D, Bovo R, Breun M, Calbucci F, Carlson ML, Caruso A, Cayé-Thomasen P, Cazzador D, Champagne PO, Colangeli R, Conte G, D'Avella D, Danesi G, Deantonio L, Denaro L, Di Berardino F, Draghi R, Ebner FH, Favaretto N, Ferri G, Fioravanti A, Froelich S, Giannuzzi A, Girasoli L, Grossardt BR, Guidi M, Hagen R, Hanakita S, Hardy DG, Iglesias VC, Jefferies S, Jia H, Kalamarides M, Kanaan IN, Krengli M, Landi A, Lauda L, Lepera D, Lieber S, Lloyd SLK, Lovato A, Maccarrone F, Macfarlane R, Magnan J, Magnoni L, Marchioni D, Marinelli JP, Marioni G, Mastronardi V, Matthies C, Moffat DA, Munari S, Nardone M, Pareschi R, Pavone C, Piccirillo E, Piras G, Presutti L, Restivo G, Reznitsky M, Roca E, Russo A, Sanna M, Sartori L, Scheich M, Shehata-Dieler W, Soloperto D, Sorrentino F, Sterkers O, Taibah A, Tatagiba M, Tealdo G, Vlad D, Wu H, Zanetti D. Surgery of the lateral skull base: a 50-year endeavour. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2019; 39:S1-S146. [PMID: 31130732 PMCID: PMC6540636 DOI: 10.14639/0392-100x-suppl.1-39-2019] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Disregarding the widely used division of skull base into anterior and lateral, since the skull base should be conceived as a single anatomic structure, it was to our convenience to group all those approaches that run from the antero-lateral, pure lateral and postero-lateral side of the skull base as “Surgery of the lateral skull base”. “50 years of endeavour” points to the great effort which has been made over the last decades, when more and more difficult surgeries were performed by reducing morbidity. The principle of lateral skull base surgery, “remove skull base bone to approach the base itself and the adjacent sites of the endo-esocranium”, was then combined with function preservation and with tailoring surgery to the pathology. The concept that histology dictates the extent of resection, balancing the intrinsic morbidity of each approach was the object of the first section of the present report. The main surgical approaches were described in the second section and were conceived not as a step-by-step description of technique, but as the highlighthening of the surgical principles. The third section was centered on open issues related to the tumor and its treatment. The topic of vestibular schwannoma was investigated with the current debate on observation, hearing preservation surgery, hearing rehabilitation, radiotherapy and the recent efforts to detect biological markers able to predict tumor growth. Jugular foramen paragangliomas were treated in the frame of radical or partial surgery, radiotherapy, partial “tailored” surgery and observation. Surgery on meningioma was debated from the point of view of the neurosurgeon and of the otologist. Endolymphatic sac tumors and malignant tumors of the external auditory canal were also treated, as well as chordomas, chondrosarcomas and petrous bone cholesteatomas. Finally, the fourth section focused on free-choice topics which were assigned to aknowledged experts. The aim of this work was attempting to report the state of the art of the lateral skull base surgery after 50 years of hard work and, above all, to raise questions on those issues which still need an answer, as to allow progress in knowledge through sharing of various experiences. At the end of the reading, if more doubts remain rather than certainties, the aim of this work will probably be achieved.
Collapse
Affiliation(s)
- E Zanoletti
- Department of Neuroscience DNS, Otolaryngology Section, Padova University, Padova, Italy
| | - A Mazzoni
- Department of Neuroscience DNS, Otolaryngology Section, Padova University, Padova, Italy
| | - A Martini
- Department of Neuroscience DNS, Otolaryngology Section, Padova University, Padova, Italy
| | - R V Abbritti
- Department of Neurosurgery, Lariboisière Hospital, University of Paris Diderot, Paris, France
| | | | - E Alexandre
- Department of Neuroscience DNS, Otolaryngology Section, Padova University, Padova, Italy
| | - V Baro
- Academic Neurosurgery, Department of Neuroscience DNS, University of Padova Medical School, Padova, Italy
| | - S Bartolini
- Neurosurgery, Bellaria Hospital, Bologna, Italy
| | - D Bernardeschi
- AP-HP, Groupe Hôspital-Universitaire Pitié-Salpêtrière, Neuro-Sensory Surgical Department and NF2 Rare Disease Centre, Paris, France
- Sorbonne Université, Paris, France
| | - R Bivona
- ENT and Skull-Base Surgery Department, Department of Neurosciences, Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - M Bonali
- Otolaryngology-Head and Neck Surgery Department, University Hospital of Modena, Italy
| | - I Borghesi
- Neurosurgery, Maria Cecilia Hospital, Cotignola (RA), Italy
| | - D Borsetto
- Department of Neuroscience DNS, Otolaryngology Section, Padova University, Padova, Italy
| | - R Bovo
- Department of Neuroscience DNS, Otolaryngology Section, Padova University, Padova, Italy
| | - M Breun
- Department of Neurosurgery, Julius Maximilians University Hospital Würzburg, Bavaria, Germany
| | - F Calbucci
- Neurosurgery, Maria Cecilia Hospital, Cotignola (RA), Italy
| | - M L Carlson
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN, USA
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA
| | - A Caruso
- Gruppo Otologico, Piacenza-Rome, Italy
| | - P Cayé-Thomasen
- The Department of Otorhinolaryngology, Head & Neck Surgery and Audiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - D Cazzador
- Department of Neuroscience DNS, Otolaryngology Section, Padova University, Padova, Italy
- Department of Neuroscience DNS, Section of Human Anatomy, Padova University, Padova, Italy
| | - P-O Champagne
- Department of Neurosurgery, Lariboisière Hospital, University of Paris Diderot, Paris, France
| | - R Colangeli
- Department of Neuroscience DNS, Otolaryngology Section, Padova University, Padova, Italy
| | - G Conte
- Department of Neuroradiology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy
| | - D D'Avella
- Academic Neurosurgery, Department of Neuroscience DNS, University of Padova Medical School, Padova, Italy
| | - G Danesi
- ENT and Skull-Base Surgery Department, Department of Neurosciences, Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - L Deantonio
- Department of Radiation Oncology, University Hospital Maggiore della Carità, Novara, Italy
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - L Denaro
- Academic Neurosurgery, Department of Neuroscience DNS, University of Padova Medical School, Padova, Italy
| | - F Di Berardino
- Unit of Audiology, Department of Clinical Sciences and Community Health, University of Milano, Italy
- Department of Surgery, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy
| | - R Draghi
- Neurosurgery, Maria Cecilia Hospital, Cotignola (RA), Italy
| | - F H Ebner
- Department of Neurosurgery, Eberhard Karls University Tübingen, Germany
| | - N Favaretto
- Department of Neuroscience DNS, Otolaryngology Section, Padova University, Padova, Italy
| | - G Ferri
- Otolaryngology-Head and Neck Surgery Department, University Hospital of Modena, Italy
| | | | - S Froelich
- Department of Neurosurgery, Lariboisière Hospital, University of Paris Diderot, Paris, France
| | | | - L Girasoli
- Department of Neuroscience DNS, Otolaryngology Section, Padova University, Padova, Italy
| | - B R Grossardt
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - M Guidi
- Gruppo Otologico, Piacenza-Rome, Italy
| | - R Hagen
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, "Julius-Maximilians" University Hospital of Würzburg, Bavaria, Germany
| | - S Hanakita
- Department of Neurosurgery, Lariboisière Hospital, University of Paris Diderot, Paris, France
| | - D G Hardy
- Department of Neurosurgery, Cambridge University Hospital, Cambridge, UK
| | - V C Iglesias
- ENT and Skull-Base Surgery Department, Department of Neurosciences, Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - S Jefferies
- Oncology Department, Cambridge University Hospital, Cambridge, UK
| | - H Jia
- Department of Otolaryngology Head and Neck Surgery, Shanghai Ninh People's Hospital, Shanghai Jiatong University School of Medicine, China
| | - M Kalamarides
- AP-HP, Groupe Hôspital-Universitaire Pitié-Salpêtrière, Neuro-Sensory Surgical Department and NF2 Rare Disease Centre, Paris, France
- Sorbonne Université, Paris, France
| | - I N Kanaan
- Department of Neurosciences, King Faisal Specialist Hospital & Research Center, Alfaisal University, College of Medicine, Riyadh, KSA
| | - M Krengli
- Department of Radiation Oncology, University Hospital Maggiore della Carità, Novara, Italy
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - A Landi
- Academic Neurosurgery, Department of Neuroscience DNS, University of Padova Medical School, Padova, Italy
| | - L Lauda
- Gruppo Otologico, Piacenza-Rome, Italy
| | - D Lepera
- ENT & Skull-Base Department, Ospedale Nuovo di Legnano, Legnano (MI), Italy
| | - S Lieber
- Department of Neurosurgery, Eberhard Karls University Tübingen, Germany
| | - S L K Lloyd
- Department of Neuro-Otology and Skull-Base Surgery Manchester Royal Infirmary, Manchester, UK
| | - A Lovato
- Department of Neuroscience DNS, Audiology Unit, Padova University, Treviso, Italy
| | - F Maccarrone
- Otolaryngology-Head and Neck Surgery Department, University Hospital of Modena, Italy
| | - R Macfarlane
- Department of Neurosurgery, Cambridge University Hospital, Cambridge, UK
| | - J Magnan
- University Aix-Marseille, France
| | - L Magnoni
- Unit of Audiology, Department of Clinical Sciences and Community Health, University of Milano, Italy
- Department of Surgery, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy
| | - D Marchioni
- Otolaryngology-Head and Neck Surgery Department, University Hospital of Verona, Italy
| | | | - G Marioni
- Department of Neuroscience DNS, Otolaryngology Section, Padova University, Padova, Italy
| | | | - C Matthies
- Department of Neurosurgery, Julius Maximilians University Hospital Würzburg, Bavaria, Germany
| | - D A Moffat
- Department of Neuro-otology and Skull Base Surgery, Cambridge University Hospital, Cambridge, UK
| | - S Munari
- Department of Neuroscience DNS, Otolaryngology Section, Padova University, Padova, Italy
| | - M Nardone
- ENT Department, Treviglio (BG), Italy
| | - R Pareschi
- ENT & Skull-Base Department, Ospedale Nuovo di Legnano, Legnano (MI), Italy
| | - C Pavone
- Department of Neuroscience DNS, Otolaryngology Section, Padova University, Padova, Italy
| | | | - G Piras
- Gruppo Otologico, Piacenza-Rome, Italy
| | - L Presutti
- Otolaryngology-Head and Neck Surgery Department, University Hospital of Modena, Italy
| | - G Restivo
- ENT and Skull-Base Surgery Department, Department of Neurosciences, Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - M Reznitsky
- The Department of Otorhinolaryngology, Head & Neck Surgery and Audiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - E Roca
- Department of Neurosurgery, Lariboisière Hospital, University of Paris Diderot, Paris, France
| | - A Russo
- Gruppo Otologico, Piacenza-Rome, Italy
| | - M Sanna
- Gruppo Otologico, Piacenza-Rome, Italy
| | - L Sartori
- Academic Neurosurgery, Department of Neuroscience DNS, University of Padova Medical School, Padova, Italy
| | - M Scheich
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, "Julius-Maximilians" University Hospital of Würzburg, Bavaria, Germany
| | - W Shehata-Dieler
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, "Julius-Maximilians" University Hospital of Würzburg, Bavaria, Germany
| | - D Soloperto
- Otolaryngology-Head and Neck Surgery Department, University Hospital of Verona, Italy
| | - F Sorrentino
- Department of Neuroscience DNS, Otolaryngology Section, Padova University, Padova, Italy
| | - O Sterkers
- AP-HP, Groupe Hôspital-Universitaire Pitié-Salpêtrière, Neuro-Sensory Surgical Department and NF2 Rare Disease Centre, Paris, France
- Sorbonne Université, Paris, France
| | - A Taibah
- Gruppo Otologico, Piacenza-Rome, Italy
| | - M Tatagiba
- Department of Neurosurgery, Eberhard Karls University Tübingen, Germany
| | - G Tealdo
- Department of Neuroscience DNS, Otolaryngology Section, Padova University, Padova, Italy
| | - D Vlad
- Gruppo Otologico, Piacenza-Rome, Italy
| | - H Wu
- Department of Otolaryngology Head and Neck Surgery, Shanghai Ninh People's Hospital, Shanghai Jiatong University School of Medicine, China
| | - D Zanetti
- Unit of Audiology, Department of Clinical Sciences and Community Health, University of Milano, Italy
- Department of Surgery, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy
| |
Collapse
|
16
|
Pamias-Portalatin E, Mahato D, Rincon-Torroella J, Vivas-Buitrago T, Quiñones-Hinojosa A, Boahene KO. Endoscope-assisted contralateral transmaxillary approach to the clivus and the hypoglossal canal: technical case report. J Neurosurg 2019; 130:1609-1615. [PMID: 29932381 DOI: 10.3171/2018.1.jns171972] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 01/15/2018] [Indexed: 11/06/2022]
Abstract
Clival lesions are still considered surgically complex due to their anatomical location. Critical structures, such as the internal carotid arteries (ICAs), cavernous sinuses, cranial nerves, and brainstem, may be encased within the lesion. Although advances in endoscopic endonasal approaches have provided new routes to these lesions, exposure and resection of clival tumors through the endonasal route remain a technical challenge. Here, the authors report a left-sided endoscopic transmaxillary approach to access the right aspect of the clivus and the hypoglossal canal.A 35-year-old woman presented with progressive right 6th cranial nerve palsy. MRI revealed a contrast-enhancing right petroclival chondrosarcoma that involved Meckel's cave and extended into the right hypoglossal canal. An endoscopic-contralateral-transmaxillary approach through a left sublabial incision was used to access the right petroclival region and right hypoglossal canal. A left maxillary osteoplastic flap was elevated to expose the left maxillary sinus. This was followed by a left medial maxillectomy, gaining access to the left posterior nasal cavity. The posterior third of the left inferior turbinate and nasal septum were removed to access the right side of the petroclival region. Near-total resection was achieved without any vascular or neurological complications. A thin shell of residual tumor was left behind due to involvement of vital structures, such as the ICA, and further treated with proton-beam radiotherapy.The endoscopic-contralateral-transmaxillary approach provides a direct surgical corridor and good lateral visualization of the skull base vasculature. This approach allows wide maneuverability around the ICA and hypoglossal canal, which, in this case, allowed maximal tumor resection with full preservation of neurological function.
Collapse
Affiliation(s)
- Eva Pamias-Portalatin
- 1Department of Neurosurgery, University of Puerto Rico Medical Science Campus, San Juan, Puerto Rico
- 3Department of Neurosurgery, Mayo Clinic School of Medicine, Jacksonville, Florida; and
| | - Deependra Mahato
- 3Department of Neurosurgery, Mayo Clinic School of Medicine, Jacksonville, Florida; and
| | | | - Tito Vivas-Buitrago
- 3Department of Neurosurgery, Mayo Clinic School of Medicine, Jacksonville, Florida; and
- 4Universidad de Santander UDES, School of Medicine, Bucaramanga, Colombia
| | | | - Kofi O Boahene
- 2Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| |
Collapse
|
17
|
Liu J, Wang Z, Xu C, Qi Y, Zhang Q. Solamargine inhibits proliferation and promotes apoptosis of CM-319 human chordoma cells through suppression of notch pathway. Transl Cancer Res 2019; 8:509-519. [PMID: 35116783 PMCID: PMC8798112 DOI: 10.21037/tcr.2019.03.07] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 02/28/2019] [Indexed: 12/16/2022]
Abstract
Background Solamargine (SM), which represents a natural steroid alkaloid glycoside compound and a cytotoxic agent, has been proved to enhance the sensitivity of lung cancer cells to tumor necrosis factors (TNFs). In this study, we aimed to investigate the roles and mechanisms of SM in chordoma. Methods Cell viability, proliferation, apoptosis and cell cycle were measured by cell counting Kit-8 (CCK-8) assay, 5(6)-carboxyfluorescein diacetate succinimidyl ester (CFSE) labeling and flow cytometry (FCM), respectively. Western blot and quantitative real-time reverse transcription PCR (qRT-PCR) assays were performed to detect the expressions of related mRNAs and proteins. Results The results revealed that SM distinctly suppressed the proliferation of CM-319 cells. SM significantly induced the CM-319 cells apoptosis through up-regulating the expression levels of Caspase-3/8/9. The cell cycle of CM-319 cells was blocked by SM in G1 phase. Moreover, SM could significantly suppress the Notch pathway in CM-319 cells. Conclusions In conclusion, SM suppressed the proliferation and enhanced the apoptosis ability of CM-319 cells via suppressing the Notch pathway. The results suggested that SM might be a novel therapeutic agent and supported the utilization of SM in chordoma.
Collapse
Affiliation(s)
- Junqi Liu
- Department of Otolaryngology, Xuanwu Hospital Capital Medical University, Beijing 100053, China
| | - Zhenlin Wang
- Department of Otolaryngology, Xuanwu Hospital Capital Medical University, Beijing 100053, China
| | - Cong Xu
- Department of Otolaryngology, Xuanwu Hospital Capital Medical University, Beijing 100053, China
| | - Yan Qi
- Department of Otolaryngology, Xuanwu Hospital Capital Medical University, Beijing 100053, China
| | - Qiuhang Zhang
- Department of Otolaryngology, Xuanwu Hospital Capital Medical University, Beijing 100053, China
| |
Collapse
|
18
|
Liu H, Zhang X, Zhang M, Zhang J, Ning W, Yue A, Zhao R, Sun Y, Yu C. Skull bone tumor: a review of clinicopathological and neuroimaging characteristics of 426 cases at a single center. Cancer Commun (Lond) 2019; 39:8. [PMID: 30850028 PMCID: PMC6407197 DOI: 10.1186/s40880-019-0353-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 02/22/2019] [Indexed: 11/18/2022] Open
Affiliation(s)
- Hailong Liu
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, No. 50 Yikesong Road, Xiangshan Ave, Beijing, 100093, P. R. China.,Department of Neurosurgery, Chinese People's Liberation Army General Hospital, Beijing, 100853, P. R. China
| | - Xueying Zhang
- School of Public Health, Peking University, Beijing, 100191, P. R. China
| | - Mingshan Zhang
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, No. 50 Yikesong Road, Xiangshan Ave, Beijing, 100093, P. R. China
| | - Junping Zhang
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, No. 50 Yikesong Road, Xiangshan Ave, Beijing, 100093, P. R. China
| | - Weihai Ning
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, No. 50 Yikesong Road, Xiangshan Ave, Beijing, 100093, P. R. China
| | - Angela Yue
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, No. 50 Yikesong Road, Xiangshan Ave, Beijing, 100093, P. R. China.,Tate Cancer Center, Baltimore Washington Medical Center, University of Maryland, Glen Burnie, MD, 21061, USA
| | - Rugang Zhao
- Department of Orthopedics, Beijing Ditan Hospital, Capital Medical University, Beijing, 10015, P. R. China
| | - Youliang Sun
- School of Basic Medical Science, Capital Medical University, Beijing, 10069, P. R. China
| | - Chunjiang Yu
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, No. 50 Yikesong Road, Xiangshan Ave, Beijing, 100093, P. R. China.
| |
Collapse
|
19
|
Simon F, Feuvret L, Bresson D, Guichard JP, El Zein S, Bernat AL, Labidi M, Calugaru V, Froelich S, Herman P, Verillaud B. Surgery and protontherapy in Grade I and II skull base chondrosarcoma: A comparative retrospective study. PLoS One 2018; 13:e0208786. [PMID: 30557382 PMCID: PMC6296545 DOI: 10.1371/journal.pone.0208786] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 11/26/2018] [Indexed: 11/19/2022] Open
Abstract
Objective Skull base chondrosarcoma is a rare tumour usually treated by surgery and proton therapy. However, as mortality rate is very low and treatment complications are frequent, a less aggressive therapeutic strategy could be considered. The objective of this study was to compare the results of surgery only vs surgery and adjuvant proton therapy, in terms of survival and treatment adverse effects, based on a retrospective series. Methods Monocentric retrospective study at a tertiary care centre. All patients treated for a skull base grade I and II chondrosarcoma were included. We collected data concerning surgical and proton therapy treatment and up-to-date follow-up, including Common Terminology Criteria for Adverse Events (CTCAE) scores. Results 47 patients (23M/24F) were operated on between 2002 and 2015; mean age at diagnosis was 47 years-old (10–85). Petroclival and anterior skull base locations were found in 34 and 13 patients, respectively. Gross total resection was achieved in 17 cases (36%) and partial in 30 (64%). Adjuvant proton therapy (mean total dose 70 GyRBE,1.8 GyRBE/day) was administered in 23 cases. Overall mean follow-up was 91 months (7–182). Of the patients treated by surgery only, 8 (34%) experienced residual tumour progression (mean delay 51 months) and 5 received second-line proton therapy. Adjuvant proton therapy was associated with a significantly lower rate of relapse (11%; p = 0.01). There was no significant difference in 10-year disease specific survival between patients initially treated with or without adjuvant proton therapy (100% vs 89.8%, p = 0.14). Difference in high-grade toxicity was not statistically significant between patients in both groups (25% (7) vs 11% (5), p = 0.10). The most frequent adverse effect of proton therapy was sensorineural hearing loss (39%). Conclusion Long-term disease specific survival was not significantly lower in patients without adjuvant proton therapy, but they experienced less adverse effects. We believe a surgery only strategy could be discussed, delaying as much as possible proton therapy in cases of relapse. Further prospective studies are needed to validate this more conservative strategy in skull base chondrosarcoma.
Collapse
Affiliation(s)
- François Simon
- AP-HP, Hôpital Lariboisière, Department of Otorhinolaryngology and Paris Diderot University, Paris, France
- * E-mail:
| | - Loïc Feuvret
- AP-HP, Hôpital Pitié-Salpêtrière, Department of Radiation Oncology and Pierre et Marie Curie University, Paris, France
- Institut Curie-Centre de protonthérapie d’Orsay, Department of Radiation Oncology and INSERM U61, Centre Universitaire, Orsay, France
| | - Damien Bresson
- AP-HP, Hôpital Lariboisière, Department of Neurosurgery and Paris Diderot University, Paris, France
| | - Jean-Pierre Guichard
- AP-HP, Hôpital Lariboisière, Department of Radiology and Paris Diderot University, Paris, France
| | - Sophie El Zein
- AP-HP, Hôpital Lariboisière, Department of Pathology and Paris Diderot University, Paris, France
| | - Anne-Laure Bernat
- AP-HP, Hôpital Lariboisière, Department of Neurosurgery and Paris Diderot University, Paris, France
| | - Moujahed Labidi
- AP-HP, Hôpital Lariboisière, Department of Neurosurgery and Paris Diderot University, Paris, France
| | - Valentin Calugaru
- Institut Curie-Centre de protonthérapie d’Orsay, Department of Radiation Oncology and INSERM U61, Centre Universitaire, Orsay, France
| | - Sébastien Froelich
- AP-HP, Hôpital Lariboisière, Department of Neurosurgery and Paris Diderot University, Paris, France
| | - Philippe Herman
- AP-HP, Hôpital Lariboisière, Department of Otorhinolaryngology and Paris Diderot University, Paris, France
| | - Benjamin Verillaud
- AP-HP, Hôpital Lariboisière, Department of Otorhinolaryngology and Paris Diderot University, Paris, France
| |
Collapse
|
20
|
Kim YH, Jeon C, Se YB, Hong SD, Seol HJ, Lee JII, Park CK, Kim DG, Jung HW, Han DH, Nam DH, Kong DS. Clinical outcomes of an endoscopic transclival and transpetrosal approach for primary skull base malignancies involving the clivus. J Neurosurg 2018; 128:1454-1462. [DOI: 10.3171/2016.12.jns161920] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVEThe endoscopic endonasal approach for treating primary skull base malignancies involving the clivus is a formidable task. The authors hypothesized that tumor involvement of nearby critical anatomical structures creates hurdles to endoscopic gross-total resection (GTR). The aim of this study was to retrospectively review the clinical outcomes of patients who underwent an endoscopic endonasal approach to treat primary malignancies involving the clivus and to analyze prognostic factors for GTR.METHODSBetween January 2009 and November 2015, 42 patients underwent the endoscopic endonasal approach for resection of primary skull base malignancies involving the clivus at 2 independent institutions. Clinical data; tumor locations within the clivus; and anatomical involvement of the cavernous or paraclival internal carotid artery, cisternal trigeminal nerve, hypoglossal canal, and dura mater were investigated to assess the extent of resection. Possible prognostic factors affecting GTR were also analyzed.RESULTSOf the 42 patients, 37 were diagnosed with chordomas and 5 were diagnosed with chondrosarcomas. The mean (± SD) preoperative tumor volume was 25.2 ± 30.5 cm3 (range 0.8–166.7 cm3). GTR was achieved in 28 patients (66.7%) and subtotal resection in 14 patients (33.3%). All tumors were classified as upper (n = 17), middle (n = 17), or lower (n = 8) clival tumors based on clival involvement, and as central (24 [57.1%]) or paramedian (18 [42.9%]) based on laterality of the tumor. Univariate analysis identified the tumor laterality (OR 6.25, 95% CI 1.51–25.86; p = 0.011) as significantly predictive of GTR. In addition, the laterality of the tumor was found to be a statistically significant predictor in multivariate analysis (OR 41.16, 95% CI 1.12–1512.65; p = 0.043).CONCLUSIONSAn endoscopic endonasal approach can provide favorable clinical and surgical outcomes. However, the tumor laterality should be considered as a potential obstacle to total removal.
Collapse
Affiliation(s)
| | | | | | - Sang Duk Hong
- 3Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | | | | | | | | | | | - Doo Hee Han
- 4Otorhinolaryngology–Head and Neck Surgery, Seoul National University Hospital, Seoul National University College of Medicine; and
| | | | | |
Collapse
|
21
|
Abstract
Purpose of Review Chordoma are rare tumours of the axial skeleton which occur most often at the base of the skull and in the sacrum. Although chordoma are generally slow-growing lesions, the recurrence rate is high and the location makes it often difficult to treat. Both computed tomography (CT) and magnetic resonance imaging (MRI) are crucial in the initial diagnosis, treatment planning and post-treatment follow-up. Recent Findings Basic MRI and CT characteristics of chordoma were described in the late 1980s and early 1990s. Since then, imaging techniques have evolved with increased resolution and new molecular imaging tools are rapidly evolving. New imaging tools have been developed not only to study anatomy, but also physiologic changes and characterization of tissue and assessment of tumour biology. Recent studies show the uptake of multiple PET tracers in chordoma, which may become an important aspect in the diagnosis, follow-up and personalized therapy. Summary This review gives an overview of skull base chordoma histopathology, classic imaging characteristics, radiomics and state-of-the-art imaging techniques that are now emerging in diagnosis, treatment planning and disease monitoring of skull base chordoma.
Collapse
|
22
|
Abstract
OBJECTIVE To analyze clinical outcomes after treatment of petroclival chondrosarcoma and to propose a novel staging system. STUDY DESIGN Retrospective case review, 1995 to 2015. SETTING Multicenter study. PATIENTS Consecutive patients with histopathologically proven petroclival chondrosarcoma. INTERVENTION(S) Microsurgery, endoscopic endonasal surgery, radiation therapy, observation. MAIN OUTCOME MEASURES Disease- and treatment-associated morbidity, recurrence, mortality. RESULTS Fifty-five patients (mean age 42 years; 56% women) presenting with primary or recurrent petroclival chondrosarcoma were analyzed. The mean duration of follow-up was 74 months. Among 47 primary cases, the most common presenting symptoms were headache (55%) and diplopia (49%) and the mean tumor size at diagnosis was 3.3 cm. Subtotal resection was performed in 33 (73%) patients and gross total resection in 12 (27%). Adjuvant postoperative radiation was administered in 30 (64%) cases. Preoperative cranial neuropathy improved in 13 (29%), worsened in 11 (24%), and remained stable in 21 (47%) patients; notably, 11 preoperative sixth nerve palsies resolved after treatment. Nine recurrences occurred at a mean of 42 months. The 1-, 3-, 5- and 10-year recurrence-free survival rate for all 45 patients who underwent primary microsurgery with or without adjuvant radiation therapy was 97%, 89%, 70%, and 56%, respectively. Higher tumor stage, larger categorical size (<4 versus ≥4 cm), lack of adjuvant radiation, and longer duration of follow-up were associated with greater risk of recurrence. The overall mortality rate was 2% for patients presenting with primary disease.Analyzing the cohort of 17 cases with 20 recurrences, 3 received salvage surgery alone, 5 radiation therapy alone, 11 multimodality treatment, and one patient has been observed. Tumor control was ultimately achieved in 15 of 17 patients with recurrent disease. One patient (6%) with grade 3 petroclival chondrosarcoma died as a result of rapidly progressive disease within 6 months of salvage treatment. The overall mortality rate was 6% for patients with recurrent disease. CONCLUSION Gross total or subtotal resection with adjuvant radiation provides durable tumor control with minimal morbidity in most patients. Surgery may improve preoperative cranial nerve dysfunction, particularly in the case of cranial nerve 6 paralysis.
Collapse
|
23
|
Yao M, Wang X, Zhao Y, Wang X, Gao F. Expression of MMPs is dependent on the activity of mitogen-activated protein kinase in chondrosarcoma. Mol Med Rep 2016; 15:915-921. [PMID: 28035378 DOI: 10.3892/mmr.2016.6077] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 11/10/2016] [Indexed: 11/05/2022] Open
Abstract
Matrix metalloproteinases (MMPs) and tissue inhibitors of matrix metalloproteinases (TIMPs) serve an important role in chondrosarcoma. The present study investigated whether the expression of MMPs was dependent on the activity of mitogen-activated protein kinase (MAPK) in chondrosarcoma. Surgical pathological specimens were collected to detect MMP-1, MMP-13, TIMP-1, type II collagen and phosphorylated MAPK levels in normal cartilage, enchondroma and chondrosarcoma tissues. The expression of MMP‑1, MMP‑13, TIMP‑1 and type II collagen was investigated utilizing MAPK inhibitors in chondrosarcoma cells. It was noted that the expression levels of MMP‑1, MMP‑13 and TIMP‑1 were increased in chondrosarcoma with the activity of MAPK. After chondrosarcoma cells were pretreated with MAPK inhibitors, the levels of MMP‑1, MMP‑13 and TIMP‑1 were inhibited. Furthermore, MMP‑1 and MMP‑13 are essential in regulating the degradation of type II collagen and decomposing cartilage matrix major. The high expression levels of MMP‑1 and MMP‑13 in chondrosarcoma expedite the invasion by chondrosarcoma cells and their expression can be depressed by MAPK inhibitors.
Collapse
Affiliation(s)
- Min Yao
- Department of Pathology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, P.R. China
| | - Xiaomei Wang
- Department of Pathology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, P.R. China
| | - Yufeng Zhao
- Department of Pathology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, P.R. China
| | - Xiaomeng Wang
- Department of Pathology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, P.R. China
| | - Feng Gao
- Department of Pathology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, P.R. China
| |
Collapse
|
24
|
Zamora C, Castillo M. Sellar and Parasellar Imaging. Neurosurgery 2016; 80:17-38. [DOI: 10.1093/neuros/nyw013] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 10/18/2016] [Indexed: 11/13/2022] Open
Abstract
Abstract
The skull base is a complex anatomical region that harbors many important neurovascular structures in a relatively confined space. The pathology that can develop at this site is varied, and many disease processes may present with similar clinical and neuroimaging findings. While computed tomography maintains a role in the evaluation of many entities and can, for instance, delineate osseous erosion with great detail and characterize calcified tumor matrices, magnetic resonance imaging (MRI) is the mainstay in the neuroimaging assessment of most pathology occurring at the skull base. Various MRI sequences have proven to be robust tools for tissue characterization and can provide information on the presence of lipids, paramagnetic and diamagnetic elements, and tumor cellularity, among others. In addition, currently available MRI techniques are able to generate high spatial resolution images that allow visualization of cranial nerves and their involvement by adjacent pathology. The information obtained from such examinations may aid in the distinction of these disease processes and in the accurate delineation of their extent prior to biopsy or treatment planning.
Collapse
|
25
|
Frankl J, Grotepas C, Stea B, Lemole GM, Chiu A, Khan R. Chordoma dedifferentiation after proton beam therapy: a case report and review of the literature. J Med Case Rep 2016; 10:280. [PMID: 27729085 PMCID: PMC5059891 DOI: 10.1186/s13256-016-1076-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 09/23/2016] [Indexed: 01/23/2023] Open
Abstract
Background Chordoma is a rare invasive bone tumor that may occur anywhere along the neuraxis. A total of three primary histological varieties have been identified: conventional, chondroid, and dedifferentiated. Case presentation We report a case of an 8-year-old white girl who presented with conventional chordoma, was treated with surgical resection and mixed proton and photon beam therapy, and had a recurrence in the resection cavity 2.5 years later with dedifferentiated morphology. The recurrent tumor did not express brachyury, a recently identified protein specific to tissue of notochordal origin. Conclusions The short time period between radiation therapy and dedifferentiation, low dose of photons, and rarity of dedifferentiated skull base chordomas in pediatric patients should alert clinicians to the possibility of chordoma dedifferentiation after proton beam therapy.
Collapse
Affiliation(s)
- Joseph Frankl
- University of Arizona College of Medicine, 1501 N Campbell Ave, Tucson, AZ, 85724, USA.
| | - Cassi Grotepas
- Department of Pathology, University of Arizona College of Medicine, 1501 N Campbell Ave, Tucson, AZ, 85724, USA
| | - Baldassare Stea
- Department of Radiation Oncology, University of Arizona College of Medicine, 1501 N Campbell Ave, Tucson, AZ, 85724, USA
| | - G Michael Lemole
- Department of Surgery, University of Arizona College of Medicine, 1501 N Campbell Ave, Tucson, AZ, 85724, USA
| | - Alexander Chiu
- Department of Otolaryngology - Head and Neck Surgery, University of Arizona College of Medicine, 1501 N Campbell Ave, Tucson, AZ, 85724, USA
| | - Rihan Khan
- Department of Medical Imaging, University of Arizona College of Medicine, 1501 N Campbell Ave, Tucson, AZ, 85724, USA
| |
Collapse
|
26
|
Kakkar A, Nambirajan A, Suri V, Sarkar C, Kale SS, Singh M, Sharma MC. Primary Bone Tumors of the Skull: Spectrum of 125 Cases, with Review of Literature. J Neurol Surg B Skull Base 2016; 77:319-25. [PMID: 27441157 DOI: 10.1055/s-0035-1570347] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 10/31/2015] [Indexed: 10/22/2022] Open
Abstract
AIMS Primary skull bone tumors, benign or malignant, are rare, and include a vast repertoire of lesions. These tumors are not reported systematically in the literature, with most studies being on individual entities or as single case reports. METHODS Primary bone tumors diagnosed over a period of 12 years were retrieved, histological diagnoses reviewed, and clinical parameters noted. RESULTS We identified 125 primary skull bone tumors. The mean age at diagnosis was 32 years (range: 2-65 years). Majority of patients were adults (82.4%); male preponderance was noted (72.8%). Malignant tumors were more frequent than benign tumors. Most common malignant tumor was chordoma (n = 37), while most common benign tumor was osteoma (n = 7). Tumors were most frequently located at the skull base, of which clivus was most common location. Chordomas accounted for majority of clival tumors, while chondrosarcoma predominated at other skull base locations. Benign tumors were extremely rare in skull base. Tumors of the vault bones were infrequent; with chondrosarcoma and osteoma being the most common malignant and benign tumors, respectively. CONCLUSIONS This is the largest series of primary skull bone tumors from India. Documentation of such a series will aid in approaching differential diagnosis of skull tumors in a systematic manner.
Collapse
Affiliation(s)
- Aanchal Kakkar
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Aruna Nambirajan
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Vaishali Suri
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Chitra Sarkar
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Shashank S Kale
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Manmohan Singh
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Mehar Chand Sharma
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
27
|
Liu JQ, Zhang QH, Wang ZL. Clinicopathological significance of p16, cyclin D1, Rb and MIB-1 levels in skull base chordoma and chondrosarcoma. World J Otorhinolaryngol Head Neck Surg 2015; 1:50-56. [PMID: 29204540 PMCID: PMC5698503 DOI: 10.1016/j.wjorl.2015.09.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 09/18/2015] [Accepted: 09/29/2015] [Indexed: 11/25/2022] Open
Abstract
Objective To investigate the expression of p16, cyclin D1, retinoblastoma tumor suppressor protein (Rb) and MIB-1 in skull base chordoma and chondrosarcoma tissues, and to determine the clinicopathological significance of the above indexes in these diseases. Methods A total of 100 skull base chordoma, 30 chondrosarcoma, and 20 normal cartilage tissue samples were analyzed by immunohistochemistry. The expression levels of p16, cyclinD1, Rb and MIB-1 proteins were assessed for potential correlation with the clinicopathological features. Results As compared to normal cartilage specimen (control), there was decreased expression of p16, and increased expression of cyclin D1, Rb and MIB-1 proteins, in both skull base chordoma and chondrosarcoma specimens. MIB-1 LI levels were significantly increased in skull base chordoma specimens with negative expression of p16, and positive expression of cyclin D1 and Rb (P < 0.05). Significantly elevated MIB-1 LI was also detected in skull base chondrosarcoma tissues, while there was negative expression of p16, cyclin D1 and Rb (P < 0.05). In skull base chordoma, p16 negatively correlated with cyclin D1 and Rb, while cyclin D1 positively correlated with Rb. Additionally, p16, cyclin D1, Rb, or MIB-1 expression showed no correlation with age, gender, or pathological classification of patients with skull base chordoma (P > 0.05). However, p16 and MIB-1 levels correlated with the intradural invasion, and expression of p16, Rb and MIB-1 correlated with the number of tumor foci (P < 0.05). Further, the expression of p16 and MIB-1 appeared to correlate with the prognosis of patients with skull base chordoma. Conclusions The abnormal expression of p16, cyclin D1 and Rb proteins might be associated with the tumorigenesis of skull base chordoma and chondrosarcoma.
Collapse
Affiliation(s)
- Jun-Qi Liu
- Xuanwu Hospital Capital Medical University, China
| | | | | |
Collapse
|
28
|
Reumann S, Shogren KL, Yaszemski MJ, Maran A. Inhibition of Autophagy Increases 2-Methoxyestradiol-Induced Cytotoxicity in SW1353 Chondrosarcoma Cells. J Cell Biochem 2015; 117:751-9. [DOI: 10.1002/jcb.25360] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 09/01/2015] [Indexed: 12/30/2022]
Affiliation(s)
- Stephan Reumann
- Department of Orthopedics; College of Medicine; Mayo Clinic Rochester, Minnesota 55905
- Paracelsus Medical University; Salzburg; Austria
| | - Kristen L. Shogren
- Department of Orthopedics; College of Medicine; Mayo Clinic Rochester, Minnesota 55905
| | - Michael J. Yaszemski
- Department of Orthopedics; College of Medicine; Mayo Clinic Rochester, Minnesota 55905
| | - Avudaiappan Maran
- Department of Orthopedics; College of Medicine; Mayo Clinic Rochester, Minnesota 55905
| |
Collapse
|