Subscribe to RSS
![](/products/assets/desktop/img/oa-logo.png)
DOI: 10.1055/s-0035-1564606
Primary Osteosarcoma of the Skull Base Treated with Endoscopic Endonasal Approach: A Case Report and Literature Review
Publication History
04 May 2015
10 August 2015
Publication Date:
19 October 2015 (online)
![](https://www.thieme-connect.de/media/jnlsr/201502/lookinside/thumbnails/10-1055-s-0035-1564606_150035-1.jpg)
Abstract
Introduction Giant cell-rich osteosarcoma (GCRO) is a rare pathologic diagnosis, and most cases have involved the appendicular skeleton. We present a challenging diagnosis of GCRO of the skull base treated with an endoscopic endonasal approach.
Case Presentation An 18-year-old female patient presented with acute monocular visual loss. Imaging revealed a large clival mass encasing the internal carotid arteries bilaterally with pituitary and optic nerve compression. The lesion was resected via a staged endoscopic endonasal approach and the patient's vision normalized postoperatively. The final pathological diagnosis was challenging and, after consultation with multiple North American centers, was concluded as GCRO. The tumor recurred and further surgery was performed, followed by adjuvant chemoradiation.
Conclusion We highlight diagnostic challenges of GCRO of the skull base, and describe, with intraoperative pictures, successful surgical resection via an endoscopic endonasal approach. Based on our literature review, this is the first published case report of GCRO of the skull base.
-
References
- 1 Oda D, Bavisotto LM, Schmidt RA , et al. Head and neck osteosarcoma at the University of Washington. Head Neck 1997; 19 (6) 513-523
- 2 Gadwal SR, Gannon FH, Fanburg-Smith JC, Becoskie EM, Thompson LD. Primary osteosarcoma of the head and neck in pediatric patients: a clinicopathologic study of 22 cases with a review of the literature. Cancer 2001; 91 (3) 598-605
- 3 Sato K, Yamamura S, Iwata H, Sugiura H, Nakashima N, Nagasaka T. Giant cell-rich osteosarcoma: a case report. Nagoya J Med Sci 1996; 59 (3–4) 151-157
- 4 Verma RK, Gupta G, Bal A, Yadav J. Primary giant cell rich osteosarcoma of maxilla: an unusual case report. J Maxillofac Oral Surg 2011; 10 (2) 159-162
- 5 Fu HH, Zhuang QW, He J, Wang LZ, He Y. Giant cell-rich osteosarcoma or giant cell reparative granuloma of the mandible?. J Craniofac Surg 2011; 22 (3) 1136-1139
- 6 Kassam AB, Thomas A, Carrau RL , et al. Endoscopic reconstruction of the cranial base using a pedicled nasoseptal flap. Neurosurgery 2008; 63 (1) (Suppl. 01) ONS44-ONS52 , discussion ONS52–ONS53
- 7 Ha PK, Eisele DW, Frassica FJ, Zahurak ML, McCarthy EF. Osteosarcoma of the head and neck: a review of the Johns Hopkins experience. Laryngoscope 1999; 109 (6) 964-969
- 8 Salvati M, Ciappetta P, Raco A. Osteosarcomas of the skull. Clinical remarks on 19 cases. Cancer 1993; 71 (7) 2210-2216
- 9 Mirra JM. Bone tumors: Clinical, radiologic and pathologic correlations. 2nd ed. Philadelphia, PA: Lea & Febiger; 1989: 941-1020
- 10 Bathurst N, Sanerkin N, Watt I. Osteoclast-rich osteosarcoma. Br J Radiol 1986; 59 (703) 667-673
- 11 Federman N, Bernthal N, Eilber FC, Tap WD. The multidisciplinary management of osteosarcoma. Curr Treat Options Oncol 2009; 10 (1–2) 82-93
- 12 Kassir RR, Rassekh CH, Kinsella JB, Segas J, Carrau RL, Hokanson JA. Osteosarcoma of the head and neck: meta-analysis of nonrandomized studies. Laryngoscope 1997; 107 (1) 56-61
- 13 Guadagnolo BA, Zagars GK, Raymond AK, Benjamin RS, Sturgis EM. Osteosarcoma of the jaw/craniofacial region: outcomes after multimodality treatment. Cancer 2009; 115 (14) 3262-3270