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Continuum (Minneapolis, Minn.) Dec 2023This article reviews the presenting features, molecular characteristics, diagnosis, and management of selected skull base tumors, including meningiomas, vestibular... (Review)
Review
OBJECTIVE
This article reviews the presenting features, molecular characteristics, diagnosis, and management of selected skull base tumors, including meningiomas, vestibular schwannomas, pituitary neuroendocrine tumors, craniopharyngiomas, chordomas, ecchordosis physaliphora, chondrosarcomas, esthesioneuroblastomas, and paragangliomas.
LATEST DEVELOPMENTS
Skull base tumors pose a management challenge given their complex location and, as a result, the tumors and treatment can result in significant morbidity. In most cases, surgery, radiation therapy, or both yield high rates of disease control, but the use of these therapies may be limited by the surgical accessibility of these tumors and their proximity to critical structures. The World Health Organization classification of pituitary neuroendocrine tumors was updated in 2022. Scientific advances have led to an enhanced understanding of the genetic drivers of many types of skull base tumors and have revealed several potentially targetable genetic alterations. This information is being leveraged in the design of ongoing clinical trials, with the hope of rendering these challenging tumors treatable through less invasive and morbid measures.
ESSENTIAL POINTS
Tumors involving the skull base are heterogeneous and may arise from bony structures, cranial nerves, the meninges, the sinonasal tract, the pituitary gland, or embryonic tissues. Treatment often requires a multidisciplinary approach, with participation from radiation oncologists, medical oncologists, neuro-oncologists, and surgical specialists, including neurosurgeons, otolaryngologists, and head and neck surgeons. Treatment has largely centered around surgical resection, when feasible, and the use of first-line or salvage radiation therapy, with chemotherapy, targeted therapy, or both considered in selected settings. Our growing understanding of the molecular drivers of these diseases may facilitate future expansion of pharmacologic options to treat skull base tumors.
Topics: Humans; Skull Base Neoplasms; Skull Base; Neurosurgical Procedures; Pituitary Neoplasms; Meningeal Neoplasms; Neuroendocrine Tumors
PubMed: 38085897
DOI: 10.1212/CON.0000000000001361 -
Facial Plastic Surgery Clinics of North... May 2024
Topics: Humans; Nose; Rhinoplasty; Nose Neoplasms
PubMed: 38575291
DOI: 10.1016/j.fsc.2024.02.002 -
Klinische Monatsblatter Fur... Sep 2023Malignant masses of the orbit include a large variety of neoplasms of epithelial or mesenchymal origin. The treatment of orbital malignancies is an essential...
Malignant masses of the orbit include a large variety of neoplasms of epithelial or mesenchymal origin. The treatment of orbital malignancies is an essential interdisciplinary field of medicine that integrates ENT medicine, facial surgery, plastic surgery, neurosurgery, oncology and radiology.The main symptom of malignant orbital masses is the exophthalmos. A symptom that can help to differentiate a benign from a malignant orbital mass can be the pain. The main diagnostic tool is the MRI including new sequences like DWI and DCE.After presenting symptoms and diagnostic strategies of malignant orbital masses, this article starts with the description of malignant epithelial neoplasms of the lacrimal gland. Furthermore, it describes new insights in orbital lymphomas, followed by the discussion of semimalignant orbital masses. Last but not least the text deals with malignant neoplasms of the skin that can grow secondarily in the orbit. Finally, the manuscript discusses orbital metastases.
Topics: Humans; Orbit; Orbital Neoplasms; Magnetic Resonance Imaging; Orbital Diseases; Exophthalmos
PubMed: 37586398
DOI: 10.1055/a-2129-1194 -
Facial Plastic Surgery Clinics of North... May 2024Prosthetic nasal reconstruction provides a restorative option for patients with nasal defects, and these can be retained with a variety of methods including adhesives... (Review)
Review
Prosthetic nasal reconstruction provides a restorative option for patients with nasal defects, and these can be retained with a variety of methods including adhesives and implants. These prostheses can significantly improve appearance, self-esteem, and quality of life for patients and they restore many functions of the external nose. Traditional fabrication methods are often used by the skilled professionals who make these custom prostheses, but digital technology is improving the workflow for design and fabrication of silicone nasal prostheses. Nasal prosthetic reconstruction requires multidisciplinary coordination between surgeons, maxillofacial prosthodontists, anaplastologists, and other members of the healthcare team. Prosthetic treatment can be considered as an alternative to, or an addition to treatment with surgical reconstruction.
Topics: Humans; Nose; Prosthesis Design; Quality of Life; Prostheses and Implants; Maxillofacial Prosthesis; Nose Neoplasms
PubMed: 38575290
DOI: 10.1016/j.fsc.2023.12.002 -
Otolaryngologic Clinics of North America Aug 2023Reconstruction of the lateral temporal bone with adequate functional and cosmetic outcomes depends on a multidisciplinary approach including the head and neck surgeon,... (Review)
Review
Reconstruction of the lateral temporal bone with adequate functional and cosmetic outcomes depends on a multidisciplinary approach including the head and neck surgeon, reconstructive surgeon, neurotologist, and anaplastologist. Approaching the defect includes consideration of the location, tissue type, function, and patient/tumor characteristics. Anatomic limitations due to prior therapy also play an important role in reconstructive choices. Here, we review contemporary literature regarding the reconstruction of this complex region.
Topics: Humans; Plastic Surgery Procedures; Skull Base; Skull Base Neoplasms; Temporal Bone
PubMed: 37258407
DOI: 10.1016/j.otc.2023.04.016 -
Neurosurgery Clinics of North America Jul 2023Meningiomas are the most common intracranial extra-axial primary tumor. Although most are low grade and slow growing, resection can be technically challenging,... (Review)
Review
Meningiomas are the most common intracranial extra-axial primary tumor. Although most are low grade and slow growing, resection can be technically challenging, particularly when located at the skull base. Appropriate craniotomy and approach selection are of paramount importance to minimize brain retraction, optimize exposure, and achieve complete resection. This article summarizes various craniotomies and their approaches to meningiomas, and illustrates some nuances in performing these techniques with cadaveric dissection and operative videos.
Topics: Humans; Meningioma; Meningeal Neoplasms; Neurosurgical Procedures; Skull Base; Craniotomy; Skull Base Neoplasms
PubMed: 37210127
DOI: 10.1016/j.nec.2023.02.004 -
Endocrine Sep 2023Parathyroid carcinoma (PC) is an extremely rare malignant tumor of the parathyroid glands, accounting for less than 1% of primary hyperparathyroidism, commonly... (Review)
Review
Parathyroid carcinoma (PC) is an extremely rare malignant tumor of the parathyroid glands, accounting for less than 1% of primary hyperparathyroidism, commonly characterized by severe and unmanageable hypercalcemia, aggressive behavior, high metastatic potential, and poor prognosis. PC manifests prevalently as a sporadic tumor and only occasionally it is part of congenital syndromic and non-syndromic endocrine diseases. Molecular pathogenesis of this form of parathyroid tumor is not fully elucidated and it appears to be caused by multiple genetic and epigenetic drivers, differing among affected patients and not yet clearly stated in distinguishing PC from the benign parathyroid adenoma (PA). Congenital forms of PC have been prevalently associated with germline heterozygous loss-of-function mutations of the CDC73 tumor suppressor gene, both in the context of the hyperparathyroidism jaw-tumor syndrome (HPT-JT) and of the isolated familial hyperparathyroidism (FIPH). Currently, surgical en bloc resection of affected gland(s) and other involved structures is the elective therapy for both primary and recurrent PC. However, it usually results ineffective for advance and metastatic disease, and a high percentage of post-operative recurrence is reported. Targeted medical therapies for surgically untreatable PC, based on the molecular profile of PC samples, are, therefore, needed. The characterization of genetic and epigenetic alterations and deregulated pathways in PC samples will be of fundamental importance to tailor treatment for each patient. Here, we reviewed main findings on molecular pathogenetic aspects of PC, and the current state of the art of therapies.
Topics: Humans; Parathyroid Neoplasms; Tumor Suppressor Proteins; Neoplasm Recurrence, Local; Jaw Neoplasms; Hyperparathyroidism, Primary
PubMed: 37160841
DOI: 10.1007/s12020-023-03376-w -
Atlas of the Oral and Maxillofacial... Sep 2023
Review
Topics: Child; Humans; Bone Transplantation; Mandible; Mandibular Neoplasms; Mandibular Reconstruction; Free Tissue Flaps; Treatment Outcome
PubMed: 37500201
DOI: 10.1016/j.cxom.2023.04.002 -
Otolaryngologic Clinics of North America Aug 2023Anterior skull base reconstruction requires careful preoperative planning to use the most effective technique for the expected defect. Adherence to the principles of... (Review)
Review
Anterior skull base reconstruction requires careful preoperative planning to use the most effective technique for the expected defect. Adherence to the principles of skull base reconstruction is imperative to minimize complications and improve patient outcomes.
Topics: Humans; Surgical Flaps; Plastic Surgery Procedures; Skull Base; Skull Base Neoplasms; Retrospective Studies; Cerebrospinal Fluid Leak
PubMed: 37268516
DOI: 10.1016/j.otc.2023.04.015 -
Ugeskrift For Laeger Dec 2023In this case report, a 61-year-old male presented with odynophagia and ulceration in palatum durum after inhalating dust from machinery containing a weak acid. It was at...
In this case report, a 61-year-old male presented with odynophagia and ulceration in palatum durum after inhalating dust from machinery containing a weak acid. It was at first diagnosed as an acidic ulcer due to two biopsies verifying this. Because of progressing ulceration a third biopsy was taken - this time with the diagnosis extranodal NK/T-cell lymphoma, nasal type. This illustrates the diagnostic challenges of the illness, typically requiring multiple biopsies, and one should have this differential diagnosis in mind in case of progressing ulceration.
Topics: Male; Humans; Middle Aged; Lymphoma, Extranodal NK-T-Cell; Nose Neoplasms; Nose; Biopsy; Diagnosis, Differential
PubMed: 38078472
DOI: No ID Found