Skull base surgery for pediatric parameningeal sarcomas

Abstract

Background: Localized pediatric parameningeal sarcomas are usually treated exclusively by chemotherapy and radiotherapy. In this location, surgery is complicated but sometimes attempted to improve local control.

Methods: A retrospective bicentric study was conducted to examine its place with particular reference to acute and long-term morbidity. Fifteen patients under the age of 20 years with parameningeal sarcoma underwent surgery between 2000 and 2007.

Results: Surgery was performed for 8 primary sarcomas and 7 radiation-induced sarcomas, mainly in infratemporal fossa. Three children had intracranial extension, 3 had metastases, and 1 had both. Median follow-up was 46 months (16-154 months). Five children experienced local relapse. Eight presented sequelae. Eleven children are alive with no evidence of disease, and 4 died.

Conclusion: Skull base surgery should be considered as a possible treatment in pediatric parameningeal sarcomas. Surgery is the only option in radiation-induced sarcoma. Larger studies are necessary to more clearly define surgical indications.