title: Skull base dumbbell tumor: surgical experience with two adolescents.
abstract: Pediatric skull base tumors are rare and until recently were considered unresectable. We present two patients with tumors of similar anatomic position with an extracranial component in the infratemporal fossa and parapharyngeal space, an isthmus at the foramen ovale, and a superior component in the middle cranial fossa in the region of the cavernous sinus. A 15-year-old girl experienced contiguous spread of a spindle cell sarcoma; an 18-year-old boy developed a chondrosarcoma. A middle fossa approach provided the advantage of surgical avoidance of structures such as the middle ear and mastoid, facial nerve, and mandible. Postoperative recovery was rapid. Our impression is that preoperative carotid artery occlusion and a middle fossa approach for tumor resection can be performed in a young patient with acceptable morbidity and at least short-term benefit. Surgery can, therefore, provide an additional therapeutic approach to complement irradiation and chemotherapy.
authors.affiliation: Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston 02114.
authors.forename: R D
authors.initials: RD
authors.lastname: Eavey
authors.forename: P
authors.initials: P
authors.lastname: Janfaza
authors.forename: P H
authors.initials: PH
authors.lastname: Chapman
authors.forename: B
authors.initials: B
authors.lastname: Swearingen
authors.forename: N
authors.initials: N
authors.lastname: Liebsch
authors.forename: A
authors.initials: A
authors.lastname: Weber
authors.forename: K R
authors.initials: KR
authors.lastname: Davis
authors.forename: W S
authors.initials: WS
authors.lastname: Ferguson
mesh_terms: D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002813:Chondrosarcoma / Q000532:radiotherapy / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D012509:Sarcoma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D012888:Skull Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*
chemical_list: D000970:Antineoplastic Agents