title: Staged transcrusal and transsphenoidal endoscopic resection of an atypical clival melanoma: a case report and literature review.
abstract: We present a case of an atypical clival meningeal melanoma treated with a multidisciplinary staged transcrusal and transsphenoidal endoscopic surgical approach. A 45-year-old woman presented with a 15-month history of visual symptoms, neck pain, and unsteadiness. Magnetic resonance imaging of the head revealed a clival mass with both intracranial and extracranial involvement. Endoscopic clival biopsy suggested a melanocytic tumor. Extensive imaging and dermatological workup did not demonstrate a primary source. A multidisciplinary staged surgical resection included a transcrusal approach to resect the intracranial component, followed by transsphenoidal endoscopic resection of the extracranial component. Postoperatively, she received adjuvant radiation. At 1 year following surgery, the patient retains full preservation of hearing, facial nerve function, and extraocular movements. To our knowledge, this is the first case report of a combined surgical approach for a primary clival meningitic melanoma.
authors.affiliation: Division of Neurosurgery, Department of Clinical Neurosciences, University of Western Ontario, London, Ontario, Canada.
authors.forename: Navjot
authors.initials: N
authors.lastname: Chaudhary
authors.forename: Amanda
authors.initials: A
authors.lastname: Hu
authors.forename: Brian W
authors.initials: BW
authors.lastname: Rotenberg
authors.forename: Neil
authors.initials: N
authors.lastname: Duggal
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Howlett
authors.forename: Robert R
authors.initials: RR
authors.lastname: Hammond
authors.forename: Lorne
authors.initials: L
authors.lastname: Parnes
authors.forename: Steve P
authors.initials: SP
authors.lastname: Lownie