title: Metastasis of soft-tissue myoepithelial carcinoma to clivus.
abstract: The differential diagnosis for masses involving the clivus is broad. The authors present a case of myoepithelial carcinoma metastatic to the clivus, a lesion that has not been reported to their knowledge. This 14-year-old girl with a history of myoepithelial carcinoma originating in the soft tissues of the left hip and metastatic to the lung presented with left lateral gaze palsy. Imaging demonstrated a 3 × 3-cm osteolytic mass in the clivus. Microscopic transsphenoidal resection with endoscopic assistance was performed. Pathological findings were consistent with the previously diagnosed myoepithelial carcinoma. Within 4 weeks postoperatively and 2 weeks into a chemotherapeutic regimen, the tumor exhibited progression. Radiation therapy was started and growth of the tumor was halted.   Myoepithelial carcinoma should be included in the differential diagnosis for clival masses, especially in patients with previously diagnosed myoepithelial carcinoma. The primary management of this tumor should be with chemotherapy and radiation, with surgery serving only for decompression.
authors.affiliation: Goodman Campbell Brain and Spine, Indiana University Department of Neurological Surgery, Indianapolis, Indiana 46202, USA. bbohnste@iupui.edu
authors.forename: Bradley N
authors.initials: BN
authors.lastname: Bohnstedt
authors.forename: Matthew
authors.initials: M
authors.lastname: Tomcik
authors.forename: Todd
authors.initials: T
authors.lastname: Eads
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Hagen
authors.forename: Mitesh
authors.initials: M
authors.lastname: Shah
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003388:Cranial Fossa, Posterior / Q000473:pathology* / Q000601:surgery*; D004724:Endoscopy; D005260:Female; D006615:Hip / Q000473:pathology; D006801:Humans; D015192:Infratentorial Neoplasms / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D008175:Lung Neoplasms / Q000556:secondary; D008279:Magnetic Resonance Imaging; D008866:Microsurgery; D009208:Myoepithelioma / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods; D012983:Soft Tissue Neoplasms / Q000473:pathology; D013100:Sphenoid Bone / Q000601:surgery; D014057:Tomography, X-Ray Computed
chemical_list: D000970:Antineoplastic Agents