A rare case of giant cell tumor involving the clivus resected through Le Fort I Osteotomy and median maxillotomy.
BACKGROUND
Giant cell tumors (GCTs) are bone tumors that seldom involve the skull. Skull GCTs preferentially occur in the sphenoid and temporal bones with few reported cases involving the clivus. Due to the rarity and complex location, surgical management is not well established for clival GCTs.


METHODS
A 49-year-old male presented with headaches and blurred vision in the right eye for 2 weeks. Computed tomography (CT) with contrast revealed a sellar mass eroding through the sphenoid sinuses with compression of optic chiasm. Biopsy was consistent with GCT. Patient underwent tumor resection by Le Fort I Osteotomy and median maxillotomy for an extended transsphenoidal approach. Upon discharge, patient showed no neurological deficits and intact cranial nerves.


CONCLUSIONS
This case contributes to the limited amount of skull-based GCT cases worldwide. Additionally, the extended transoral approach can be performed safely in the context of a GCT within the clivus with acceptable morbidity and cosmesis.
Department of Neurosurgery, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan, USA.
Julie
J
Le
Department of Plastic and Reconstructive Surgery, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan, USA.
Kongkrit
K
Chaiyasate
Department of Pathology, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan, USA.
Kliment
K
Donev
Department of Neurosurgery, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan, USA.
Daniel K
DK
Fahim
Clivus; Le Fort osteotomy; giant cell tumor; skull-based neoplasm