title: High-grade glioma with anterior skull base erosion and intranasal extension: case report.
abstract: The authors describe the case of a large WHO Grade III anaplastic oligoastrocytoma extending through the anterior skull base and into the right nasal cavity and sinuses. Glial neoplasms are typically confined to the intracranial compartment within the brain parenchyma and rarely extend into the nasal cavity without prior surgical or radiation therapy. This 42-year-old woman presented with progressive headaches and sinus congestion. MR imaging findings revealed a large intracranial lesion with intranasal extension. Endoscopic nasal biopsy revealed pathology consistent with an infiltrating glioma. The patient subsequently underwent a combined transcranial/endonasal endoscopic approach for resection of this lesion. Pathological diagnosis revealed a WHO Grade III oligoastrocytoma. This report reviews the mechanisms of extradural glioma extension. To the authors' knowledge, it is the second report of a high-grade glioma exhibiting nasal extension without prior surgical or radiation treatment.
authors.affiliation: George Washington University School of Medicine and Health Sciences; and.
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Stib
authors.affiliation: Departments of 2 Neurosurgery.
authors.forename: Michael
authors.initials: M
authors.lastname: Johnson
authors.affiliation: Departments of 2 Neurosurgery.
authors.forename: Alan
authors.initials: A
authors.lastname: Siu
authors.affiliation: Pathology, and.
authors.forename: M Isabel
authors.initials: MI
authors.lastname: Almira-Suarez
authors.affiliation: Departments of 2 Neurosurgery.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Litvack
authors.affiliation: Otolaryngology, George Washington University, Washington, DC.
authors.forename: Ameet
authors.initials: A
authors.lastname: Singh
authors.affiliation: Departments of 2 Neurosurgery.
authors.forename: Jonathan H
authors.initials: JH
authors.lastname: Sherman
mesh_terms: D000328:Adult; D004724:Endoscopy; D005260:Female; D005910:Glioma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D009296:Nasal Cavity; D009361:Neoplasm Invasiveness; D010256:Paranasal Sinuses; D019292:Skull Base Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*
keywords: GFAP = glial fibrillary acidic protein; endoscopic approach; extradural glioma; high-grade glioma; nasal extension; oligoastrocytoma; oncology; transcranial approach