Abstract
Rhabdomyosarcomas are common tumors of the head and neck region in children. However,
a primarily intracranial localization of this tumor entity is rare. We report on a
3-year-old boy presenting with double vision due to left VIth nerve palsy. No other neurological deficits were recognized by clinical inspection.
MRI scans visualized an enhancing mass lesion in the upper clivus compressing the
cavernous sinus and the pituitary gland. Transsphenoidal biopsy was performed and
histopathological examination as well as molecular diagnostics confirmed the diagnosis
of an alveolar rhabdomyosarcoma (ARMS). Staging identified a metastatic lesion in
the fourth thoracic vertebra resulting in the diagnosis of stage IV disease. Treatment
modality included stereotactic radio- and chemotherapy.
Zusammenfassung
Rhabdomyosarkome sind häufige Tumoren in der Kopf-Hals-Region bei Kindern. Im Gegensatz
dazu ist die primäre intrakranielle Lokalisation dieser Tumorentität selten. Wir berichten
über einen dreijährigen Jungen mit Doppelbildern aufgrund einer Abduzensparese auf
der linken Seite. Klinisch fanden sich keine weiteren Defizite. Im MRT zeigte sich
ein kontrastmittelaufnehmender raumfordernder Prozess im Bereich des Klivus mit Kompression
des Chiasma opticum und der Hypophyse. Nach transsphenoidaler Biopsie ergab sowohl
die histopathologische als auch die molekularbiologische Aufarbeitung des Gewebes
die Diagnose eines alveolären Rhabdomyosarkomes (ARMS). Im Staging fand sich ein metastasensuspekter
Befund in Höhe BWK 4, entsprechend einem Grad IV nach internationalem Staging. Die
weitere Behandlung beinhaltete eine stereotaktische Radio- und Chemotherapie.
Key words
rhabdomyosarcoma - sella turcica - clivus
Schlüsselwörter
Rhabdomyosarkom - Sella turcica - Klivus
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Dr. med. J. Kreutzer
Neurochirurgische Klinik · Universität Erlangen-Nürnberg
Schwabachanlage 6
91054 Erlangen
Germany
Phone: +49/91 31/8 53 30 01
Fax: +49/91 31/8 53 45 69
Email: juergen.kreutzer@nch.imed.uni-erlangen.de