Abstract
Background About one-third of rhabdomyosarcomas arise in the head and neck, with parameningeal
primaries accounting for half of these. Principles of management involve chemotherapy,
radiation, or both, in addition to surgical biopsy, debulking, and complete or near-complete
resection. In the head and neck, diagnostic biopsies have historically been performed
without attempt at resection due to proximity to critical structures and cosmetic
considerations.
Methods Retrospective chart review of three cases of rhabdomyosarcoma at the cranial base
managed through minimally invasive endoscopic surgical resection and adjuvant therapy.
Results Three patients were identified as having undergone endoscopic surgical debulking
or margin-negative resection of a rhabdomyosarcoma of the cranial base. Two of three
patients had complete resection based on intraoperative margin control. All three
patients underwent adjuvant therapy within 1 month of diagnosis. Follow-up time ranged
from 5 months to 3 years with all patients disease-free at last follow-up.
Conclusion Skull base surgeons should routinely be involved in multidisciplinary treatment planning
for parameningeal rhabdomyosarcomas, as surgical options have evolved to allow for
potential endoscopic resection with low morbidity and no or minimal delay in additional
treatment options.
Keywords
rhabdomyosarcoma - parameningeal - endoscopic - minimally invasive
