Skull base surgery for pediatric parameningeal sarcomas.

Abstract

Localized pediatric parameningeal sarcomas are usually treated exclusively by chemotherapy and radiotherapy. In this location, surgery is complicated but sometimes attempted to improve local control. A retrospective bicentric study was conducted to examine its place with particular reference to acute and long-term morbidity. Fifteen patients under the age of 20 years with parameningeal sarcoma underwent surgery between 2000 and 2007. Surgery was performed for 8 primary sarcomas and 7 radiation-induced sarcomas, mainly in infratemporal fossa. Three children had intracranial extension, 3 had metastases, and 1 had both. Median follow-up was 46 months (16-154 months). Five children experienced local relapse. Eight presented sequelae. Eleven children are alive with no evidence of disease, and 4 died. Skull base surgery should be considered as a possible treatment in pediatric parameningeal sarcomas. Surgery is the only option in radiation-induced sarcoma. Larger studies are necessary to more clearly define surgical indications.