Article Text

Download PDFPDF
Recurrence of a complex anterior skull base tumour managed with an uncommon surgical approach
  1. Muhammad Ibaad ur Rehman Alvi1,
  2. Omar Pathmanaban1,2,
  3. Raj Bhalla1,2 and
  4. Navin Mani1,2
  1. 1 Manchester Royal Infirmary, Manchester, UK
  2. 2 ENT, Manchester Royal Infirmary, Manchester, UK
  1. Correspondence to Dr Muhammad Ibaad ur Rehman Alvi, malvi{at}, muhammad.alvi{at}


A well 74 -year-old woman presented to routine ophthalmology clinic instituted following treatment of a frontoethmoidal sarcoma initially excised in 1989 and diagnosed then as a sinus mucosal melanoma. At review in ophthalmology clinic, a reduction in right visual fields was noted. CT scan showed recurrence of a mass now involving the frontoethmoidal region, frontal sinus and abutting the cribiform plate. Endoscopic biopsy confirmed the recurrence as a low-grade biphenotypic sarcoma. This was discussed at the sarcoma multidisciplinary meeting. Using a three-dimensional printed model of the patients skull for planning, primary surgery with craniofacial resection combining intracranial and transfacial approaches with reconstruction was decided on. The implications of no treatment would be tumour involvement of the dura and brain as well as the right only-seeing eye. Craniofacial surgery would involve otolaryngolical, neurosurgical and maxillofacial multispecialty involvement and close teamwork. The goal was en bloc excision with negative surgical margins.

  • head and neck cancer
  • otolaryngology/Ent
  • cancer intervention

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors MIurA planned, researched and wrote this case report based on available patient notes and speaking personally to the patient along with a review of the literature. OP, RB and NM were the main surgeons involved in the patient’s surgery and presurgery planning. Participating surgeons also include Tim Blackburn Maxfax surgeon. In addition, NM reviewed the description of treatment in the text and made contributions along with providing specialist information about the nature of the procedure and its preoperative planning.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.