Background: Metastatic lesions of the clivus are extremely rare, having previously been estimated as representing 0.02% of all intracranial tumors. Owing to its close intracranial relationship with the clivus before entering the cavernous sinus, clinical palsies of the sixth cranial nerve have been classically associated with destructive lesions of this structure.
Methods: A comprehensive search of PubMed was conducted for studies of patients with metastasis to the clivus from primary cancer at any site. Studies reported in English in the past 20 years from our last search on April 12, 2021 were included. The data collected included patient age, sex, symptoms at presentation, histopathology and treatment timeline of the primary tumor, treatment, follow-up, and mortality.
Results: After the literature review, 46 studies reporting on 58 patients with clivus metastasis were included in the final analysis. The mean age of the patients was 57.5 years, and 39 were male (67.2%). The most common sites of the primary tumor were the prostate (22%), gastrointestinal tract (15%), lung (13%), and kidney (11%). In 43% of patients, symptoms of clivus metastasis had presented before the diagnosis of primary cancer was known, and 71% of the patients had presented with sixth nerve palsy. Of the 58 patients, 53% had undergone surgery, and 37% had received adjuvant radiotherapy. Of the 58 patients, 25% had received radiotherapy alone. The endoscopic transsphenoidal approach to the clivus was almost uniquely used for surgical management. Survival data were available for 31 patients. Death had occurred at a mean of 9.4 months after the presentation of clivus metastasis. A strong correlation was found between the interval from primary cancer to the presentation of clivus metastasis and mortality.
Conclusions: Although an extremely rare occurrence, clivus metastasis should be considered in patients with a history of malignancy, in particular, prostate malignancy, presenting with new-onset isolated sixth nerve palsy.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.wneu.2021.11.105 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
An unusual case of aggressive endometrial adenocarcinoma metastasis to the clivus: illustrative case.
J Neurosurg Case Lessons
October 2024
Departments of Neurosurgery, University of Arizona, Tucson, Arizona.
Background: Though endometrial carcinomas are a relatively common cancer of the female genitourinary tract, they rarely metastasize. Similarly, clival metastases make up a tiny fraction of all brain metastases. To the authors' knowledge, an endometrial carcinoma clival metastasis has never been described in the literature; therefore, the authors present the following unusual case of a 69-year-old female with a history of an initially grade 2 endometrial adenocarcinoma that metastasized to her clivus.
View Article and Find Full Text PDFOutcomes of the Endoscopic Endonasal Approach for the Treatment of Clival Chordomas: A Single-Center Experience.
J Neurol Surg B Skull Base
October 2024
Department of Neurosurgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Article Synopsis
- - Chordoma is a rare and low-grade tumor that arises from remnants of the embryonic notochord, and this study evaluates the effectiveness of the expanded endoscopic endonasal approach (EEA) for its surgical removal combined with radiotherapy.
- - The study reviewed 17 patients treated between 2016 and 2021, showing that most had their tumors removed using EEA, with good outcomes in terms of survival and minimal severe side effects from radiation therapy.
- - The findings suggest that EEA followed by CyberKnife radiotherapy is a promising treatment option for clival chordomas, but more research is needed to compare it with other treatments like proton beam therapy.
The Clinical Outcomes of Cervical Spine Chordoma: A Nationwide Multicenter Retrospective Study.
Neurospine
September 2024
Neuroscience Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Article Synopsis
- The study focuses on chordoma, a rare and aggressive tumor of the cervical spine, highlighting its resistance to standard treatments and the necessity of surgical intervention.
- Conducted across 7 medical centers, the research analyzes data from 45 patients over a median of 52 months, tracking local recurrence and survival outcomes.
- Results show that while age significantly influences mortality rates, the method of tumor removal and additional treatments do not have a considerable impact on controlling the disease or improving survival rates.
Case report of large solitary skull base metastasis from renal cell carcinoma as initial clinical presentation: Radiological findings and differentials.
Radiol Case Rep
November 2024
Department of Diagnostic and Interventional Radiology, Queen Elizabeth Hospital, Kowloon, Hong Kong SAR.
A 58-year-old male with good past health presented with headache and visual disturbance for 1 month. Computed tomography (CT) and magnetic resonance imaging (MRI) were performed, showing a large aggressive midline mass with epicenter at the skull base and sellar-suprasellar region. There was marked heterogenous enhancement and intratumoral calcifications.
View Article and Find Full Text PDFUnveiling diagnostic challenges: A case report of noncontagious vertebral involvement in spinal tuberculosis mimicking metastasis.
Radiol Case Rep
November 2024
Department of Pathology, Bir hospital, Kathmandu, Nepal.
Spinal tuberculosis usually involves intervertebral disc, pardiscal vertebra and has associated perivertebral collection. Involvement of vertebral body including the posterior element, noncontagious vertebral involvement and sparing of intervertebral discs is typical of metastasis. Index case, a 19 years old Nepali patient presented to our hospital with complaints of severe backache.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!