Читать книгу Anterior Skull Base Tumors - Группа авторов - Страница 19

The anterior skull base is a complex anatomic site which may be involved by a large number of biologically heterogenous neoplasms. They arise from the epithelium, both surface mucosa and glands, as well as soft tissues, bone, and cartilage. Many benign and malignant tumours in the anterior skull base are similar to their counterparts in other anatomic sites. Interestingly, unique tumours including teratocarcinosarcoma, olfactory neuroblastoma, and angiofibroma can also be found. Recognition of overlapping morphologic features of entities encountered in this anatomic site and the corresponding differential diagnosis is critical. The integration of both morphologic features and immunohistochemical evaluation is essential for correct diagnostic interpretation. This is particularly notable in small round blue cell tumours for which morphologic lineage differentiation is lacking, thus requiring immunohistochemical characterisation. Moreover, challenges in accessing tissue for diagnosis leads to limited biopsies that require proper handling for adequate assessment. Histologic evaluation combined with communication between surgeons and pathologists are necessary components in the work-up and evaluation of these rare tumours.

© 2020 S. Karger AG, Basel

The skull base region comprises diverse structures and tissue lineages that give rise to phenotypically and biologically heterogeneous neoplasms. Histologic classification of tumours arising at these sites may lead to diagnostic challenges especially on presurgical materials [1]. In general, diagnosis of skull base tumours is made by tissue biopsy in the office, operating room, or, in selected cases, by core biopsy under CT guidance. In view of the risk of misdiagnosis, intraoperative diagnosis based on frozen sections should be limited to deep-located lesions, which are difficult to access under local anaesthesia, after an in-depth discussion between the surgeon and pathologist. Tissue biopsies provide limited materials and efforts to ensure proper handling and processing are critical. Accurate diagnosis mandates knowledge, experience, judicial use of lineage and genetic markers, and close interactions between surgeons and pathologists. This pathology paper presents a concise review of the tumours more commonly encountered in the anterior skull base region and their differential diagnosis for practitioners.