Extending the traditional resection limits of squamous cell carcinoma of the anterior skull base

Objectives: Preliminary report to evaluate the efficacy of resection of squamous cell carcinomas that demonstrate intracranial invasion. Methods: A retrospective review of all cases of extracranial squamous cell carcinomas that extend intracranially treated by a single surgeon. Results: A total of 21 cases were reviewed. In 6 cases, there was noted to be overt brain invasion. Complete resection of the intracranial disease was achieved in each of the remaining 15 cases. There were no instances of CSF leak, meningitis, brain abscess, stroke, or other intracranial complication noted either acutely or secondarily. In follow-ups that ranged from 10 months (single patient died of disease at 10 months) to 6 years (average, 3.8 years), there were no instances of intracranial recurrence. There was a disease-free control rate of 67.7% at an average follow-up of 4.1 years. Conclusions: Extending the resection of squamous cell carcinoma into the intracranial vault judiciously as outlined appears to be associated with acceptable outcomes in the treatment of advanced squamous cell carcinoma of the skull base.