Metástasis asintomáticas de la base craneal: evolución clínica y alternativas terapéuticas

Abstract

Skull base metastases (SBM) are an infrequent and late type of cancer progression that are associated to poor prognosis. Its clinical manifestations may be grouped in five clinical syndromes and radiotherapy is its more frequent treatment. Because of the improvement in imaging tests and the close follow up of cancer patients, SBM can be diagnosed incidentally. In this group the best option of treatment has not been established. To analyze the clinical features and outcomes of patients with SBM diagnosed incidentally. Between January 2012 and December 2015, 31 patients with diagnoses of SBM from solid primary tumor were reviewed. SBM were diagnosed due to skull base syndromes (n = 24) or incidentally (n = 7). Symptomatic patients were treated with radiotherapy. Patients diagnosed incidentally remained without symptoms of craneal base involvement during the follow up, although they frequently had other types of intracranial progression. A statistically significant difference in survival was observed between symptomatic and asymptomatic patients (p = 0.001). The incidentally diagnosed SBM were frequently associated to other types of intracranial progression, limiting the options of treatment.