Díaz-Castillejos A, Zottis-Grapiglia C, Rehder R, Borba LAB

Idioma: Español
Referencias bibliográficas: 41
Paginas: 133-149
Archivo PDF: 1591.41 Kb.

RESUMEN

Introducción Los cordomas son tumores poco frecuentes, generalmente de crecimiento lento, localmente destructivos, que se originan de restos de la notocorda primitiva. Se originan en el centro de la base del cráneo, muestran diferentes patrones de extensión en todas direcciones, incluyendo la penetración de la duramadre y recubrimiento de estructuras vasculares, lo que limita la extensión de la extirpación.
Objetivo: Analizar el desenlace y complicaciones del tratamiento quirúrgico de cordomas de la base del cráneo en un centro de referencia.
Métodos: Entre 2002 y 2012, 31 pacientes con cordomas de la base del cráneo fueron tratados quirúrgicamente en el Hospital Universitario Evangélico de Curitiba, Curitiba-Brasil. El periodo de seguimiento fue de 1-72 meses. Todos fueron evaluados con TAC e IRM cerebral y manejados quirúrgicamente, utilizando diversos tipos de abordajes teniendo como objetivo la resección radical. Algunos fueron tratados postquirúrgicamente con radioterapia.
Resultados: Se realizó una resección radial en 81%. La tasa de supervivencia global a los cinco años fue de 75%. La capacidad de lograr una resección radical dependió del volumen tumoral preoperatorio y del número de zonas anatómicas implicadas por el tumor. Las complicaciones posquirúrgicas más frecuentes fueron la parálisis del VI nervio craneal y fístula de líquido cefalorraquídeo.
Conclusiones: El objetivo final del tratamiento quirúrgico de los cordomas de la base del cráneo es la resección radical, esto se puede lograr a través de diversos abordajes quirúrgicos con un riesgo aceptable.

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