Book review
https://doi.org/10.55378/rv.50.2.11
Aggressive perineural and intracranial progression of a skull base lesion with subsequently detected sarcomatoid carcinoma
Arijana Petković
; Klinika za onkologiju, Klinički bolnički centar Zagreb, Hrvatska
*
Vedran Manestar
; Klinika za onkologiju, Klinički bolnički centar Zagreb, Hrvatska
* Corresponding author.
Abstract
Objective: A case report of a 52-year-old patient who was treated for chronic inflammation and fungal infection (Aspergillus), underwent multiple surgeries without improvement, and was ultimately diagnosed with sarcomatoid carcinoma of the orbit and sinuses. The role of radiotherapy as the primary therapy for sarcomatoid carcinoma is presented. Case report: A patient who was initially treated for chronic inflammation and fungal infection also underwent multiple surgeries that did not lead to improvement. After a new biopsy was performed in 2026, the diagnosis of sarcomatoid carcinoma of the orbit and sinuses was revealed. The tumour rapidly spread along the nerves to the orbit, auditory canal, and brainstem, causing severe neurological damage (loss of vision, hearing, and facial sensation). Sarcomatoid carcinoma is a rare and very aggressive tumour with features of both carcinoma and sarcoma. This tumour rapidly destroys bone tissue and metastasises very quickly. Because of its specific structure and symptoms that resemble inflammatory processes, it is very difficult to diagnose, so biopsy is the gold standard for diagnosing this tumour. To treat this extensive and aggressive process, we delivered primary radiotherapy to the tumour area with 6 MeV photon beams using the VMAT technique, with daily positioning control via kV CBCT. TD 54 Gy/27 fractions was applied to the tumour area that infiltrates the initial brainstem, and TD 68 Gy in 34 fractions was applied to the remaining area. Conclusion: The combination of an aggressive tumour and invasive fungal infection with brain penetration is an extremely rare diagnostic and therapeutic challenge. Primary radiation therapy using the VMAT technique was performed successfully.
Keywords
fungal infection, sarcomatoid carcinoma, rare tumours, radiotherapy planning
Hrčak ID:
352463
URI
Publication date:
26.10.2026.
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