Surgery and dose-escalated radiotherapy for a de novo intracranial squamous cell carcinoma of the cerebellopontine angle

Abstract

We report an extremely rare case of de novo intracranial squamous cell carcinoma of the cerebellopontine angle. The patient underwent craniotomy for debulking of the lesion to relieve mass effect on the brainstem and to establish a tissue diagnosis. Cancer staging revealed no other primary cancers and no evidence of metastatic disease. Postoperatively, he received image-guided intensity-modulated radiotherapy to the tumor bed followed by fractionated radiosurgery boost to the gross residual disease for a total average dose of 7000 cGy. He had a complete response to radiation and remains 42-months' disease-free post-treatment.

Primary Intracranial Squamous Cell Carcinoma: Case Report and Literature Review

“…Primary intracranial SCC was first described in 1976 by Wong et al [5]. To our knowledge, only nine other cases have been reported since [6][7][8][9][10][11][12][13][14].…”

Intracranial squamous papillary lesion

“…In fact, some authors speculate whether RCCs and PCPs are truly separate entities 7 . On the other side, lesions with keratinised mature squamous epithelium may prompt the consideration of metastatic squamous carcinoma, 8 direct infiltration of a head and neck squamous carcinoma 9 or even a central nervous system primary squamous carcinoma, thought to be derived from an epidermoid cyst 10 . In these cases, cytological atypia and brain parenchyma infiltration may be key findings, as well as the probable lack of BRAF mutations.…”

“…of metastatic squamous carcinoma, 8 direct infiltration of a head and neck squamous carcinoma 9 or even a central nervous system primary squamous carcinoma, thought to be derived from an epidermoid cyst. 10 In these cases, cytological atypia and brain parenchyma infiltration may be key findings, as well as the probable lack of BRAF mutations.…”

Primary Intracranial Squamous Cell Carcinoma: Case Report and Literature Review

“…Primary intracranial SCC was first described in 1976 by Wong et al (5). To our knowledge, only nine other cases have been reported since [6][7][8][9][10][11][12][13][14].…”