Challenges in Histologic Diagnosis of XXXX of the Clivus.

@entity75 @entity1 @entity245 @entity79
IMPORTANCE: @entity75 are rare and represent a wide range of different benign and malignant pathologies. For an accurate and specific final diagnosis, biopsy procedures and/or resections followed by histologic examination are mandatory. OBJECTIVE: To illustrate the challenges in obtaining a final histologic diagnosis in @entity1 with various types of @entity75 . DESIGN, SETTING, AND @entity1 : We performed a retrospective analysis of medical records of 24 @entity1 who underwent endonasal endoscopic biopsy of the clivus between February 1, 2005, and June 1, 2013, in 2 medical university hospitals. Analysis was conducted between January 1 and August 15, 2014. INTERVENTIONS: All @entity1 underwent endoscopic biopsy of the clivus. MAIN OUTCOMES AND MEASURES: The number of biopsies performed to establish a diagnosis in @entity75 and the problems encountered when analyzing the radiologic findings and histologic results. RESULTS: In 14 of 24 @entity1 (58%), a conclusive histologic diagnosis of the @entity75 could be determined. Despite up to 3 endonasal endoscopic biopsies, the histologic result could not be clearly specified in the remaining 10 @entity1 (42%). No major complications occurred. Treatment based on the testing results included endonasal endoscopic surgery, radiotherapy or radiochemotherapy, and/or follow-up examination. CONCLUSIONS AND RELEVANCE: Challenges can occur in the radiologic evaluation and pathologic differentiation of diverse @entity79 with overlapping morphologic features as well as in the differentiation between neoplastic, reactive, inflammatory, and metabolic @entity79 and @entity245 . Despite more than 1 biopsy, histologic classification will not always lead to a definitive diagnosis. In such cases, an interdisciplinary team should decide whether additional biopsies should be performed or whether clinical, endoscopic, and radiologic controls are sufficient.
