Post-operative Management and Outcomes
Following surgery, 2 patients received proton beam radiation therapy, including one with widely disseminated disease and another with increased mitotic activity and necrosis; neither has recurred at last follow-up (1.18 and 3.19 years). No patient received chemotherapy.
Two patients with disseminated disease, elevated mitotic activity, and necrosis had new metastatic disease/progression of non-resected metastatic foci at 2.6 and 26.8 months.  One patient underwent an incomplete surgical resection of the original tumor. Both of these patients received radiation therapy, and have remained progression free since (3.01 and 9.34 years). All patients were alive at last follow-up (median follow-up 1.31 years, range: 0.66-11.75 years).