Abstract
Five patients with chondrosarcoma, grade I or II, and one with mesenchymal chondrosarcoma of the skull base were treated at our clinic between 1967 and 1991. The patients were three men and three women who ranged in age from 21 to 39 years. The presenting symptoms were diplopia, decreased visual acuity, or symptoms of involvement of VIIIth and lower cranial nerves. The duration of the symptoms ranged from 18 months to 14 years. A plain skull x-ray and tomography of the skull, computed tomographic (CT) scans, and magnetic resonance images (MRI) revealed a calcified mass. Angiograms showed an occlusion of the arteries or venous sinuses, or both, in four patients, and a distinct tumor stain in one. The tumors were subtotally removed in all six cases. Two patients received postoperative irradiation for the residual tumor. In one patient, extraocular movement was compromised postoperatively, although in the other five patients there was no aggravation of the neurologic signs. Follow-up CT scans and MRI demonstrated no recurrent tumors nor any enlargement of residual tumors. Based on these findings, we advocate aggressive surgical removal of these tumors, which should be augmented by radiation therapy if the postoperative CT scans or MRI reveal residual tumors.
Full text
PDFImages in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Acampora S., Troisi F., Fusco G., Del Gaizo S. Voluminous intracranial chondroma. Surg Neurol. 1982 Oct;18(4):254–257. doi: 10.1016/0090-3019(82)90335-4. [DOI] [PubMed] [Google Scholar]
- Austin-Seymour M., Munzenrider J., Goitein M., Verhey L., Urie M., Gentry R., Birnbaum S., Ruotolo D., McManus P., Skates S. Fractionated proton radiation therapy of chordoma and low-grade chondrosarcoma of the base of the skull. J Neurosurg. 1989 Jan;70(1):13–17. doi: 10.3171/jns.1989.70.1.0013. [DOI] [PubMed] [Google Scholar]
- Bahr A. L., Gayler B. W. Cranial chondrosarcomas. Report of four cases and review of the literature. Radiology. 1977 Jul;124(1):151–156. doi: 10.1148/124.1.151. [DOI] [PubMed] [Google Scholar]
- Cianfriglia F., Pompili A., Occhipinti E. Intracranial malignant cartilaginous tumours. Report of two cases and review of literature. Acta Neurochir (Wien) 1978;45(1-2):163–175. doi: 10.1007/BF01774391. [DOI] [PubMed] [Google Scholar]
- Coltrera M. D., Googe P. B., Harrist T. J., Hyams V. J., Schiller A. L., Goodman M. L. Chondrosarcoma of the temporal bone. Diagnosis and treatment of 13 cases and review of the literature. Cancer. 1986 Dec 15;58(12):2689–2696. doi: 10.1002/1097-0142(19861215)58:12<2689::aid-cncr2820581224>3.0.co;2-p. [DOI] [PubMed] [Google Scholar]
- Evans H. L., Ayala A. G., Romsdahl M. M. Prognostic factors in chondrosarcoma of bone: a clinicopathologic analysis with emphasis on histologic grading. Cancer. 1977 Aug;40(2):818–831. doi: 10.1002/1097-0142(197708)40:2<818::aid-cncr2820400234>3.0.co;2-b. [DOI] [PubMed] [Google Scholar]
- Fu Y. S., Perzin K. H. Non-epithelial tumors of the nasal cavity, paranasal sinuses, and nasopharynx: a clinicopathologic study. 3. Cartilaginous tumors (chondroma, chondrosarcoma). Cancer. 1974 Aug;34(2):453–463. doi: 10.1002/1097-0142(197408)34:2<453::aid-cncr2820340233>3.0.co;2-i. [DOI] [PubMed] [Google Scholar]
- Gardner G., Cocke E. W., Jr, Robertson J. T., Trumbull M. L., Palmer R. E. Combined approach surgery for removal of glomus jugulare tumors. Laryngoscope. 1977 May;87(5 Pt 1):665–688. doi: 10.1002/lary.5540870503. [DOI] [PubMed] [Google Scholar]
- Grossman R. I., Davis K. R. Cranial computed tomographic appearance of chondrosarcoma of the base of the skull. Radiology. 1981 Nov;141(2):403–408. doi: 10.1148/radiology.141.2.7291563. [DOI] [PubMed] [Google Scholar]
- Harsh G. R., 4th, Wilson C. B. Central nervous system mesenchymal chondrosarcoma. Case report. J Neurosurg. 1984 Aug;61(2):375–381. doi: 10.3171/jns.1984.61.2.0375. [DOI] [PubMed] [Google Scholar]
- Harwood A. R., Krajbich J. I., Fornasier V. L. Radiotherapy of chondrosarcoma of bone. Cancer. 1980 Jun 1;45(11):2769–2777. doi: 10.1002/1097-0142(19800601)45:11<2769::aid-cncr2820451111>3.0.co;2-x. [DOI] [PubMed] [Google Scholar]
- Kondziolka D., Lunsford L. D., Flickinger J. C. The role of radiosurgery in the management of chordoma and chondrosarcoma of the cranial base. Neurosurgery. 1991 Jul;29(1):38–46. doi: 10.1097/00006123-199107000-00007. [DOI] [PubMed] [Google Scholar]
- Kveton J. F., Brackmann D. E., Glasscock M. E., 3rd, House W. F., Hitselberger W. E. Chondrosarcoma of the skull base. Otolaryngol Head Neck Surg. 1986 Jan;94(1):23–32. doi: 10.1177/019459988609400104. [DOI] [PubMed] [Google Scholar]
- Matz S., Israeli Y., Shalit M. N., Cohen M. L. Computed tomography in intracranial supratentorial osteochondroma. J Comput Assist Tomogr. 1981 Feb;5(1):109–115. doi: 10.1097/00004728-198102000-00022. [DOI] [PubMed] [Google Scholar]
- Ozgen T., Pamir M. N., Akalan N., Bertan V., Onol B. Intracranial solitary chondroma. Case report. J Neurosurg. 1984 Aug;61(2):399–401. doi: 10.3171/jns.1984.61.2.0399. [DOI] [PubMed] [Google Scholar]
- Sanerkin N. G. The diagnosis and grading of chondrosarcoma of bone: a combined cytologic and histologic approach. Cancer. 1980 Feb;45(3):582–594. doi: 10.1002/1097-0142(19800201)45:3<582::aid-cncr2820450326>3.0.co;2-#. [DOI] [PubMed] [Google Scholar]
- Saunders W. M., Chen G. T., Austin-Seymour M., Castro J. R., Collier J. M., Gauger G., Gutin P., Phillips T. L., Pitluck S., Walton R. E. Precision, high dose radiotherapy. II. Helium ion treatment of tumors adjacent to critical central nervous system structures. Int J Radiat Oncol Biol Phys. 1985 Jul;11(7):1339–1347. doi: 10.1016/0360-3016(85)90250-0. [DOI] [PubMed] [Google Scholar]
- Sekhar L. N., Janecka I. P., Jones N. F. Subtemporal-infratemporal and basal subfrontal approach to extensive cranial base tumours. Acta Neurochir (Wien) 1988;92(1-4):83–92. doi: 10.1007/BF01401977. [DOI] [PubMed] [Google Scholar]
- Sekhar L. N., Schramm V. L., Jr, Jones N. F. Subtemporal-preauricular infratemporal fossa approach to large lateral and posterior cranial base neoplasms. J Neurosurg. 1987 Oct;67(4):488–499. doi: 10.3171/jns.1987.67.4.0488. [DOI] [PubMed] [Google Scholar]
- Sen C. N., Sekhar L. N., Schramm V. L., Janecka I. P. Chordoma and chondrosarcoma of the cranial base: an 8-year experience. Neurosurgery. 1989 Dec;25(6):931–941. doi: 10.1097/00006123-198912000-00013. [DOI] [PubMed] [Google Scholar]
- Suit H. D., Goitein M., Munzenrider J., Verhey L., Davis K. R., Koehler A., Linggood R., Ojemann R. G. Definitive radiation therapy for chordoma and chondrosarcoma of base of skull and cervical spine. J Neurosurg. 1982 Mar;56(3):377–385. doi: 10.3171/jns.1982.56.3.0377. [DOI] [PubMed] [Google Scholar]
- Unni K. K. Classification of bone tumours. Can J Surg. 1977 Nov;20(6):504–509. [PubMed] [Google Scholar]