Chondrosarcoma of the Skull Base

Neff, Brian A.; Sataloff, Robert T.; Storey, Leslie; Hawkshaw, Mary J.; Spiegel, Joseph R.

doi:10.1097/00005537-200201000-00023

Cited by 87 publications

(59 citation statements)

References 21 publications

(42 reference statements)

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“…31,32 Although chondrosarcomas often involve the clivus, patients with these lesions typically present with more lateral extensions, which are not ideal indications for purely midline approaches, and thus transcranial routes are often preferred. 1,10,45,58 A minimally invasive technique, such as the EEE approach, is appealing as it exploits an anatomical corridor (nasal cavities and sinuses) to reach deep-seated structures without the need for craniotomy and brain retraction and their associated morbidity. An endoscope allows a significantly wider and better-illuminated field of view.…”

Section: Current State Of the Art In Surgical Approaches For Clival Lmentioning

confidence: 99%

Surgery for clival lesions: open resection versus the expanded endoscopic endonasal approach

Carrabba¹,

Dehdashti²,

Gentili³

2008

FOC

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Object Clival lesions pose significant challenges with regard to their surgical management. The expanded endoscopic endonasal (EEE) approach is a promising minimally invasive technique for lesions of the central skull base. The authors' aim in the current paper was to discuss the surgical treatment of clival lesions and to present the technical details, indications, and limitations of the EEE approach. Data from a recent endoscopically treated group will be compared with findings in a previous cohort of patients treated via classic open anterior and lateral approaches. Methods Since June 2005, 17 patients with clival lesions underwent surgery via the EEE approach. Suitable candidates were chosen according to lesion characteristics, clinical parameters, and surgical goals. Neurological outcomes, Karnofsky Performance Scale scores, the extent of lesion resection, and complications were evaluated among these patients. Eighteen percent of the patients in the endoscopic group presented with recurrent disease. Another series of 43 patients, who had undergone resection of clival lesions via an anterior (rhinotomy, maxillectomy, microscopic transsphenoidal surgery, or transoral surgery) or lateral (pterional, frontoorbitozygomatic, or combined suprainfratentorial retrosigmoid) approach, was similarly reviewed. Twenty-three of these patients (53%) presented with recurrent disease and thus had undergone prior surgery. Results Following the EEE approach, 11 (79%) of 14 patients who had presented with neurological symptoms experienced improvement, and gross-total resection was achieved in 59% of the patients and subtotal removal in 41%. Complications included CSF leakage (24%), tension pneumocephalus (6%), and intracranial hematoma (6%). The patient with the latter complication was the only one who experienced permanent neurological worsening. In the open resection group, neurological worsening occurred in 33% of the patients (14 of 43). Total and grosstotal removals were achieved in 84% of patients and subtotal removal in 14%. Conclusions The EEE approach has been shown to be a safe and effective technique for the resection of clival lesions with limited lateral extension. The choice of surgical approach must be tailored according to both patient and tumor characteristics. Although the 2 patient series featured in this paper are not comparable—because of a selection bias—higher rates of neurological morbidity and total and gross-total resections were observed in the open resection group. Given the long survival of some patients, the EEE approach should be favored whenever reasonable.

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Section: Current State Of the Art In Surgical Approaches For Clival Lmentioning

confidence: 99%

Surgery for clival lesions: open resection versus the expanded endoscopic endonasal approach

Carrabba¹,

Dehdashti²,

Gentili³

2008

FOC

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“…According to the enchondral development of the osseous areas along the synchondrosis, the origin of chondrosarcomas could be explained by the degeneration of remnants of this enchondral cartilage. An association of this tumour with Paget's disease and multiple enchondromatosis (Ollier's disease) [3] has been reported.…”

Section: Discussionmentioning

confidence: 91%

Skull base chondrosarcoma: a case treated by the CyberKnife system

et al. 2008

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Skull base chondrosarcomas represent 2% of all chondrosarcomas. They usually have a low grade of malignity and a complete resection may be curative. However, often they are considered irresectable because of the difficult approach and another kind of treatment is needed. We present a 54-year-old male case who, after weeks suffering from diplopia, was diagnosed with skull base chondrosarcoma and treated with the CyberKnife system. A review of radiosurgery techniques for skull base neoplasms is carried out.

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“…Generally, patients present with an extensive history of headaches and symptoms associated with increased intracranial pressure. Histologically, intracranial chondrosarcomas are classified into three subtypes: Well-differentiated (classical type), intermediate (myxoid type) and undifferentiated (mesenchymal type) (10,11). In a review of 192 chondrosarcoma cases by Chandler et al (12), 62% were of the classical subtype, while the mesenchymal and myxoid types accounted for 30 and 8% of cases, respectively.…”

Section: Discussionmentioning

confidence: 99%

Classical intracranial chondrosarcoma: A case report

2016

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Abstract. Intracranial chondrosarcoma is a rare malignant cartilage-forming tumor, with only a small number of cases in the posterior cranial fossa reported previously. The present study reports the case of a 40-year-old male patient who was admitted to Tianjin Huanhu Hospital with a progressive headache and dizziness that had lasted for 2 years. Physical and neurological examinations were normal. Radiography of the skull identified an opaque lesion in the left frontal region of the brain. Cranial computed tomography and magnetic resonance imaging revealed a lesion with calcification and homogenous contrast enhancement in the left frontal region. Subsequently, the patient underwent bicoronal craniotomy and gross total resection of the tumor. Pathological examination confirmed the diagnosis of classical intracranial chondrosarcoma. The patient was discharged 10 days after surgery, with no neurological deficit. One month after initial discharge, the patient underwent γ-knife treatment. A follow-up examination 9 months after surgery revealed that the patient was still alive and had returned to work, with no obvious symptoms or evidence of recurrence.

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Chondrosarcoma of the Skull Base

Abstract: There is a role for en bloc resection of large areas of the skull base for treatment of chondrosarcoma. It appears that treatment combining surgery and radiation therapy is most likely to be effective.

Cited by 87 publications

References 21 publications

Surgery for clival lesions: open resection versus the expanded endoscopic endonasal approach

Surgery for clival lesions: open resection versus the expanded endoscopic endonasal approach

Skull base chondrosarcoma: a case treated by the CyberKnife system

Classical intracranial chondrosarcoma: A case report

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