Intracranial Mesenchymal Chondrosarcoma: A Case Report

Abstract

Primary intracranial mesenchymal chondrosarcoma is an extremely rare tumor. We present a case of primary intracranial mesenchymal chondrosarcoma in a young female who presented with headache, loss of vision, and one episode of convulsions associated with nausea and vomiting. MRI brain revealed a large, well-marginated, lobulated, partially calcified, intensely enhancing lesion with a broad dural base in bilateral frontal regions with marked mass effect suggestive of meningioma. Bilateral frontal craniotomy with gross tumor excision was performed. Histopathology revealed mesenchymal chondrosarcoma. Adjuvant radiotherapy was delivered and patient is currently on follow-up. We emphasize that intracranial mesenchymal chondrosarcoma is a rare neoplasm and should be considered in the differential diagnoses of intracranial mass along with meningioma. Treatment of choice is surgery followed by adjuvant radiotherapy. We review the relevant literature and discuss the characteristics of this rare tumor.

Keywords

mesenchymal chondrosarcoma - intracranial - surgery - radiotherapy

Presentation at a Meeting

None.

• References

• 1 Lightenstein L, Bernstein D. Unusual benign and malignant chondroid tumors of bone. A survey of some mesenchymal cartilage tumors and malignant chondroblastic tumors, including a few multicentric ones, as well as many atypical benign chondroblastomas and chondromyxoid fibromas. Cancer 1959; 12: 1142-1157
• 2 Nakashima Y, Unni KK, Shives TC, Swee RG, Dahlin DC. Mesenchymal chondrosarcoma of bone and soft tissue. A review of 111 cases. Cancer 1986; 57 (12) 2444-2453
• 3 Hassounah M, Al-Mefty O, Akhtar M, Jinkins JR, Fox JL. Primary cranial and intracranial chondrosarcoma. A survey. Acta Neurochir (Wien) 1985; 78 (3-4) 123-132
• 4 Scheithauer BW, Rubinstein LJ. Meningeal mesenchymal chondrosarcoma: report of 8 cases with review of the literature. Cancer 1978; 42 (6) 2744-2752
• 5 Bloch OG, Jian BJ, Yang I , et al. A systematic review of intracranial chondrosarcoma and survival. J Clin Neurosci 2009; 16 (12) 1547-1551
• 6 Alvira MM, McLaurin RL. Asymptomatic subdural chondrosarcoma. Case report. J Neurosurg 1978; 48 (5) 825-828
• 7 Harsh IV GR, Wilson CB. Central nervous system mesenchymal chondrosarcoma. Case report. J Neurosurg 1984; 61 (2) 375-381
• 8 Lau DP, Wharton SB, Antoun NM, Bottrill ID, Moffat DA. Chondrosarcoma of the petrous apex. Dilemmas in diagnosis and treatment. J Laryngol Otol 1997; 111 (4) 368-371
• 9 Coltrera MD, Googe PB, Harrist TJ, Hyams VJ, Schiller AL, Goodman ML. Chondrosarcoma of the temporal bone. Diagnosis and treatment of 13 cases and review of the literature. Cancer 1986; 58 (12) 2689-2696
• 10 Seidman MD, Nichols RD, Raju UB, Mehta B, Levy HG. Extracranial skull base chondrosarcoma. Ear Nose Throat J 1989; 68 (8) 626-632 , 635
• 11 Korten AG, ter Berg HJ, Spincemaille GH, van der Laan RT, Van de Wel AM. Intracranial chondrosarcoma: review of the literature and report of 15 cases. J Neurol Neurosurg Psychiatry 1998; 65 (1) 88-92
• 12 Rushing EJ, Armonda RA, Ansari Q, Mena H. Mesenchymal chondrosarcoma: a clinicopathologic and flow cytometric study of 13 cases presenting in the central nervous system. Cancer 1996; 77 (9) 1884-1891
• 13 Vergeer RA, Vink R, Avenarius JK, Driesse MJ. A 71-year-old woman with an intracranial dural-based mesenchymal chondrosarcoma. J Clin Neurosci 2012; 19 (8) 1170-1171
• 14 Austin-Seymour M, Munzenrider J, Goitein M , et al. Fractionated proton radiation therapy of chordoma and low-grade chondrosarcoma of the base of the skull. J Neurosurg 1989; 70 (1) 13-17
• 15 Gay E, Sekhar LN, Rubinstein E , et al. Chordomas and chondrosarcomas of the cranial base: results and follow-up of 60 patients. Neurosurgery 1995; 36 (5) 887-896 , discussion 896–897
• 16 Sen CN, Sekhar LN, Schramm VL, Janecka IP. Chordoma and chondrosarcoma of the cranial base: an 8-year experience. Neurosurgery 1989; 25 (6) 931-940 , discussion 940–941
• 17 Stapleton SR, Wilkins PR, Archer DJ, Uttley D. Chondrosarcoma of the skull base: a series of eight cases. Neurosurgery 1993; 32 (3) 348-355 , discussion 355–356
• 18 Neff B, Sataloff RT, Storey L, Hawkshaw M, Spiegel JR. Chondrosarcoma of the skull base. Laryngoscope 2002; 112 (1) 134-139
• 19 Isaacson B, Kutz JW, Roland PS. Lesions of the petrous apex: diagnosis and management. Otolaryngol Clin North Am 2007; 40 (3) 479-519 , viii
• 20 Aksoy S, Abali H, Kiliçkap S, Güler N. Successful treatment of a chemoresistant tumor with temozolomide in an adult patient: report of a recurrent intracranial mesenchymal chondrosarcoma. J Neurooncol 2005; 71 (3) 333-334
• 21 Sardi I, Massimino M, Genitori L, Buccoliero AM, Giangaspero F, Ferrari A. Intracranial mesenchymal chondrosarcoma: report of two pediatric cases. Pediatr Blood Cancer 2011; 56 (4) 685-686
• 22 Oikawa H, Satoh T, Masuda T, Arai H, Ehara S, Muro-Oka G. Intracranial low-grade chondrosarcoma with hyperostosis of the skull: a case report. J Neurooncol 2000; 49 (3) 249-254