Chondrosarcoma of the Sella Turcica: Case Report and Review

Chondrosarcomas are rare, cartilage-producing, malignant mesenchymal tumors that typically develop in the bone or surrounding soft tissues. Chondrosarcomas of the midline skull base are particularly rare, with a small subset presenting as lesions of the sella and parasellar region. We present a case of chondrosarcoma presenting as a primary intrasellar mass with cavernous sinus invasion, and review the literature on chondrosarcomas of the sella, parasellar, and cavernous sinus regions.

A 57-year-old man presented with a 5-month history of progressive diplopia. On the physical examination, he was found to have a right abducens nerve palsy with intact visual acuity. Imaging demonstrated a contrast-enhancing multicystic heterogeneous mass involving the right sella turcica and cavernous sinus. The tumor was resected via an expanded endoscopic endonasal approach without complications, and histopathology was consistent with a low-grade chondrosarcoma.

Chondrosarcomas of the sella and parasellar region are particularly uncommon and may mimic pituitary adenoma in both clinical and radiographic presentation. Complete surgical resection followed by adjuvant radiotherapy is recommended due to high incidence of tumor recurrence. Albeit rare, chondrosarcoma should be included in the differential diagnosis of pituitary region masses.

Fig. 1 Magnetic resonance imaging demonstrated a contrast-enhancing multi-cystic 2.2 cm × 2.1 cm × 1.9 cm mass occupying the sella turcica with extension into the right cavernous sinus. There was radiographic evidence of encasement of the right internal carotid artery. Computed tomography images demonstrated lytic destruction of the right side of the clivus, sella, and dorsum sella from the mass.

Fig. 2 Repeat magnetic resonance imaging scan 6 weeks after surgery demonstrated a small lateral cavernous sinus residual mass. Residual mass stable at 6 months of postoperative.

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Artikel online veröffentlicht:
12. Februar 2021