Diagnosis and Surgical Treatment of Chondromas and Chondrosarcomas of the Cranial Base

Background and Objective: Chondromas and chondrosarcomas involving the cranial base are rare neoplastic diseases. The objective of the study is to discuss and evaluate diagnosis and surgical treatment of the intractable cranial base tumors.

Methods: The hospital data of 16 patients who had undergone microsurgery and were pathologically diagnosed with cranial base chondromas or chondrosarcomas were reviewed.

Results: Chondromas and chondrosarcomas of the cranial base arise commonly from the sphenopetrosal or spheno-occipital synchondrosis, and most frequently locate in the parasellar region of middle cranial fossa. Most patients presented with headache and cranial nerve palsy. Among the 16 patients, 12 underwent total or near-total resection and 4 underwent subtotal resection. The major postoperative complications included cranial nerve palsy and cerebrospinal fluid leakage; there were no postoperative deaths. Of 14 patients who were followed up for a mean of 5.7 years, 11 regained normal lives in society, 2 maintained self-care daily lives, and 1 needed nursing care. Two patients in the series had recurrent tumors.

Conclusion: In most cranial base chondromas or chondrosarcomas, preoperative diagnosis can be presumed definitely on the basis of neuroradiological examinations and presenting symptoms and signs. In some cases, immunohistochemical studies are necessary to differentiate chondrosarcomas from chordomas. Surgical resection is the principal treatment for cranial base chondromas or chondrosarcomas and can prolong survival.