J Neurol Surg B Skull Base 2014; 75 - p005
DOI: 10.1055/s-0034-1384155

Chondrosarcoma of the Skull Base Associated with Intracerebral Hemorrhage

Eui Kyo Seo 1
  • 1Ewha Womans university, Republic of Korea

We report a case of intracranial chondrosarcoma originated from dorsum sellae with massive intra- and peritumoral hemorrhage. A 32-year-old woman admitted via ER due to sudden metal deterioration in 2007. In 1999, she got a craniotomy and removal of tumor, which was diagnosed chondrosarcoma. Computed tomography (CT) scan demonstrated a mass extending from the right side of the clivus to the parasellar region and petrous apex and intraventricular hemorrhage and subarachnoid hemorrhage with obstructive hydrocephalus. The mass was partially calcified and had destroyed the base of the middle cranial fossa. The lesion had homogeneous enhancement with contrast medium. Due to rapid deterioration of mental status, she got emergent craniotomy and removal of tumor and hemorrhage via transcallosal approach. The tumor cells were composed of hyperchromatic nuclei and eosinophilic cytoplasm, but there was no evidence of notochordal differentiation. The tumor cells reacted positively for S-100 protein, vimentin, and cytokeratin, but negatively for epithelial membrane antigen (EMA) and carcinoembryonic antigen (CEA). In view of these histopathological findings, the diagnosis of low-grade chondrosarcoma was established. Intratumoral hemorrhage often occurs in malignant brain tumors, such as glioblastoma and metastatic brain tumor, but chondroid tumors rarely develop a massive intratumoral hemorrhage. We discuss the immunohistochemical features and spontaneous intratumoral hemorrhage of chondrosarcoma.