Surgical Treatment and Long-Term Follow-Up of Chondromas and Chondrosarcomas of the Skull Base

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

Methods: The hospital data of 17 patients who had undergone microsurgery and were pathologically diagnosed as having cranial base chondromas or chondrosarcomas were reviewed.

Results: Chondromas and chondrosarcomas of the cranial base commonly arise in the sphenopetrosal junction as well as the sphenoclival junction and the petroclival junction, and most frequently locate in the parasellar region of the middle cranial base extradurally. Headache and cranial nerve palsy were the most common presenting symptoms. The average preoperative Karnofsky performance score (KPS) was 87.1. Among the 17 patients, 12 underwent total or near-total resection, 4 underwent subtotal resection, and 1 underwent partial resection. The major postoperative complications included cranial nerve palsy and cerebrospinal fluid leakage, and there were no postoperative deaths. Fifteen patients were followed up for a mean of 5.6 years (range, 5–140 months), of which 11 (73.3%) lived a normal life (KPS: 80–90). Two patients in the series had recurrent tumors.

Conclusion: In most cranial base chondromas or chondrosarcomas, preoperative diagnosis can be presumed 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 and chondrosarcomas and can prolong survival.