Chondromyxoid Fibroma of the Skull Base: A Case Report of an Unusual Location

Introduction

Chondromyxoid fibromas are rare benign tumors of the bone and constitute only 0.5% of all primary bone tumors[13]. They originate from cartilaginous tissue and usually occur in young adults. Chondromyxoid fibromas frequently arise from the metaphysis of the long bones [18]. Chondromyxoid fibroma of the skull is extremely rare ([Table 1]). Residual embryonic cartilage tissue may be the origin of skull chondromyxoid fibromas. Here we describe a case of chondromyxoid fibroma located in the cerebellopontine angle.

Table 1 Reported cases in literature. Case Authors Site Age (years)/Gender Treatment Radiotherapy Outcome NA = Not Available; NED = No Evidence of Disease 1 Everke et al. 1966 petrosphenoidal junction 26/M excision no NA 2 Okubo et al. 1973 petrous pyramid NA NA NA NA 3 Inoue et al. 1978 intrasellar 30/F subtotal excision no recurrence 6 years and 7 years after first surgery (removed each time) 4 Frank et al. 1987 petrosphenoidal junction 26/M gross tumor resection no NA 5 Viswanathan et al. 1987 parasellar 33/M intracapsular removal no NA 6 Morikawa et al. 1987 skull base extending from middle fossa to posterior fossa 57/F excision no NA 7 Maruyama et al. 1994 petrous temporal bone 67/M NA NA NA 8 Nazeer et al. 1996 sphenoid sinus 66/F curettage no recurrence 1 year and re-curettage NED 6 months 9 Keel et al. 1997 clivus 34/F curettage yes NED 11 months after surgery 10 Keel et al. 1997 clivus 65/F excision no NED 26 months after surgery 11 Keel et al. 1997 sphenoid sinus 66/F excision no recurrence 6 months after first surgery: excision 12 Keel et al. 1997 clivus 42/M NA NA NA 13 Keel et al. 1997 sphenoid, ethmoid sinus 51/F NA NA NA 14 Patino-Cordoba et al.1998 clivus 41/F biopsy yes recurrence 6 years after first surgery: excision 15 Wu et al. 1998 sphenoid bone NA partial excision no NA 16 Wu et al. 1998 sphenoid bone NA partial excision no NA 17 Wu et al. 1998 sphenoid bone NA partial excision no NA 18 Shek et al. 1999 sphenoid body, superior nasal cavity, posterior ethmoidal sinuses 6/F excision no recurrence 4 and 10 years after first surgery; 50 Gy radiation after third surgery 19 Tarhan et al. 2000 left temporal bone (tympanic portion) 44/F total excision no NA 20 Bloom et al. 2004 clivus and right occipital condyle NA resection no NA 21 Feuvret et al. 2005 right sphenoid bone 28/F partial resection yes recurrence 11 months after first surgery: 61 Gy; NED 48 months after radiotherapy 22 Feuvret et al. 2005 left cavernous sinus 19/M biopsy yes NED 1 year 23 Kiralj et al. 2007 skull base and maxilla 65/F NA NA NA

References

• 1 Baujat B, Attal P, Racy E. et al . Chondromyxoid fibroma of the nasal bone with extension into the frontal and ethmoidal sinuses: report of one case and a review of the literature.  Am J Otolaryngol. 2001;  22 150-153
• 2 Bloom KK, Ellen J, Kaye D. Occipital neuralgia and twelfth nerve palsy from a chondromyxoid fibroma.  J Ky Med Assoc. 2004;  102 ((6)) 255-258
• 3 Desai SS, Jambhekar NA, Samanthray S. et al . Chondromyxoid fibromas: A study of 10 cases.  Surg Oncol. 2004;  89 ((1)) 28-31
• 4 Feuvret L, Noel G, Calugaru V. et al . Chondromyxoid fibroma of the skull base: differential diagnosis and radiotherapy: two case reports and a review of the literature.  Acta Oncol. 2005;  44 ((6)) 545-553
• 5 Fletcher CD, Unni KK, Mertens F. World Health Organization classification of tumors.. Pathology and genetics of tumors of soft tissue and bone. LYON: IARC press; 2002
• 6 Haberal AN, Bilezikci B, Coskun M. et al . Unusual presentation of a chondromyxoid fibroma of the temporal bone.  Tr J of Med Sci. 2001;  31 91-93
• 7 Hakan T, Aker VF. Chondromyxoid fibroma of frontal bone: A case report and review of the literature.  Turkish Neurosurg. 2008;  18 ((3)) 249-253
• 8 Jaffé HL, Lichtenstein L. Chondromyxoid fibroma of bone. A distinctive benign tumor likely to be mistaken especially for chondrosarcoma.  Arch Pathol. 1948;  45 541-551
• 9 Kanamaru R, Gondo M, Hirahara K. et al . A giant chondromyxoid fibroma originated from the right orbital roof. A case report.  No Shinkei Geka. 1982;  10 ((7)) 731-736
• 10 Karkuzhali P, Chitraklekha S, Muthuvel E. et al . Chondromyxoid fibroma of the parietal bone.  Neuropathology. 2005;  25 ((1)) 84-88
• 11 Keel SB, Bhan AK, Liebsch NJ. et al . Chondromyxoid fibroma of the skull base: a tumor which may be confused with chordoma and chondrosarcoma. A report of three cases and review of the literature.  Am J Surg Pathol. 1997;  21 ((5)) 577-582
• 12 Mitchell M, Sartoris DJ, Resnick D. Magnetic resonance imaging of chondromyxoid fibroma of the third metatarsal.  J Foot Surg. 1990;  29 613-617
• 13 Rahimi A, Beabout JW, Ivins JC. et al . Chondromyxoid fibroma: a clinicopathologic study of 76 cases.  Cancer. 1972;  30 726-736
• 14 Schajowicz F. Tumor and Tumorlike Lesions of Bone and Joints.. Berlin, Heidelberg; New YorkSpringer; 1981: 148-160
• 15 Unni KK. Chondromyxoid fibroma. Dahlin's Bone Tumors. General Aspects and Data on 11 087 Cases. 5th ed.  Lippincot-Raven, Philadelphia. 1996;  59-69
• 16 Watanabe Y, Goto T, Sasaki T. et al . [A case of chondromyxoid fibroma of the frontal bone].  No Shinkei Geka. 1985;  13 ((2)) 167-172
• 17 Wolf DA, Chaljub G, Maggio W. et al . Intracranial chondromyxoid fibroma. Report of a case and review of the literature.  Arch Pathol Lab Med. 1997;  121 ((6)) 626-630
• 18 Wu CT, Inwards CY, O’Laughlin S. et al . Chondromyxoid fibroma of bone: a clinicopathologic review of 278 cases.  Hum Pathol. 1998;  29 438-446
• 19 Zillmer DA, Dorfman HD. Chondromyxoid fibroma of bone: thirty-six cases with clinicopathologic correlation.  Hum Pathol. 1989;  20 952-964

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