Chondrosarcoma is a malignant (cancerous) form of chondroma. Intracranial chondrosarcomas are most often found in the sphenoid bone (the bone behind the eyes), and especially the clivus (the middle portion of the skull base in front of the brain stem). They are usually attached to the dura mater (the covering over the brain).
They are classified as conventional, clear cell, mesenchymal or dedifferentiated based upon their appearance using the pathologist’s microscope. They may be further subdivided into grades I, II or III. Chondrosarcomas behave aggressively in the area where they are located.
Chondrosarcomas occur most often in adult males. Mortality is most often related to recurrence following treatment.
Signs and Symptoms
Symptoms of a chondrosarcoma are generally related to its affect on the brainstem and cranial nerves. These may include headache, motor, vision and/or hearing disturbances.
The exact cause of a chondrosarcoma is not fully understood. It may develop from rests (small nests) of cartilage cells that were leftover during the formation of the skull base bones in the embryo.
The development of symptoms from a cranial chondrosarcoma usually lead to the physician visit. Following a medical history and neurological examination, a magnetic resonance imaging ( MRI ) of the brain or computerized tomographic ( CT ) scan of the head may be ordered. Either of these tests may be combined with angiography to provide a more detailed view of the vessels as well.
A customized treatment plan is put together specifically for you. The most common options include:
- Surgery This is typically the first treatment for cranial chondrosarcoma. Because of its hard-to-access location in the middle of the skull base and the close relationship to brainstem and cranial nerves, surgery is usually difficult and challenging. It is often performed through the nose or mouth by neurosurgeons specialized in skull base operations.
- Radiation therapy Radiation is frequently used following surgery. It appears to be beneficial in reducing the chance for recurrence.
- Chemotherapy This may also be a consideration, but surgery and radiation are currently the primary forms of treatment.