A multicenter retrospective analysis of clinical outcomes of intracranial chondrosarcoma in 26 patients

Abstract

Intracranial chondrosarcoma is a rare tumor with limited reports. We reviewed the clinical outcomes, imaging findings, and pathological characteristics at three centers to improve the diagnosis and treatment of intracranial chondrosarcoma. We retrospectively analyzed 26 patients with intracranial chondrosarcoma who had undergone surgical treatment at Tangdu Hospital of Air Force Military Medical University, Mianyang Central Hospital, and Nanchong Central Hospital from January 2010 to July 2022. Clinical manifestations, imaging features, surgical treatment, prognosis, and overall survival (OS) were analyzed. All 26 chondrosarcomas were located at the skull base. Gross total resection (GTR), subtotal resection (STR), and partial resection (PR) were performed in 14, 10, and 2 cases, respectively. Four cases underwent endoscopic transnasal surgery, while the remaining cases underwent craniotomy. The clinical symptoms were evaluated 1 week after surgery, and 15 cases were relieved to varying degrees. Postoperative complications included pulmonary infection, subcutaneous hydrops, dysphagia and choking, facial numbness, abducens paralysis, and intracranial infection (ICI). Fifteen cases received postoperative adjuvant radiotherapy. Seven cases showed recurrence: two with PR, four with STR, and one with GTR. Six cases received reoperation or radiotherapy after tumor progression, and one untreated patient died 5 months after tumor recurrence. The extent of tumor resection (HR 21.74, 95% CI 1.25–376.6, P = 0.03) and pathological grading (HR 131.99, 95% CI 4.05–4300.5, P = 0.006) were associated with improved OS. We presented our experience in the treatment of intracranial chondrosarcoma at three centers in the past 12 years. Intracranial chondrosarcoma lacked typical imaging features and are difficult to differentiate from other skull base lesions. Maximum extent of tumor resection with minimal injury to neurological function remains the most important treatment strategy. The extent of surgical resection and pathological grading were found to be predictors for OS.

Skull-Base Chondrosarcoma: A Systematic Review of the Role of Postoperative Radiotherapy

“…Liu et al [ 18 ] included patients whose tumors were removed by craniotomy (n = 20) and by endoscopic endonasal transsphenoidal approach (n = 4). The craniotomy approach included the pterional or expanded pterional approach, posterior sigmoid sinus approach, orbitozygomatic approach, paramedian approach, posterior median extension approach, and combined supratentorial and infratentorial approach.…”

Subacute Hydrocephalus Revealing a Cryptococcus Infection in a Seven-Year-Old Child

“…Some complications associated with VP shunting include infection (fungal infection or other secondary infections), shunt obstruction, and excessive shunting [ 7 ]. However, the benefits may outweigh the risks when compared with the poor neurological prognosis and possible death associated with untreated ICH and hydrocephalus in CM of the immunocompromised [ 11 , 13 ]. Data on long-term outcomes after VP shunting are not easily found since most studies are retrospective and life expectancy in these patients is short, not allowing for a proper follow-up [ 11 , 13 ].…”

“…However, the benefits may outweigh the risks when compared with the poor neurological prognosis and possible death associated with untreated ICH and hydrocephalus in CM of the immunocompromised [ 11 , 13 ]. Data on long-term outcomes after VP shunting are not easily found since most studies are retrospective and life expectancy in these patients is short, not allowing for a proper follow-up [ 11 , 13 ]. The study carried out by Wen et al on 72 patients was the first to obtain results of long-term follow-up, showing an improved overall survival rate even in critically ill patients undergoing VP shunting compared with the group of patients who did not [ 11 ].…”

An Unusual Presentation of a Primary Chondrosarcoma of the Cranial Vault

“…Chondrosarcomas (CSs) are slow-growing malignant cartilaginous tumors, usually affecting the pelvic bone and long bones metaphysis and diaphysis [ 1 , 2 ]. The skull remains an extremely rare localization and CS from extracranial sources rarely metastasize to the brain [ 3 , 4 ]. Primitive chondrosarcomas (PCS) represent 0.16% of intracranial neoplasms [ 3 , 5 ].…”

“…The skull remains an extremely rare localization and CS from extracranial sources rarely metastasize to the brain [ 3 , 4 ]. Primitive chondrosarcomas (PCS) represent 0.16% of intracranial neoplasms [ 3 , 5 ]. The base of the cranium is the most frequent intracranial localization, specifically the petrous and sphenoid bones [ 2 ].…”