Chondroblastoma of the Clivus: Case Report and Review

Abstract

Background and Importance Chondroblastoma is a benign primary bone tumor that typically develops in the epiphyses of long bones. Chondroblastoma of the craniofacial skeleton is extremely rare, with most cases occurring in the squamosal portion of the temporal bone. In this report, we describe the first case of chondroblastoma of the clivus presenting with cranial neuropathy that was treated with endoscopic endonasal resection. We review the literature on craniofacial chondroblastomas with particular emphasis on extratemporal lesions. Case Presentation A 27-year-old woman presented with severe headache, left facial dysesthesias, and diplopia. Physical examination revealed hypesthesia in the left maxillary nerve dermatome, and complete left abducens nerve palsy. Imaging demonstrated an expansile intraosseous mass originating in the upper clivus with extension superiorly into the sella turcica and laterally to involve the medial wall of the left cavernous sinus. The tumor was completely resected via an endoscopic endonasal approach, with postoperative improvement in lateral gaze palsy. Histopathology was consistent with chondroblastoma. Conclusion Chondroblastoma is a rare tumor of the craniofacial skeleton that should be included in the differential diagnosis of an osteolytic lesion of the clivus. Complete surgical resection remains the mainstay of treatment.

Rare chondroblastoma of the 6th left rib, video-assisted thoracoscopy resected: one case report and literature review

“…However, it is not present in the majority of lesions making it a secondary diagnostic criterion. IHC staining for S100 or K36M is positive in chondroblastoma, and is a useful ancillary method for making a diagnosis of chondroblastoma [ 9 , 10 ].…”

“…Radiotherapy is a treatment option for patients who are poor surgical candidates, and for patients with recurrent or unresectable disease, and prevent the recurrence, but which is not a standard method treatment [ 10 ]. Radiotherapy is not recommended after complete resection, due to the possibility of radiation-induced chondrosarcoma [ 6 ].…”

Imaging features of cartilaginous tumors of the head and neck

“…Craniofacial chondroblastomas are uncommon, accounting for 2–7% of all chondroblastomas. [ 1 , 23 , 24 ] The most common location in the head and neck region is the skull base, with a predilection for the squamous portion of the temporal bone adjacent to the temporomandibular joint. The other less common sites include mandibular condyle [ Figure 4 ], paranasal sinuses, and maxilla.…”

Volumetric comparative analysis of anatomy through far-lateral approach: surgical space and exposed tissues

“…The lesions at the inferior clivus pose a surgical challenge with high morbidity and mortality to neurosurgeons because of the critical neurovascular structures surrounding the lesion [ 1 – 4 ]. Many studies have described the far-lateral approach which exposed the inferior clivus superior to the anterior edge of foramen magnum [ 5 – 8 ]. The concern of neurovascular protection and skull base reconstruction promotes the development of surgical anatomy for the far-lateral approach [ 9 – 11 ].…”