Primary non-skeletal intracranial cartilaginous neoplasms: report of a chondroma and a mesenchymal chondrosarcoma

Abstract

Primary intracranial cartilaginous neoplasms which do not arise from bones of the skull are extremely rare (Alpers, 1935;Chorobski, Jarzymski, and Ferens, 1939;Dahlin and Henderson, 1962;Flyger, Freidenfeldt, and Orell, 1963;Siris and Angrist, 1942). We report herein two such tumours; one benign and the other malignant.CASE 1: CHONDROMA During the seventh month of pregnancy L.W., a 32-yearold white woman, began to exp-rience fainting spells of 15 minutes' duration followed by increasingly severe speech difficulty and weakness in the right arm. She was admitted to the hospital approximately one month after delivery, or three months after the onset of symptoms, at which time she was having generalized convulsions, bit her tongue, and lost consciousness for a 30 minute period.The past history, family history, and system review were negative or non-contributory except as related to the present illness.Physical examination revealed a well-developed, wellnourished, white female with mild speech slurring. There was a contusion in the right frontal region of the scalp.The fundi showed slight blurring of the nasal and upper disc margins and the pupils were equal and reacted to light. Right hemiparesis with hyperactive reflexes on the right was present. Hoffman's sign was positive on the right, but the Babinski reaction was negative. There was no astereognosis.Moderate nasal obstruction with yellowish nasal discharge was noted. Artificial dentures were well-fitting and oral hygiene was good. The breasts were full and lactating. The physical examination was otherwise negative and the blood pressure was 130/70 mm Hg.Radiographs of the skull showed a shell-like calcification on the left just posterior to the coronal suture and in the region of the middle meningeal vessels, the grooves of which appeared more pronounced on the left. The adjacent skull was thickened, but the falx, although calcified, was not shifted. The sella was intact.A left carotid arteriogram showed an abnormal vascular pattern in the left parietal area adjacent to the skull. Ventriculography disclosed downward displacement of the lateral, superior portion of the left lateral ventricle.

Dural osteochondroma: case report, review of the literature and proposal of a new classification

“…13,28 These tum ours are intradural and replacing the bone¯ap does not increase the likelihood of recurrence. Surgery is curative w ith long follow up reported by W u et al (14 years) 35 and by Hardy et al (22 years). 32 T he only case of recurrence or malignant degeneration of a m eningeal chondrom a w as reported by Alpers.…”

“…M eningeal chondrom as are avascular; vascularization being an ominous sign of sarcom atous changes. 34,35 The m ain differential diagnoses of m eningeal chondrom as, from the radiological point of view , are convexity osteom as and m eningiom as. Unlike m eningeal chondrom as, m eningiomas usually pick up contrast profusely and are well vascularized.…”

“…T he tum our appears as a hard, lobulated, avascular, whitish m ass. 7,24,29,31,35 It should be rem oved piecemeal or gently dissected from the surrounding brain for fear of lacerating the adherent blood vessels. It is our opinion that the bone¯ap should not be sacri® ced as advocated by som e authors.…”

Malignant Meningioma with Cartilage and Giant Cells

“…Care is necessary in distinguishing from meningiomas those intracranial cartilagenous tumors which appear to arise in the skull and secondarily involve the intracranial cavity. Chondromas, osteochondromas and chondrosarcomas have been identified as arising from the falx or from the dura of the cerebral convexity without obvious involvement of the adjacent skull (10,11). Giant cells' have been reported occasionally, especially in meningotheliomatous type.…”

A 12-year-old Girl With an Extraosseous Chondrosarcoma

“…Second, the tumor arises from metaplasia of fibroblasts. And finally, the tumor is formed de novo from multipotent cells of the meninges or choroid plexus [6].…”