About a Rare Case of Low-Grade Chondrosarcoma of the Cranial Vault

• Leonello Tacconi

  Unita’ di Neurochirurgia, Azienda Universitaria Integrata, Trieste, Italia

• Gennaro D’Acunzi

  U.O.C. Neurochirurgia, P.O. “Umberto I” ” - Nocera Inferiore-Pagani, Plesso di Nocera Inferiore, ASL Salerno, Italy

• Camilla Russo

  Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli “Federico II”, Napoli, Italy

• Andrea Manto

  Servizio di Neuroradiologia, P.O. “Umberto I” - Nocera Inferiore-Pagani, Plesso di Nocera Inferiore, ASL Salerno, Italy

• Ginevra F. D’Onofrio

  U.O.C. Neurochirurgia, P.O. “Umberto I” ” - Nocera Inferiore-Pagani, Plesso di Nocera Inferiore, ASL Salerno, Italy

• Raffaele Fristachi

  Servizio di Anatomia Patologica, D.E.A. Nocera Inferiore-Pagani, Plesso di Pagani, ASL Salerno, Italy

Chondrosarcoma is a rare malignant tumour arising from the cartilage with a high variability in the clinicalcourse and overall prognosis. This entity has, generally, a predilection for long bones of the limbs and pelvis and the location in the cranial bones is quite rare. We report a case of a 38 year male with a large and poorly symptomatic parafalcine chondrosarcoma of the cranial vault which was removed en bloc. The described location is extremely rare.

Magnetic Resonance Imaging permitted to better delineate the lesion and plan the most appropriate therapeutic approach. Final diagnosis was based on histological examination, which confirmed the hypothesis of low-grade parafalcine chondrosarcoma. Even though surgery remains the mainstay of treatment for cerebral chondrosarcomas, adjuvant radiotherapy such as stereotactic, proton beam or carbon ion-beam therapy might be necessary in aggressive or incomplete removed cases.

Evans L, Ayala A, Romsdahl M. Prognostic Factors in Chondrosrcoma. Cancer 1977; 40: 818-31. https://doi.org/10.1002/1097-0142(197708)40:2<818::AID-CNCR2820400234>3.0.CO;2-B

Dorfman H, Czerniak B. Malignant cartilage tumors. In: Dorfman HD, Czerniak B E, editor. Bone tumors. St. Louis: Mosby 1998; pp. 353-440.

Berkmen Y, Blatt E. Cranial and intracranial cartilaginous tumours. Clin Radiol 1968; 19: 327-33. https://doi.org/10.1016/S0009-9260(68)80019-4

Healey J, Lane J. Chondrosarcoma. Clin Orthop Relat Res 1986; 204: 119-29. https://doi.org/10.1097/00003086-198603000-00012

Ryzewicz M, Manaster B, Naar E, Lindeque B. Low-grade cartilage tumors: diagnosis and treatment. Orthopedics 2007; 30: 35-46.

Korten AGGC, Berg HJW, Spincemaille GH, Laan RT Van Der. Intracranial chondrosarcoma?: review of the literature and report of 15 cases. J Neurol Neurosurg Psychiatry 1998; 65: 88-92. https://doi.org/10.1136/jnnp.65.1.88

Bloch OG, Jian BJ, Yang I, Han SJ, Aranda D, Ahn BJ, et al. Cranial Chondrosarcoma and Recurrence. Skull Base 2010; 1(212): 149-56. https://doi.org/10.1055/s-0029-1246218

Oruckaptan HH, Berker M, Soylemezoglu F, Ozcan OE. Parafalcine Chondrosarcoma: An Unusual Localization For A Classical Variant. Surg Neurol 2001; 55: 174-9. https://doi.org/10.1016/S0090-3019(01)00329-9

Mott FW. Chondrosarcoma springing from the sella turcica. Arch Neurol Psychiat 1899; 1: 432-433.

Gunes M, Gunaldi O, Tugcu B, Tanriverdi O, Guler AK, Colluoglu B. Intracranial chondrosarcoma: a case report and review of the literature. Minim. Invasive Neurosurgery 2009; 52(5-6): 238-41. https://doi.org/10.1055/s-0028-1128117

Wanebo JE, Bristol RE, Porter RR, Coons SW, Spetzler RF. Management of cranial base chondrosarcomas. Neurosurgery 2006; 58: 249-55. https://doi.org/10.1227/01.NEU.0000194834.74873.FB

Chandler JP, Yashar P, Laskin WB, Russell EJ. Intracranial chondrosarcoma?: a case report and review of the literature. J Neurooncol 2004; 68: 33-9. https://doi.org/10.1023/B:NEON.0000024728.72998.7d

Parker JR, Zarabi MC, Parker JC Jr. Intracerebral mesenchymal chondrosarcoma. Ann Clin Lab Sci 1989; 19: 401-407.

Prostetic reconstruction of the femur for primary bone sarcoma Gerrand CH, Currie D, Grigoris P, Reid R, Hamblen DL. Int Orthop 1999; 23: 286-90. https://doi.org/10.1007/s002640050373

Striano S, Striano P, Tortora F, Elefante A. Intractable epilepsy in Turner syndrome associated with bilateral perisylvian hypoplasia?: one case report. Clin Neurol Neurosurg 2005; 108: 56-9. https://doi.org/10.1016/j.clineuro.2004.11.012

Kothary N, Law M, Cha S, Zagzag D. Conventional and Perfusion MR Imaging of Parafalcine Chondrosarcoma. AJNR 2003; 24: 245-8.

Reinshagen C, Redjal N, Sajed DP, Nahed BV, Walcott BP. Intracranial dural based chondroma. J Clin Neurosci [Internet]. Elsevier Ltd; 2015. https://doi.org/10.1016/j.jocn.2015.05.052

Ginat DT, Yeaney G, Ekholm S. Diffusion-Weighted Imaging of Skull Lesions. J Neurol Surg 2014; 75: 204-13. https://doi.org/10.1055/s-0034-1371362

Safaee M, Clark AJ, Tihan T, Parsa AT, Bloch O. Falcine and parasagittal chondrosarcomas. J Clin Neurosci [Internet]. Elsevier Ltd 2013; 20(9): 1232-6. http://dx.doi.org/10.1016/j.jocn.2013.01.004

Akakin A, Urgun K, Eksi MS, Yapicier O, Mestanoglu M, Toktas ZO, et al. Falcine myxoid chondrosarcoma: a rare aggressive case. Asian J Neurosurg 2018; 13: 68-71. https://doi.org/10.4103/1793-5482.181116

Bosma JJ, Kirollos RW, Broome J, Eldridge PR. Primary intradural classic chondrosarcoma: Case report and literature review. Neurosurgery 2001; 48: 420-423.

Frisch S, Timmermann B. The evolving role of proton beam therapy for sarcomas. Clin Oncol (R Coll Radiol) 2017; 29: 500-506. https://doi.org/10.1016/j.clon.2017.04.034

Demizu Y, Mizumoto M, Onoe T, Nakamura N, Kikuchi Y, Shibata T, et al. Proton Proton beam therapy for bone sarcomas of the skull base and spine: A retrospective nationwide multicenter study in Japan. Cancer Sci 2017; 108: 972-977. https://doi.org/10.1111/cas.13192

Li D, Weng JC, Zhang GJ, Hao SY, Tang J, Zhang LW, et al. Proposed treatment paradigm for intracranial chondrosarcomas based on multidisciplinary coordination. World Neurosurg 2018; 109: e517-e530. https://doi.org/10.1016/j.wneu.2017.10.013

Gatfield ER, Noble DJ, Barnett GC, Early NY, Hoole ACF, Kirkby NF, et al. Tumour volume and dose influence outcome after surgery and high-dose photon radiotherapy for chordoma and chondrosarcoma of the skull base and spine. Clin Oncol (R. Coll. Radiol.) 2018; 30: 243-253. https://doi.org/10.1016/j.clon.2018.01.002

Mattke M, Vogt K, Bougatf N, Welzel T, Oelmann-Avendano H, Hauswald H, et al. High control of proton- and carbon ion-beam treatment with intensity-modulated active raster scanning in 101 patients with skull base chondrosarcoma at the Heidelberg ion beam therapy center. Cancer 2018. https://doi.org/10.1002/cncr.31298

Raza SM, Gidley JM, Neis JM, Grosshans DR, Bell D, De Monte F. Multimodality treatment of skull base chondrosarcomas: the role of histology specific treatment protocols. Neurosurgery 2017; 81: 520-530. https://doi.org/10.1093/neuros/nyx042

Yakkioui Y, Speel EM, Van Overbeeke JJ, Boderie MJM, Pujari S, Hausen AZ, et al. Oncogenic viruses in skull base chordomas. World Neurosurg 2017.

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