Intracranial solitary chondroma. Case report

Giant Intracranial Chondroma

Intracranial chondroma is extremely rare. The treatment of choice is total tumor excision when resectable. A 30-year-old female patient presented with a giant intracranial chondroma that had enlarged for 18 years. In this case, we totally removed the tumor and reconstructed the meninges, cranium, and left ear using fascia lata, a combination of titan mesh and cement, and the posterior auricular artery axial flap, respectively. The aesthetic outcome was acceptable. No recurrence was identified after 7 months of follow-up. The patient was satisfied with the outcome. The lack of access to high-tech tools, such as 3-dimensional simulation, makes preoperative planning more difficult. Total tumor removal is currently the treatment of choice when the mass is resectable. It is a safe surgery, and with proper reconstruction procedures, an acceptable appearance can be achieved. Further multicenter studies with a greater sample size are needed to make a systematic treatment approach for intracranial chondroma.

Falcine chondroma: illustrative case

BACKGROUND

Chondromas are benign cartilaginous tumors that are rarely seen in the brain.

OBSERVATIONS

A 58-year-old woman had undergone routine brain imaging after a motor vehicle accident and was incidentally found to have a right falcine lesion. Contrast magnetic resonance imaging showed a mostly nonenhancing mass with discontinuous rim enhancement. She was taken to the operating room and pathology revealed a chondroma.

LESSONS

Falcine intracranial chondromas are rare and typically misdiagnosed as meningiomas. Chondromas should be in the differential for patients presenting with nonenhancing falcine lesions.

Chondroma of the falx cerebri: A case report and review of literature

Chondroma is a benign cartilage-forming tumor which usually occurs in small bones of extremities but occasionally occurs in the brain. Usually, intracranial chondromas originate from skull base; however, chondroma of the falx cerebri is a very rare condition. We here report a rare case of falcine chondroma in a 19-year-old man who had normal physical examination without signs of any syndromic disorder. The neuroimaging findings were inconclusive, and the diagnosis was based on histopathological examination. The purpose of this paper is to raise attention about intracranial chondromas and suggest that chondroma must be ruled out in any patient presenting with masses arising from the falx.

Chondroma of the Falx Cerebri with Central Cystic Degeneration and Hemorrhage: A Case Report

Patient: Male, 44

Final Diagnosis: Falx cerberi chondroma

Symptoms: Headache

Medication: —

Clinical Procedure: Resection of the tumor

Specialty: Neurosurgery

Intracranial extra-axial chondroma: a case report

Intracranial chondroma is a rare benign neoplasm that occurs most often at the skull base. In extremely rare instances, it arises from the dura mater of the convexity or from the falx cerebri. The tumor cells are thought to originate from meningeal fibroblasts, perivascular mesenchymal tissue, or ectopic chondrocytes. Because the clinical presentation of such cases is nonspecific and because neuroimaging findings are not pathognomonic, intracranial chondromas mimic other intracranial tumors. Herein, we report a chondroma originating from the dura mater in the frontal region. The patient had been followed-up radiologically for 3 years after a preliminary diagnosis of meningioma until the correct diagnosis of chondroma was established with postoperative histological examination.

Giant convexity chondroma with dural involvement: Case report and review of literature

Intracranial chondromas are rare benign cartilaginous tumors arising usually from the skull base. We present a case of giant chondroma with dural attachment. Imaging modalities and management pearls are discussed. A brief review of literature is also presented.

Giant Chondroma of the Saddle Area: Case Report and Literature Review

A 63-year-old man presented with sexual dysfunction of 6-year duration, 5-year history of bilateral vision loss, and left nasal obstruction for 3 years. Brain computed tomography and magnetic resonance imaging showed a large mass lesion in the saddle area and extending upward to the dorsum sellae, bilateral cavernous sinus, and suprasellar region, and down into the sphenoid sinus and nasal cavity; the optic nerves and optic chiasm were elevated upward and compressed. Endocrine tests indicated that all serum level of anterior pituitary hormones decreased. The preoperative diagnosis included invasive pituitary adenoma, chordoma, osteosarcoma, chondrosarcoma, and craniopharyngioma. The tumour was subtotally removed through transsphenoidal approach. Histopathology examination revealed a chondroma. Postoperatively, the patient was stable and his visual acuity and visual field defect improved and his pituitary function return to normal except for hypothyroidism.

Characteristic CT and MRI findings of intracranial chondroma

BACKGROUND

Intracranial chondromas are rare benign tumors. To date, few data are available on their neuroradiological features.

PURPOSE

To describe a series of patients with intracranial chondroma and to analyze and discuss the computed tomography (CT) and magnetic resonance imaging (MRI) features that may distinguish chondromas from other intracranial neoplasms.

MATERIAL AND METHODS

We retrospectively analyzed clinical and medical imaging data of six patients who had pathologically confirmed intracranial chondromas in our two institutions between July 2006 and September 2011. Both CT and MRI scanning were performed in all six cases.

RESULTS

Five tumors were located at the skull base and one originated from the falx. CT images revealed well-demarcated, irregular lobulated and variable density masses with obvious calcification (6/6), no or slight enhancement, without peritumoral edema, and frequently accompanied by erosion and destruction of surrounding bone (5/6). Tumor parenchyma appeared heterogeneously hypointense on T1WI, and hyperintense or mixed hyperintense and hypointense on T2WI, while the calcification appeared hypointense on T1WI and T2WI in five cases, demonstrating significant inhomogeneous enhancement on postcontrast MRI, which revealed the typical "punica granatum seeds" sign. Only one case showed homogeneous low signal intensity on T1WI and high signal intensity on T2WI, and relatively uniform obvious enhancement on postcontrast scans.

CONCLUSION

These characteristic CT and MR findings, combined with the location of the lesions and the history of a long duration of clinical symptoms, may prove helpful in differentiating intracranial chondromas from other more common tumors.

Solitary intracerebral chondroma without meningeal attachment: a case report with review of the literature

Intracranial chondromas are rare, benign cartilaginous tumours that account for < 0.3% of primary intracranial tumours. They usually originate from the basal synchondrosis and are extradural though, extremely rarely, they can be intracerebral. Here the case of a 45-year old female is presented with a solitary intracerebral chondroma located in the right frontal lobe with no meningeal attachment. The epidemiology, aetiology, clinical behaviour, radiological features, histological features and treatment of the case are discussed with a review of previous cases reported in the literature.

Chondrosarcoma of the skull base: report of six cases

Five patients with chondrosarcoma, grade I or II, and one with mesenchymal chondrosarcoma of the skull base were treated at our clinic between 1967 and 1991. The patients were three men and three women who ranged in age from 21 to 39 years. The presenting symptoms were diplopia, decreased visual acuity, or symptoms of involvement of VIIIth and lower cranial nerves. The duration of the symptoms ranged from 18 months to 14 years. A plain skull x-ray and tomography of the skull, computed tomographic (CT) scans, and magnetic resonance images (MRI) revealed a calcified mass. Angiograms showed an occlusion of the arteries or venous sinuses, or both, in four patients, and a distinct tumor stain in one. The tumors were subtotally removed in all six cases. Two patients received postoperative irradiation for the residual tumor. In one patient, extraocular movement was compromised postoperatively, although in the other five patients there was no aggravation of the neurologic signs. Follow-up CT scans and MRI demonstrated no recurrent tumors nor any enlargement of residual tumors. Based on these findings, we advocate aggressive surgical removal of these tumors, which should be augmented by radiation therapy if the postoperative CT scans or MRI reveal residual tumors.

Spinal drop metastasis from grade I skull base chondrosarcoma

Chondrosarcoma of the skull base is a rare tumour with a good prognosis following surgical resection. We describe a patient with low-grade chondrosarcoma of the skull base with intradural extramedullary spinal metastases. A 31-year-old female with grade 1 chondrosarcoma involving the cavernous sinus, sphenoid wing and clivus presented at age 19. The tumour was subtotally excised at initial surgery and over the following 4 years, 3 subsequent resections were undertaken for tumour progression followed by proton beam radiotherapy to the residual tumour. The patient re-presented with cervical radiculopathy 7 years later. MRI showed multiple, intradural extramedullary spinal drop metastases. Following surgical excision of the symptomatic lesion, histological diagnosis was confirmed as a mixed hyaline/myxoid grade 1 chondrosarcoma. Patients with skull base chondrosarcoma with intradural extension should have whole spine imaging as part of long-term monitoring to exclude drop metastases, particularly after intradural surgery.

Intracranial falcine and convexity chondromas: two case reports

Intracranial chondromas are uncommon intracranial tumours that most frequently arise from the skull base. They can, however, arise from the calvarium or the meninges. In these cases their neuroradiological features may mimic other intracranial tumours. We present two cases of intracranial chondroma, one that originated from the convexity and the other from the falx. Total excision was achieved in both cases. The literature on intracranial chondromas is reviewed.

Intratentorial osteochondrolipoma in a 9-year-old boy

Intracranial osteolipomas and chondromas are rare benign tumors. Forty-five chondromas, mostly supratentorial, have been reported in the literature since 1981, with origins most commonly in the sellar regions. Twenty-one osteolipomas have been described to date, usually located near the tuber cinereum or the corpus callosum. The authors present a case of an osteochondrolipoma arising from the tentorium diagnosed in a pediatric patient at the age of 9 years. The case and treatment are discussed, and a review of the literature is provided.

Periosteal chondroma of the pediatric cervical spine

Periosteal chondromas located in the spine are rare. The authors document an even more infrequent occurrence of a recurrent periosteal chondroma in the cervical spine of a 6-year-old boy. During the operation, a giant (>7 cm in diameter) periosteal chondroma with involvement of the C-5 and C-6 vertebral bodies was resected. The vertebral column was reconstructed with anterior-posterior instrumentation. The pathological examination revealed that the tumor consisted of chondroid tissue with typical chondrocytes, confirming the diagnosis of periosteal chondroma.

Intracranial falx chondroma: Literature review and a case report

Intracranial chondromas are benign tumors that represent approximately 0.5% of all intracranial tumors. They usually occur at the base of the skull but on rare occasions might present as intra-parenchymal or intra-ventricular space-occupying lesions, most likely originating from heterotopic chondrocytes or metaplastic fibroblasts of the falx, the convexity dura, or the ventricular ependyma. Chondromas are slow-growing tumors, which remain clinically silent for a prolonged period of time in the majority of cases. Their clinical presentation is non-specific and their radiographic appearance usually does not differentiate them from their more common counterparts, such as meningiomas and glial tumors. As a result, their diagnosis has remained a histopathologic one. In our current study, we present a case of a falcine intracranial chondroma. This case provided the opportunity to extensively review the pertinent literature.

Chondromas of the falx cerebri and dural convexity: report of two cases and review of the literature

Intracranial chondromas usually arise from the base of the skull. They rarely originate from the convexity dura and falx. Here we describe two cases of intracranial chondroma located at the convexity dura and falx, discuss the genesis, radiologic, histologic features and review the literature.

Intracranial chondrosarcoma: a case report and review of the literature

OBJECTIVE AND IMPORTANCE

Chondrosarcomas rarely occur intracranially away from the skull base. We present a case of a supratentorial dural-based, low-grade classic chondrosarcoma and emphasize salient imaging findings that assist in its diagnosis.

CLINICAL PRESENTATION

A 23-year-old female presented with new onset seizures. Multiple radiographic imaging studies identified a large left frontal mass with radiological findings that suggested the correct diagnosis.

INTERVENTION

The patient underwent a left frontal craniotomy and gross total resection of the lesion and associated dura.

CONCLUSION

Intracranial chondrosarcomas away from the skull based are extremely rare malignancies. As with other extra-axial masses, they often grow to a relatively large size before generating symptoms. Careful analysis of CT, MR, and angiographic imaging characteristics should suggest the correct diagnosis.

Convexity dural chondroma: a case report and review of the literature

The majority of intracranial chondromas arise from cartilage rests in the synchondrosis at the base of the skull. Chondromas are most commonly found in the sellar and parasellar regions, usually located extradurally. In rare instances, these tumours originate from the dura mater of the convexity. We report a rare case of a chondroma arising from the convexity dura mater. The origin of this tumour is analysed and the literature reviewed.

Giant chondroma arising from the dura mater of the convexity. Case report and review of the literature

Chondromas arising from the dura mater are rare intracranial tumors. The authors present a case of intracranial giant chondroma originating from the dura mater of the convexity. Neuroimaging and surgical findings are described. The diagnostic clues are discussed and similar cases from the literature are reviewed.

Intracranial low-grade chondrosarcoma with hyperostosis of the skull: a case report

We describe a case of intracranial chondrosarcoma in a 46-year-old woman. The preoperative diagnosis was meningioma as plain radiography and computed tomography of the head revealed a tumor with discrete calcifications predominantly in the right frontoparietal region and hyperostosis of the inner table of the skull overlying the tumor. However, the tumor was histologically composed of cartilaginous tissue without meningiomatous differentiation and the final diagnosis was a low-grade chondrosarcoma based on its histological appearance and size, together with the radiologic images. Intracranial chondrosarcoma occurring above the skull base is extremely rare and 19 cases were found in our literature review. Intracranial chondrosarcoma showing hyperostosis of the skull has not been reported in the cases. The discussion includes its differential diagnosis, origin, and clinical behavior.

A case of Ollier's disease associated with two intracerebral low-grade gliomas

Ollier's disease, or multiple enchondromatosis, is a deforming dysplastic disease of cartilage, characterized by multiple, asymmetrically distributed intra-osseous cartilaginous masses in the metaphyses and diaphyses of bones. When associated with soft tissue hemangiomas it is referred to as Maffucci's syndrome, in which the enchondromatosis has no unilateral distribution. The emergence of malignant neoplasms, including gliomas, is a well-recognized complication in Maffucci's syndrome. We report a 28-year-old patient with a history of Ollier's disease, who developed two low-grade cerebral gliomas as well as an intracranial chondroma. This case history questions the distinction between the two forms of enchondromatosis and supports a continuum between these disease entities.

[Falx osteochondroma: case report and review of the literature]

One case of an intracranial osteochondroma originating from the falx is described. The tumor was partially removed. Surgical aspects and etiopathogenesis of falx chondromas are discussed. The values of computerized tomography and magnetic resonance are emphasized.

Surgical removal of a cavernous sinus chondroma

BACKGROUND

Chondromas at the base of the skull are most commonly found in the parasellar and sellar regions, and present varying degrees of involvement of the cavernous sinus. However, those confined mainly to the cavernous sinus are rare, and only a few reports show detailed radiological and surgical findings.

MATERIALS AND METHODS

This 40-year-old woman experienced sudden right orbital pain followed by right third and sixth cranial nerve palsies. Computerized tomography scan and magnetic resonance image depicted a well-circumscribed mass in the right cavernous sinus. A frontotemporal craniotomy with orbito-zygomatic osteotomy was used to approach this lesion intradurally. We drilled away the anterior clinoid process using a high-speed air drill extradurally, exposed the intrapetrous carotid artery, and dissected the right sylvian fissure from the distal, fully exposing the surface of the right cavernous sinus. The soft and grayish tumor was easily removed using sucker and tumor forceps; the venous bleeding from the sinus itself was easily controlled.

RESULTS

The tumor was successfully removed via a superior triangle. Intradural invasion of the tumor and heavy venous bleeding from the sinus were not observed. Histologically, the mass was diagnosed as a mature chondroma. The tumor was presumed to originate from the right posterior clinoid process. The lesion was totally removed, and postoperative right ophthalmoplegia had fully disappeared within 6 months after surgery.

CONCLUSION

Successful surgical attack of lesions in the cavernous sinus requires comprehensive and precise knowledge of the microsurgical anatomy and neuroradiology.

Giant chondroma of the falx. Case report and review of the literature

The authors describe the radiological and pathological features in a patient with an intracranial chondroma originating in the falx cerebri. Diagnostic procedures and management in treatment are discussed, and a review of the literature is presented.

Intracranial chondroma. Report of two cases and review of the literature

INTRODUCTION

Chondromas are rare intracranial tumors. The authors present two cases of intracranial intradural chondroma, one originating from the falx cerebri and the other from the dura mater of the convexity.

METHOD AND RESULTS

Diagnostic procedures, including magnetic resonance imaging, and surgical findings are described. In both cases, pre-operative diagnosis could have been at least suspected, and the tumor was completely removed, without recurrence after a follow-up of many years. The pathogenesis and pathological findings are discussed, and cases from the literature are reviewed.

CONCLUSION

Benign intradural chondroma has a good prognosis, with no recurrence after surgical excision in most cases.

Chondromas of the spine: report of two cases and review of the literature

We report two cases of vertebral chondroma presenting with spinal cord compression. In one case there was ultimate malignant transformation.

Intracranial chondroma in a patient with Ollier's disease. Case report

A case is presented in which a solitary chondroma arose from the clivus of a patient with Ollier's disease. These tumors are rare. The diagnostic value of computerized tomography and magnetic resonance imaging is discussed.

Chondroma of the cervical spine

Chondroma is a benign cartilaginous tumor and rarely seen as a spinal cord tumor. The authors report a case of cervical chondroma with cord compression signs. After the total surgical removal of the lesion neurological recovery was seen, but one year later recurrence occurred with no sarcomatous transformation.

Chondroma of the cervical spine. Case report

The authors report a case of cervical chondroma presenting with a syndrome of spinal cord compression in a 76-year-old woman. Total surgical removal of the lesion was followed by partial neurological recovery. Chondromas of the vertebral column are rarely reported in the literature.

Parasellar chondroma: a case report

A case of a 19-year-old man with a right parasellar chondroma examined with computed tomography (CT) and nuclear magnetic resonance (NMR) scan is reported. The literature about CT and NMR scan findings of intracranial chondroma is reviewed. Typical CT findings are a round, high density mass with calcification, that is only slightly enhanced by contrast medium.