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Published on: June 13, 2018
Falcine and parasagittal chondrosarcomas
Michael Safaee1, Aaron J Clark, Tarik Tihan
1Department of Neurological Surgery, University of California, San Francisco, 505 Parnassus Ave., Room 779M, San Francisco, CA 94143-0112, USA.
Summary
Intracranial chondrosarcomas, rare skull base tumors, often arise from meninges. The mesenchymal subtype has worse outcomes, while classical subtypes and extraskeletal tumors generally have a good prognosis with surgical resection.
Area of Science:
- Neuro-oncology
- Surgical Pathology
Background:
- Intracranial chondrosarcomas are rare primary cartilaginous neoplasms, accounting for 6% of skull base tumors.
- Extraskeletal intracranial chondrosarcomas typically arise from the meninges (falx, tentorium, cerebral convexity).
- These tumors are classified as classical or mesenchymal, with the mesenchymal subtype linked to poorer prognoses.
Observation:
- This study presents an institutional series of falcine and parasagittal chondrosarcomas, supplemented by a literature review.
- The review identified 29 patients with falcine and parasagittal chondrosarcomas.
- Six recurrences were noted, predominantly in the mesenchymal subtype (five cases), with one recurrence in the classical subtype.
Findings:
- All reported deaths (n=3) occurred in patients with the mesenchymal subtype.
- Intracranial extraskeletal chondrosarcomas, despite challenges posed by skull base tumors, generally exhibit a favorable prognosis.
- Mesenchymal chondrosarcomas demonstrated significantly higher recurrence rates and mortality compared to the classical subtype.
Implications:
- Surgical resection alone is often sufficient for extraskeletal intracranial chondrosarcomas.
- Treatment strategies should be individualized based on tumor biology.
- Radiation therapy is primarily indicated for patients diagnosed with the aggressive mesenchymal subtype.
