Delayed Diagnosis and Multimodality Management of a Primary Myxoid Chondrosarcoma of the Skull Base: A Case Report

A myxoid chondrosarcoma involving the skull base is an uncommon malignant tumor that can closely resemble more frequent sellar and parasellar lesions, making diagnosis and treatment challenging. We report the case of a 41-year-old man who presented with progressive headache and visual impairment and was found to have a large skull base mass extending into adjacent intracranial compartments with compression of the optic pathway. Owing to the tumor's location and extensive neurovascular involvement, maximal safe resection was performed through a transcranial approach. Histopathologic findings favored a diagnosis of a myxoid chondrosarcoma, although immunohistochemical and molecular characterization could not be performed because of resource limitations. Histologic grade, Ki-67 proliferation index, and ancillary pathological studies were not assessable because of limited diagnostic resources. The postoperative course was complicated by transient diabetes insipidus, which responded to medical treatment, and adjuvant radiotherapy was administered for the residual tumor. This case highlights the importance of considering myxoid chondrosarcomas in the differential diagnosis of atypical sellar and parasellar masses and emphasizes the role of individualized surgical planning combined with adjuvant radiotherapy to optimize management when complete resection is not feasible.