Distinguishing Falcine Chondrosarcomas from Their Mimics and Management

• Published in: World neurosurgery Vol. 118; pp. 279 - 283
• Main Authors: Omezine, Sana, Bouali, Sofiene, Taallah, Marouen, Zehani, Alia, Kallel, Jalel, Jemel, Hafedh
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-10-2018
• Subjects: Adult; Brain Neoplasms - diagnostic imaging; Brain Neoplasms - surgery; Chondroma; Chondrosarcoma - diagnostic imaging; Chondrosarcoma - surgery; Craniotomy - methods; Diagnosis, Differential; Disease Management; Dura Mater - diagnostic imaging; Dura Mater - surgery; Falx chondrosarcoma; Follow-Up Studies; Humans; Intracranial tumor; Male; Meningeal Neoplasms - diagnostic imaging; Meningioma; Meningioma - diagnostic imaging; Mesenchymal chondrosarcoma; CT; Chondroma; Falx chondrosarcoma; MRI; Mesenchymal chondrosarcoma; Intracranial tumor; Meningioma
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2018.06.164

Primary intracranial chondrosarcoma is an extremely rare malignant tumor of the central nervous system, which accounts for <0.16% of all primary intracranial tumors. This rare tumor has a high associated morbidity from the tumor itself as well as from treatment modalities.
A 33-year-old man presented with a diffuse headache of 3 months' duration. He was admitted to our department with weakness in the right extremities that had persisted for more than a month. Findings of the neurologic examination revealed right hemiparesis. Cranial magnetic resonance imaging demonstrated a well-demarcated, parasagittal left frontal mass, which compressed to the lateral ventricle. It was hypointense on T1-weighted and hyperintense on T2-weighted images without creating edema in the surrounding tissue. A left frontoparietal craniotomy with complete excision of the mass was performed. The postoperative period was uneventful, and patient was discharged on the fourth postoperative day without any neurologic deficit. Histopathology showed a morphology that was in favor of chondrosarcoma grade 1.
Dural chondrosarcoma is a possible entity in the differential diagnosis of a presumed meningioma, particularly when atypical features are present. We report a grade 1 intracranial chondrosarcoma of the classical subtype without any neurologic problems after complete surgical excision. The patient did not receive any adjuvant therapy and at 26 months' follow-up showed no recurrence.
•Primary intracranial chondrosarcoma is a rare and poorly characterized tumor in adult population.•A review of the literature regarding this rare entity shows that only 18 cases have been reported.•We discuss potential “pitfalls” in the management of patients with this unusual pathologic entity.