Awad Mohammed, Gogos Andrew James, Kaye Andrew H
Department of Neurosurgery, The Royal Melbourne Hospital, 300 Grattan Street, Parkville, VIC 305, Australia.
Department of Neurosurgery, The Royal Melbourne Hospital, 300 Grattan Street, Parkville, VIC 305, Australia; Department of Surgery, The University of Melbourne, VIC, Australia.
J Clin Neurosci. 2016 Feb;24:1-5. doi: 10.1016/j.jocn.2015.10.029. Epub 2015 Dec 24.
Intracranial chondrosarcoma are rare tumours, accounting for approximately one in 1000 intracranial neoplasms. Although more common in the axial or appendicular skeleton, intracranial tumours present a challenging surgical and oncological problem. Chondrosarcoma have a predilection for the skull base and although commonly slow growing, Grade II and III lesions do occur. We present two illustrative patients from the Royal Melbourne Hospital, Australia, demonstrating dramatically differing presentation and clinical outcome and the diagnostic difficulties that may arise. A review of the literature regarding skull base chondrosarcoma is presented. We summarise the clinical, radiological and histological features. The evidence for surgical resection, radiotherapy and chemotherapy is presented and critically evaluated. Based on the available evidence, we advocate maximal safe resection, followed by radiotherapy for Grade II and III tumours. There is no current role for chemotherapy. Radical excision should not be attempted at the expense of neurological function.
颅内软骨肉瘤是罕见肿瘤，约占颅内肿瘤的千分之一。虽然在中轴骨或四肢骨骼中更常见，但颅内肿瘤带来了具有挑战性的手术和肿瘤学问题。软骨肉瘤好发于颅底，虽然通常生长缓慢，但确实会出现Ⅱ级和Ⅲ级病变。我们展示了来自澳大利亚皇家墨尔本医院的两名典型患者，他们表现出截然不同的症状和临床结果以及可能出现的诊断困难。本文还对有关颅底软骨肉瘤的文献进行了综述。我们总结了其临床、放射学和组织学特征。列出并批判性地评估了手术切除、放疗和化疗的证据。基于现有证据，我们主张最大程度的安全切除，随后对Ⅱ级和Ⅲ级肿瘤进行放疗。目前化疗没有作用。不应以牺牲神经功能为代价尝试根治性切除。
