Sindou M, Daher A, Vighetto A, Goutelle A
Hôpital Neurologique et Neurochirurgical Pierre-Wertheimer, Lyon.
Neurochirurgie. 1989;35(3):186-90.
Cartilaginous tumours represent 0.16% of all intracranial tumours; among them 14% are chondrosarcomas (Ch-S). A majority (56%) arise from the skull base, especially from the spheno-occipital and spheno-temporal synchondroses. The others develop at the level of the dura mater convexity, falx and choroid plexuses, probably from ectopic cartilages or mesenchymatous cells with multiple potentialities. Parasellar Ch-S originate from the spheno-temporal synchondrosis and expand inside the cavernous region. With 21 published cases, they represent 51.2% of the 41 skull base Ch-S and 28.7% of the whole 73 intracranial primary Ch-S. The authors report a recent case of such a parasellar Ch-S, revealed by a left progressive, and finally total, ophthalmoplegia. The responsible mass, which eroded the lateral part of the sella turcica, was shown partially calcified and not enhanced by contrast medium at CT-scan, and was avascular on angiogram. The tumour, which was identified as a low grade myxoid Ch-S, could be entirely removed through an intradural pteriono-temporal approach. After a two-year follow-up, the clinical status was unchanged (total ophthalmoplegia) and the CT-scan did not show any sign of recurrence. The 21 cases of parasellar Ch-S published in the literature are reviewed.
软骨肿瘤占所有颅内肿瘤的0.16%；其中14%为软骨肉瘤（Ch-S）。大多数（56%）起源于颅底，尤其是蝶枕和蝶颞软骨结合处。其他的则发生在硬脑膜凸面、大脑镰和脉络丛水平，可能起源于异位软骨或具有多种潜能的间充质细胞。鞍旁Ch-S起源于蝶颞软骨结合处，并向海绵窦区域内扩展。在已发表的21例病例中，它们占41例颅底Ch-S的51.2%，占全部73例颅内原发性Ch-S的28.7%。作者报告了1例近期的鞍旁Ch-S病例，表现为左侧进行性、最终完全性眼肌麻痹。责任肿块侵蚀了蝶鞍外侧部分，CT扫描显示部分钙化，增强造影剂后无强化，血管造影显示无血管。该肿瘤被确定为低级别黏液样Ch-S，可通过硬脑膜内翼点-颞部入路完全切除。经过两年的随访，临床状态未改变（完全性眼肌麻痹），CT扫描未显示任何复发迹象。本文对文献中报道的21例鞍旁Ch-S病例进行了综述。
