Guo Jing, Fang Qiuyue, Cheng Jianhua, Li Chuzhong, Gui Songbai, Zhang Yazhuo, Cao Lei
Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
Department of Neurosurgery, Beijing Tiantan Hospital Affiliated to Capital Medical University, Beijing, China.
Biomed Res Int. 2020 Dec 17;2020:5961358. doi: 10.1155/2020/5961358. eCollection 2020.
Chondroma of the dural convexity (CDC) is a benign and extremely rare type of intracranial chondroma. In this study, we reported five CDCs in a single center and reviewed the available literature to determine the clinical characteristics and surgical outcomes and possible origins of the disease. The clinical data of five patients (4 females) who confirmed to be CDC between 2000 and 2019 in our single center was collected together with 22 cases from literatures. The clinical characteristics and surgical outcomes were reviewed and analyzed. Among all the available CDC cases, the mean age was 31 ± 13.7 years; the mean tumor volume was 42.3 ± 40.9 cm, showing a female predominance (63% vs. 37%). The tumors showed calcification in 88.2% cases (15/17) on CT scans and hypointense on T1WI (15/19, 78.9%), mixed intense on T2WI (10/18, 55.6%), and inhomogeneous enhancement without dural tail sign after administration of gadolinium (20/21, 95.2%). Almost all the tumors were misdiagnosed as meningiomas preoperatively. In addition, almost all image available CDC lesions (24/25, 96%) located across the cranial sutures indicating that the tumor originated from ectopic chondrocytes from adjacent skull sutures. No tumors recurred after total resection in follow-up. CDCs are characterized with female predominance and may originate from ectopic chondrocytes from adjacent skull sutures. The lesion with inhomogeneous contrast enhancement without dural tail sign and avascular in cerebral angiography are key points to be differentiated from meningioma. The most effective treatment is total resection.
硬脑膜凸面软骨瘤（CDC）是一种良性且极为罕见的颅内软骨瘤。在本研究中，我们报告了单中心的5例CDC病例，并回顾了现有文献以确定该疾病的临床特征、手术结果及可能的起源。收集了2000年至2019年在我们单中心确诊为CDC的5例患者（4例女性）的临床资料以及文献中的22例病例。对临床特征和手术结果进行了回顾与分析。在所有可得的CDC病例中，平均年龄为31±13.7岁；平均肿瘤体积为42.3±40.9 cm，女性占优势（63%对37%）。CT扫描显示88.2%的病例（15/17）肿瘤有钙化，T1WI呈低信号（15/19，78.9%），T2WI呈混合高信号（10/18，55.6%），注射钆剂后呈不均匀强化且无硬脑膜尾征（20/21，95.2%）。几乎所有肿瘤术前都被误诊为脑膜瘤。此外，几乎所有可获得影像的CDC病变（24/25，96%）跨越颅缝，表明肿瘤起源于相邻颅骨缝的异位软骨细胞。随访中全切后无肿瘤复发。CDC的特点是女性占优势，可能起源于相邻颅骨缝的异位软骨细胞。增强扫描不均匀强化且无硬脑膜尾征以及脑血管造影无血管的病变是与脑膜瘤鉴别的关键点。最有效的治疗方法是全切。
