Jiang Hao Tian, Wang Pan, Wang Jun Wei, Liu Jie, Tang Chao, Zhang Gang, Pan Jin Yu, Geng Hao Fei, Wu Nan
Department of Neurosurgery, Chongqing General Hospital, Chongqing 401147, P.R. China.
Graduate Institute, Chongqing Medical University, Chongqing 400016, P.R. China.
Oncol Lett. 2023 Oct 3;26(5):498. doi: 10.3892/ol.2023.14085. eCollection 2023 Nov.
Intracranial primary chondrosarcomas are rare, accounting for <0.15% of all intracranial tumors, but exhibit a high risk of recurrence. Due to the rarity of this condition, it has proven difficult to establish efficacy-based treatment guidelines. The present study details a case of clivus chondrosarcoma exhibiting no recurrence following surgical resection using an endoscopic transsphenoidal approach and postoperative adjuvant radiotherapy. A 41-year-old female presented with primary symptoms of left eye esotropia, scotoma of the left nasal visual field and double vision. Preoperative cranial magnetic resonance imaging revealed a lesion on the clivus, which was initially diagnosed as chordoma. However, clivus chondrosarcoma was ultimately diagnosed based on intraoperative findings and postoperative histopathology. The tumor was totally resected and 25 doses of adjuvant radiotherapy with planning gross tumor volume (60 Gy) and planning clinical target volume (50 Gy) were administered for 5 weeks. The patient was discharged at 12 days post-surgery with no obvious postoperative complications. Over the 28-month follow-up period, there was no evidence of recurrence, which may be due to the successful use of combined gross total resection and adjuvant radiotherapy. Therefore, surgical resection using an endoscopic transsphenoidal approach and postoperative adjuvant radiotherapy is an effective method for treating intracranial clivus chondrosarcoma.
颅内原发性软骨肉瘤较为罕见，占所有颅内肿瘤的比例不到0.15%，但复发风险很高。由于这种疾病罕见，已证明难以制定基于疗效的治疗指南。本研究详细介绍了一例斜坡软骨肉瘤病例，采用内镜经蝶窦入路手术切除并术后辅助放疗后未复发。一名41岁女性出现左眼内斜视、左鼻侧视野暗点和复视等主要症状。术前头颅磁共振成像显示斜坡有病变，最初诊断为脊索瘤。然而，最终根据术中发现和术后组织病理学诊断为斜坡软骨肉瘤。肿瘤被完全切除，并给予25次辅助放疗，计划靶体积（60 Gy）和计划临床靶体积（50 Gy），为期5周。患者术后12天出院，无明显术后并发症。在28个月的随访期内，没有复发迹象，这可能是由于成功采用了全切除联合辅助放疗。因此，内镜经蝶窦入路手术切除并术后辅助放疗是治疗颅内斜坡软骨肉瘤的有效方法。
