Ahmed Noman, Hassan Ahmad, Aziz Hafiza Fatima, Enam S Ather
Department of Neurosurgery, Aga Khan University Hospital, Karachi, Sindh, Pakistan.
Department of Surgery, Aga Khan University Hospital, Karachi, Sindh, Pakistan.
Surg Neurol Int. 2025 Aug 22;16:350. doi: 10.25259/SNI_319_2025. eCollection 2025.
Chondromas are benign tumors accounting for 0.2-0.3% of all intracranial tumors. They are composed of embryonic cartilaginous material and mostly occur in extradural locations or less frequently in paranasal sinuses, choroid plexus, and dura. In this report, we present a case where a young patient presented with bifrontal parafalcine chondroma.
A 32-year-old female presented with headache for the past 2 years along with blurry vision and forgetfulness for the past 2 months. Magnetic resonance imaging (MRI) brain showed a bifrontal mixed-intensity lesion located in the parasagittal region on T2-weighted sequence with areas of hypo and hyperintensities. The lesion showed areas of heterogeneous contrast enhancement. She underwent neuronavigation-guided bifrontal craniotomy and maximum safe resection of the lesion. Postoperative MRI showed near total resection of the lesion along with development of acute infarcts in bilateral frontotemporal lesion. Her postoperative course was complicated by anterior cerebral artery territory infarcts, contributing to low Glasgow Coma Scale and left-sided weakness. She experienced recurrent seizures and respiratory complications, necessitating elective tracheostomy. After a 25-day hospital stay, she was discharged. At 4-month follow-up, she showed significant neurological improvement, including resolution of lower-limb weakness and tracheostomy removal. However, MRI suggested tumor recurrence, which remained stable at 6- and 9-month follow-ups.
Intracranial chondromas are rare neoplasms of the skull mostly presenting in the third decade of life. They are slow growing and can gain enormous size leading to chronic symptoms, particularly long-standing headaches. There is high variability in the location of these tumors, and our analysis suggests that more than 30% of the tumors arise from convexity. Chondromas are a rare entity which makes it difficult to distinguish from craniopharyngioma, pituitary adenoma, and meningioma, so these should be considered as important differentials. Our literature review showed 73.3% of the chondromas appeared hypointense on T1 sequence and 46.7% were found to be heterogenous on T2 sequence which aligns with previous studies. Gross total resection is the gold standard treatment while the role of radio and chemotherapy remains controversial.
软骨瘤是良性肿瘤，占所有颅内肿瘤的0.2 - 0.3%。它们由胚胎软骨组织构成，大多发生于硬膜外部位，较少见于鼻窦、脉络丛和硬脑膜。在本报告中，我们呈现了一例年轻患者出现双侧额部矢旁软骨瘤的病例。
一名32岁女性，过去2年一直头痛，近2个月出现视力模糊和记忆力减退。脑部磁共振成像（MRI）显示，在T2加权序列上，位于矢旁区域的双侧额部混合强度病变，有低信号和高信号区域。该病变有不均匀的对比增强。她接受了神经导航引导下的双侧额部开颅手术，并对病变进行了最大程度的安全切除。术后MRI显示病变几乎完全切除，同时双侧额颞部病变出现急性梗死。她的术后病程因大脑前动脉供血区梗死而复杂化，导致格拉斯哥昏迷评分较低和左侧肢体无力。她出现反复癫痫发作和呼吸并发症，需要进行选择性气管切开术。住院25天后，她出院了。在4个月的随访中，她的神经功能有显著改善，包括下肢无力症状消失和气管切开管拔除。然而，MRI提示肿瘤复发，在6个月和9个月的随访中保持稳定。
颅内软骨瘤是颅骨的罕见肿瘤，大多在生命的第三个十年出现。它们生长缓慢，可长得很大，导致慢性症状，尤其是长期头痛。这些肿瘤的位置高度可变，我们的分析表明，超过30%的肿瘤起源于脑凸面。软骨瘤是一种罕见的疾病，难以与颅咽管瘤、垂体腺瘤和脑膜瘤区分，因此应将这些视为重要的鉴别诊断。我们的文献综述显示，73.3%的软骨瘤在T1序列上呈低信号，46.7%在T2序列上呈不均匀信号，这与先前的研究一致。全切除是金标准治疗方法，而放疗和化疗的作用仍存在争议。
