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Skull Base Chondrosarcoma Presenting with Hemorrhage

Published online by Cambridge University Press:  02 December 2014

Gary L. Gallia ,
Zev A. Binder ,
Jacob Schwarz ,
John L. Moriarity  and
Jon D. Weingart
Gary L. Gallia*
Affiliation:
Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, MD
Zev A. Binder
Affiliation:
Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, MD
Jacob Schwarz
Affiliation:
Neurosurgery Associates, Nashville, TN
John L. Moriarity
Affiliation:
Mississippi Neurosurgery and Spine Center, Flowood, MS, USA
Jon D. Weingart
Affiliation:
Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, MD
*
Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, Maryland, 21287, USA.
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A 34-year-old white man with a six month history of a feeling of déjà vu presented with an acute onset of headache and blurred vision associated with nausea and vomiting. Neurological examination was significant for a right third cranial nerve palsy. Computerized tomography (CT) demonstrated a 2.0 cm rim calcified right paracavernous mass with intratumoral hemorrhage and an adjacent 2.6 cm by 2.0 cm right temporal lobe hematoma. Intraventricular hemorrhage (IVH) was present in both lateral ventricles, right more than left (Figure 1). Diagnostic cerebral angiography demonstrated no evidence of aneurysm. Brain magnetic resonance (MR) imaging revealed a 2 cm mass in the right paracavernous region extending into the suprasellar region with heterogeneous signal intensity on T1- and T2-weighted images and heterogeneous enhancement after gadolinium administration. Adjacent to the lesion was a right temporal lobe hematoma; intraventricular hemorrhage was also observed in the right lateral ventricle (Figure 2). The patient underwent a right pterional craniotomy for gross total resection of the tumour. Histopathological examination of the tumour demonstrated a low grade hyaline chondrosarcoma. The patient subsequently underwent proton beam radiotherapy and is currently 82 months out from surgery with no evidence of recurrence.

Type
Other
Information
Canadian Journal of Neurological Sciences , Volume 36 , Issue 6 , November 2009 , pp. 774 - 775
Copyright
Copyright © The Canadian Journal of Neurological 2009

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