Spinal drop metastasis from grade I skull base chondrosarcoma.
Chondrosarcoma of the skull base is a rare tumour with a good prognosis following surgical resection. We describe a patient with low-grade chondrosarcoma of the skull base with intradural extramedullary spinal metastases. A 31-year-old female with grade 1 chondrosarcoma involving the cavernous sinus, sphenoid wing and clivus presented at age 19. The tumour was subtotally excised at initial surgery and over the following 4 years, 3 subsequent resections were undertaken for tumour progression followed by proton beam radiotherapy to the residual tumour. The patient re-presented with cervical radiculopathy 7 years later. MRI showed multiple, intradural extramedullary spinal drop metastases. Following surgical excision of the symptomatic lesion, histological diagnosis was confirmed as a mixed hyaline/myxoid grade 1 chondrosarcoma. Patients with skull base chondrosarcoma with intradural extension should have whole spine imaging as part of long-term monitoring to exclude drop metastases, particularly after intradural surgery.
Department of Neurosurgery, Austin Hospital, PO Box 5555, Heidelberg, Victoria 3084, Australia. drndphall@mac.com
Nick D P
ND
Hall
Gavin
G
Fabinyi
Shahid M
SM
Gul
Lawrence
L
Cher
Norbert J
NJ
Leibsch
D000328:Adult; D002426:Cavernous Sinus / Q000473:pathology / Q000601:surgery; D002574:Cervical Vertebrae / Q000473:pathology* / Q000601:surgery; D002813:Chondrosarcoma / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D035301:Cranial Fossa, Middle / Q000473:pathology / Q000601:surgery; D003388:Cranial Fossa, Posterior / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009362:Neoplasm Metastasis / Q000473:pathology* / Q000628:therapy; D019635:Neurosurgical Procedures / Q000379:methods; D010292:Paresthesia / Q000209:etiology; D011843:Radiculopathy / Q000209:etiology; D011878:Radiotherapy / Q000379:methods; D012658:Sella Turcica / Q000473:pathology / Q000601:surgery; D019291:Skull Base / Q000473:pathology* / Q000601:surgery; D019292:Skull Base Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D013100:Sphenoid Bone / Q000473:pathology / Q000601:surgery; D013117:Spinal Cord Compression / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D013125:Spinal Neoplasms / Q000556:secondary* / Q000601:surgery; D016896:Treatment Outcome