Chondrosarcoma of the sella turcica: Case report and review

Abstract

Background: Chondrosarcomas are rare, cartilage-producing, malignant mesenchymal tumors that typically develop in the bone or surrounding soft tissues. Chondrosarcomas of the midline skull base are particularly rare, with a small subset presenting as lesions of the sella and parasellar region.Evidence acquisition: We present a primary intrasellar chondroscarcoma with cavernous sinus invasion. We review the literature for case reports of the sella, parasellar, and cavernous sinus regions through a PubMed search. We also review the literature for recommended treatment of this type of lesion including chemotherapeutics and radiation. Results: A 57-year-old man presented with a 5-month history of progressive binocular horizontal diplopia. On physical exam, he had esotropia and isolated abduction palsy of the right eye along with intact visual acuity. Imaging demonstrated a contrast-enhancing heterogeneous mass involving the right aspect of the sella turcica and right cavernous sinus. He underwent resection of the tumor via an expanded endoscopic endonasal approach without complications, and histopathology was consistent with a low-grade chondrosarcoma.Chondrosarcomas of the sella and parasellar region are particularly uncommon and may mimic pituitary adenoma in both clinical and radiographic presentation. Complete surgical resection followed by adjuvant radiotherapy is recommended due to the high incidence of tumor recurrence. Conclusion: Albeit rare, chondrosarcoma should be included in the differential diagnosis of pituitary region masses and be treated through resection and adjuvant radiotherapy.

Keywords

• Chondrosarcoma
• Sella turcica
• Endoscopic endonasal approach
• Sellar tumor
• Skull base tumor