Rare case report and literature review of intracranial mesenchymal chondrosarcoma

Abstract

Intracranial mesenchymal chondrosarcoma (IMC) is a rare primary malignant tumor in the skull, but mostly originates from the abnormal residual chondrocytes in the embryonic period, which grow slowly, and primarily occurs at the junction of the cartilage of the skull base. IMC is difficult to diagnose by preoperative imaging and is easily misdiagnosed. It needs to be differentiated from meningiomas, gliomas, hemangioma, fibroids, etc.; this article introduces a case of primary IMC in a 38-year-old female teacher, and reviews the literature on the diagnosis and treatment of symptoms. The patient suffered from persistent severe headaches without nausea and vomiting. There was no obvious abnormality in the physical examination. Magnetic resonance imaging (MRI) of the head showed a circular space-occupying lesion on the right frontal bone and forehead; the mass was approximately 5.9 cm × 5.2 cm × 5.5 cm, and there was a large edema band surrounding it. The space-occupying effect was obvious; bilateral ventricles were compressed, and on the right side, the midline structure was shifted to the left. The patient was initially diagnosed with simple meningioma. After admission, the right frontal lobe meningioma was resected under general anesthesia, and the tumor tissue was completely removed in blocks. The postoperative pathology report stated: malignant tumor of the right frontal lobe; consider mesenchymal chondrosarcoma. Following a difficult pathological consultation at the Provincial Medical Association, the tumor was found to be consistent with mesenchymal chondrosarcoma. Intracranial chondrosarcoma is a very rare malignant tumor. Other intracranial masses, such as meningioma and glioma, should be distinguished through differential diagnosis. At present, more attention is paid to surgical intervention and combined radiotherapy and chemotherapy for the treatment of IMC, which should also be the future treatment option.