Chondrosarcoma: Symptoms, Causes, Diagnosis, and Treatment - Aaron Cohen-Gadol, M.D.
Summary
TLDRNeurosurgeon Dr. Aaron Cohen Gadol discusses chondrosarcomas, rare skull-based tumors arising from cartilage cells. He explains these slow-growing but locally aggressive tumors, often recurring post-resection due to their adherence to surrounding structures. Common symptoms include visual issues, headaches, and hearing loss. Diagnosis involves CT scans, MRI, and possibly biopsies. Treatment primarily consists of surgical resection, supplemented by radiation and occasionally chemotherapy. Despite recurrence in 80-90% of cases, the five-year survival rate is positive, emphasizing the importance of specialized neurosurgical and skull-based expertise.
Takeaways
- π§ Chondrosarcomas are rare skull-based tumors that arise from cartilage cells of the bone.
- π These tumors grow slowly but can be locally aggressive and often recur after initial resection due to their tendency to adhere to surrounding structures.
- π Chondrosarcomas are less aggressive than chordomas but share similarities in location and nature.
- π₯ The incidence rate is very low, affecting one in 200,000 patients per year, and is more common in adults aged 40 to 70.
- π Symptoms of chondrosarcoma can include visual problems, headaches, vertigo, hearing loss, numbness, difficulty swallowing, and facial pain.
- π₯ For spinal location, symptoms may include lower back pain, numbness, changes in bowel or bladder function, and mobility issues.
- π Diagnostic tests typically involve CT scans for bone evaluation and MRI for soft tissue examination around the bone.
- π A biopsy may be performed prior to resection to confirm the diagnosis and assess the tumor's growth rate.
- βοΈ Treatment options include surgical resection, radiation therapy, and chemotherapy, often used in combination.
- π¨ββοΈ Surgical resection is the primary and most effective treatment, with surgeons often using a transveneral or craniotomy approach depending on the tumor's location.
- π‘ Adjuvant therapies like external beam radiation, proton beam radiation, and radiosurgery are used post-surgery to target residual tumor cells.
- π Chemotherapy is rarely used for chondrosarcomas and is typically reserved for patients with advanced disease.
- β οΈ Complications of surgery can include brain fluid leaks, loss of function in various bodily systems, and cranial nerve abnormalities.
- π The prognosis is positive, with approximately 80-90% of patients surviving and maintaining functional status at five years post-treatment.
Q & A
What is a chondrosarcoma?
-Chondrosarcomas are rare skull-based tumors that arise from the cartilage cells of the bone. They are slow-growing but can be locally aggressive and often recur after initial resection.
How rare are chondrosarcomas?
-Chondrosarcomas are very rare, affecting approximately one in 200,000 patients per year or one in a million in the population.
What age group is more commonly affected by chondrosarcomas?
-Chondrosarcomas are more commonly seen in older adults, specifically between the ages of 40 and 70.
What are some common symptoms of chondrosarcomas?
-Common symptoms include visual problems such as double vision, headaches, vertigo, hearing loss, numbness, difficulty swallowing, and facial pain. For tumors at the spine level, symptoms can include lower back pain, numbness, changes in bowel function, and mobility issues.
What diagnostic tests are typically used for chondrosarcomas?
-Diagnostic tests include computer tomography (CT) scans to evaluate the bone and magnetic resonance imaging (MRI) to review the soft tissues around the bone and see the extent of the tumor. Sometimes a biopsy is performed before resection to confirm the diagnosis and assess the tumor's growth rate.
What are the treatment options for chondrosarcomas?
-The treatment options for chondrosarcomas include surgical resection, radiation therapy, and chemotherapy. Surgical resection is the primary and most effective treatment, with the goal of removing as much of the tumor as possible.
How is the surgical resection of a chondrosarcoma typically performed?
-The surgical resection is often performed through a transveneral operation, where the surgeon goes through the nose. In some cases, a craniotomy may be performed to remove a piece of the skull and residual tumor.
What is the role of radiation therapy in the treatment of chondrosarcomas?
-Radiation therapy, including external beam radiation or proton beam therapy, is applied to the tumor bed after resection. It usually involves visits five times a week for several weeks.
Is chemotherapy commonly used for chondrosarcomas?
-Chemotherapy is rarely used for chondrosarcomas, as it is typically reserved for patients with advanced disease where the tumors are rapidly dividing.
What are some potential complications of chondrosarcoma surgery?
-Complications can include brain fluid leak through the nose, loss of bowel or brain function, loss of sexual function, pituitary function failure, numbness, movement problems, double vision, or other cranial nerve abnormalities.
What is the general prognosis for patients with chondrosarcomas?
-The outlook is positive, with approximately 80 to 90% of patients surviving and having a functional status at five years post-treatment.
Why is it important for patients with chondrosarcomas to see experienced specialists?
-It is important because the surgical anatomy in the region is very complicated, and maximizing tumor removal requires many years of experience on behalf of the surgeons involved.
Outlines
𦴠Chondrosarcoma Overview and Management
Dr. Aaron Cohen Gadol, a neurosurgeon, introduces chondrosarcomas as rare skull-based tumors arising from cartilage cells. He discusses their slow growth and potential for recurrence due to their invasive nature. Chondrosarcomas are less aggressive than chordomas and predominantly affect individuals aged 40 to 70. Common symptoms include visual problems, headaches, vertigo, hearing loss, and facial pain. Diagnostic tests such as CT scans and MRIs are used to assess the tumor's extent. Treatment primarily involves surgical resection, with the goal of removing as much of the tumor as possible, often through minimally invasive transvaginal operations or craniotomies. Additional treatments may include radiation and chemotherapy, though the latter is rarely used. The doctor emphasizes the importance of experience in managing these tumors.
π Post-Treatment Expectations and Surgical Challenges
The second paragraph focuses on the positive outlook for chondrosarcoma patients, with an 80 to 90 percent survival rate at five years. Dr. Cohen Gadol advises discussing post-treatment expectations with experienced surgeons and oncologists. He highlights the complexity of skull-based surgery and the need for extensive surgical experience to maximize tumor removal. The paragraph concludes with the doctor's willingness to be involved in patient care and a reminder of the importance of specialized care in managing these rare tumors.
Mindmap
Keywords
π‘Chondrosarcomas
π‘Neurosurgeon
π‘Skull-based tumors
π‘Resection
π‘Chordomas
π‘Symptoms
π‘CT Scan
π‘MRI
π‘Biopsy
π‘Surgical Resection
π‘Radiation Therapy
π‘Chemotherapy
π‘Complications
π‘Survival Rate
Highlights
Chondrosarcomas are rare skull-based tumors arising from cartilage cells of the bone.
They are slow-growing but can be locally aggressive and often recur after initial resection.
Chondrosarcomas are similar to but less aggressive than chordomas, another type of bone tumor.
These tumors typically occur at the skull base or the lower portion of the skull and near the spine.
Chondrosarcomas affect approximately one in 200,000 patients per year.
Symptoms include visual problems, headaches, vertigo, hearing loss, numbness, and facial pain.
Spinal chondrosarcomas may present with lower back pain, numbness, and changes in bowel and bladder function.
Diagnostic tests include CT scans, MRI, and sometimes a biopsy to confirm diagnosis and assess tumor growth rate.
Treatment options for chondrosarcomas include surgical resection, radiation, chemotherapy, and a combination of these.
Surgical resection is the primary and most effective treatment, with surgeons often using a transveneral approach.
In some cases, a craniotomy may be performed to remove residual tumor after initial resection.
External beam radiation or proton beam therapy is applied post-surgery to target the tumor bed.
Radiosurgery involves concentrated beams of radiation and is usually performed in less than an hour.
Chemotherapy is rarely used for chondrosarcomas due to their slow-dividing nature.
Complications of chondrosarcoma surgery include brain fluid leak, loss of function, and cranial nerve abnormalities.
Approximately 80-90% of patients survive with functional status at five years post-treatment.
Specialized care from experienced neurosurgeons and head and neck surgeons is crucial for optimal outcomes.
The surgical anatomy in the region is complex, requiring extensive experience for successful tumor removal.
Transcripts
[Music]
hello ladies and gentlemen my name is
aaron cohen gadol i'm a neurosurgeon i
want to talk to you today about
chondrosarcomas these are very rare
skull-based tumors
and i've been involved in the management
of this tumor type for many years
and therefore we'd like to review these
tumors and provide you with additional
information to
make your journey if you're undergoing
treatment more
efficient and
easier
chondrosarcomas are tumors that arise
from the cartilage cells of the bone and
they're relatively slow growing tumors
but can be locally aggressive and often
recur after initial resection that's
because these tumors although slow
growing can stick to their surrounding
structures and make it very difficult to
remove them completely
they are similar but less aggressive
than chordomas there are similar type of
tumors they're in the bone at the level
of skull base or lower portion of the
skull and again typically they occur at
the level of skull
and
bottom of your spine
so chondrosarcomas fortunately are very
rare they affect one in 200 000 patients
per year or one in a million
in population uh
carry such a tumor they are more
commonly seen in older adults and
specifically between the ages of 40 and
70.
what are the symptoms
that can lead you to diagnose some
chondrosarcoma typically visual problems
such as double vision headaches vertigo
or balance difficulties
hearing loss numbness difficulty
swallowing and facial pain
the common symptoms of these tumors
at the level of spine can be lower back
pain or numbness changes in bowel
function
incontinence impotence in email and
changes
in mobility and walking
what are the tests that we typically use
is a computer tomography or ct scan that
evaluates the bone out of a skull or
spine
as well as magnetic resonance imaging or
mri that can help us
review the soft tissues around the bone
and see the extent of the tumor
around the brain
sometimes we may perform a biopsy before
we do the resection to confirm the
diagnosis and assess the exact growth
rate of the tumor
the three options or maybe four for four
quantum sarcomas are surgical resection
as the primary route of treatment
radiation or chemotherapy and in fact
it's the treatment involves essentially
all three of these together at some
point
so
the surgical part of the treatment is
the primary mode of treatment and it's
the preferred one it's most effective
among the other treatment modalities the
goal is to remove as much of the tumor
as possible and typically the surgeon
goes through the nose through a
transveneral operation and surgeon has
to have extensive experience in this
area
and this minimally invasive way provides
a very effective route for removal of
the tumor based on location of the tumor
the surgeon may also perform a
craniotomy in order to
remove a piece of the skull at a later
stage to remove the residual tumor
the other modalities are external beam
radiation or proton beam where high
energy radiation is applied to the tumor
bed after a section is performed and
usually takes about five times a week
visits for several weeks and also
radiosurgery which is a concentrated
concentrated beams of radiation may be
applied and usually it takes about less
than an hour to perform
chemotherapy is rarely used for
chondrosarcomas they may you would be
using patients with advanced disease
and um
chemotherapeutic agents usually target
rapidly
dividing tumors in other words those
rare types of tumors that are
the cancerous forms of the tumors
and that really rarely occurs among
chondrosarcomas
complications of transfer neural surgery
involved brain fluid leak through the
nose loss of bowel or brain function
loss of sexual function pituitary
function failure numbness
movement problems or
double vision or other cranial nerve
abnormalities
so these tumors are slow growing but
they recur
approximately 80 to 90 of the patients
are surviving and having functional
status at five years so again the
outlook is very positive you have to
discuss your expectations after
treatment with your surgeon specifically
and make sure you see care from
oncologists and skull-based surgeons in
other words neurosurgeons and head and
neck surgeons with extensive experience
in this area the surgery can be quite
challenging the surgical anatomy in the
region is very complicated and be able
to maximize tumor removal requires many
years of experience on behalf of the
surgeons involved again thank you for
listening and i'm more than honored to
be involved in your care anytime
possible thank you
[Music]
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