Chondrosarcoma: Symptoms, Causes, Diagnosis, and Treatment - Aaron Cohen-Gadol, M.D.

Summary

Neurosurgeon 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

• 🧠 Chondrosarcomas are rare skull-based tumors that arise from cartilage cells of the bone.
• 🔄 These tumors grow slowly but can be locally aggressive and often recur after initial resection due to their tendency to adhere to surrounding structures.
• 📈 Chondrosarcomas are less aggressive than chordomas but share similarities in location and nature.
• 🏥 The incidence rate is very low, affecting one in 200,000 patients per year, and is more common in adults aged 40 to 70.
• 👀 Symptoms of chondrosarcoma can include visual problems, headaches, vertigo, hearing loss, numbness, difficulty swallowing, and facial pain.
• 🏥 For spinal location, symptoms may include lower back pain, numbness, changes in bowel or bladder function, and mobility issues.
• 🛄 Diagnostic tests typically involve CT scans for bone evaluation and MRI for soft tissue examination around the bone.
• 🔍 A biopsy may be performed prior to resection to confirm the diagnosis and assess the tumor's growth rate.
• ⚕️ Treatment options include surgical resection, radiation therapy, and chemotherapy, often used in combination.
• 👨‍⚕️ Surgical resection is the primary and most effective treatment, with surgeons often using a transveneral or craniotomy approach depending on the tumor's location.
• 💡 Adjuvant therapies like external beam radiation, proton beam radiation, and radiosurgery are used post-surgery to target residual tumor cells.
• 💊 Chemotherapy is rarely used for chondrosarcomas and is typically reserved for patients with advanced disease.
• ⚠️ Complications of surgery can include brain fluid leaks, loss of function in various bodily systems, and cranial nerve abnormalities.
• 🌟 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.