A Case of Parasellar Myxochondrosarcoma

ABSTRACT

Cartilaginous tumors of the skull base are rare. The authors recently encountered a case of parasellar myxochondrosarcoma. The clinical and more important differential diagnosis of the tumors of skull base are presented. A 49 years old Korean housewife was admitted to the dept. of Neurosurgery, Seoul National University Hospital because of the progressive visual disturbance of 3 years' duration. She had had mild headaches for 7 years. On physical examination, left homonymous hemianopia was noted. She could only see the moving hand in front of her right eye. Left visual acuity was quite normal. Other cranial nerves were not involved. Plain skull x-rays showed multiple stippled irregular calcifications around the right parasellar area. There was no evidence of bony destruction on the axial view. Right carotid angiogram showed the opening of carotid siphon, elevation of the bifurcation point of ICA, nonvisualization of the right ACA, and the forward-upward displacement with the thinning of the right internal carotid artery by the compression of the parasellar mass. There was no tumor blush or abnormal vessels. At surgery, a huge white avascular mass in the parasellar region, compressing and enveloping the right optic nerve and internal carotid artery was subtotally removed. The tumor mass extended far posterior to the dorsum sellae. The exact site of the origin was difficult to identify. The histologic diagnosis was myxochondrosarcoma. She was recommended the radiation therapy and discharged without improvement of her visual field in 3 weeks postoperatively.