CASE REPORT

Parafalcine Chondrosarcoma: clinical and surgical evaluation of a rare case

Condrossarcoma Parafalcino: avaliação clínica e cirúrgica de um caso raro

  • Muhammed Şamil Sağlam    Muhammed Şamil Sağlam
  • Hüda Eroğlu    Hüda Eroğlu
  • Hacı Hasan Esen    Hacı Hasan Esen
  • Mehmet Fatih Erdi    Mehmet Fatih Erdi
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Resumo

Introdução: Condrosarcomas intracranianos são tumores malignos extremamente raros de origem cartilaginosa, representando menos de 0,15% de todas as neoplasias intracranianas primárias. Normalmente surgem de sincrondrosas na base do crânio, enquanto locais meníngeos como a falx cerebri são incomuns. Descrição do caso: Uma mulher de 72 anos apresentou dor de cabeça progressiva e fraqueza no membro inferior direito por dois meses. Estudos de neuroimagem revelaram massa parafalcina extra-axial de 5 × 4 cm com calcificações irregulares e aumento mínimo de contraste, inicialmente sugestivo de meningioma. A angiografia computadorizada demonstrou lesão avascular. A paciente foi submetida a ressecção total via craniotomia central esquerda com neuronavegação e neuromonitoramento intraoperatório. A avaliação histopatológica confirmou condrosarcoma grau 2 e as imagens pós-operatórias não mostraram tumor residual. Não foi administrada a radioterapia adjuvante, e recomendado acompanhamento clínico e radiológico rigoroso. Conclusão: Este caso destaca uma apresentação atípica na idade avançada e enfatiza a importância de incluir o condrosarcoma no diagnóstico diferencial de lesões intracranianas calcificadas baseadas em durais.

Palavras-chave

Sarcoma; Condrosarcoma; Parafalcino

Abstract

Introduction: Intracranial chondrosarcomas are exceedingly rare malignant tumors of cartilaginous origin, accounting for less than 0.15% of all primary intracranial neoplasms. They typically arise from skull base synchondroses, whereas meningeal locations such as the falx cerebri are uncommon. Case presentation: A 72-year-old woman presented with progressive headache and right lower extremity weakness for two months. Neuroimaging revealed a 5 × 4 cm extra-axial parafalcine mass with irregular calcifications and minimal contrast enhancement, initially suggestive of meningioma. CT angiography demonstrated an avascular lesion. The patient underwent gross total resection via left central craniotomy with neuronavigation and intraoperative neuromonitoring. Histopathological evaluation confirmed a grade 2 chondrosarcoma. Postoperative imaging showed no residual tumor. Adjuvant radiotherapy was not administered, and close clinical and radiological follow-up was recommended. Conclusion: This case highlights an atypical presentation in advanced age and emphasizes the importance of including chondrosarcoma in the differential diagnosis of calcified, dural-based intracranial lesions.

Keywords

Sarcoma; Chondrosarcoma; Parafalx

References

1. Bloch OG, Jian BJ, Yang I, et al. A systematic review of intracranial chondrosarcoma and survival. J Clin Neurosci. 2009;16(12):1547-51. https://doi.org/10.1016/j.jocn.2009.05.003. PMid:19796952.

2. Salcman M, Scholtz H, Kristt D, Numaguchi Y. Extraskeletal myxoid chondrosarcoma of the falx. Neurosurgery. 1992;31(2):344-8. https://doi.org/10.1227/00006123-199208000-00021. PMid:1513440.

3. Lee YY, van Tassel P, Raymond AK. Intracranial dural chondrosarcoma. AJNR Am J Neuroradiol. 1988;9(6):1189-93. PMid:3143243.

4. Roy S, Chopra P, Prakash BB, Tandon PN. Chondrosarcoma of the meninges. Acta Neuropathol. 1972;22(3):272-4. https://doi.org/10.1007/ BF00684531. PMid:4637009.

5. Volpe NJ, Liebsch NJ, Munzenrider JE, Lesseill S. Neuroophthalmologic findings in chordoma and chondrosarcoma of the skull base. Am J Ophthalmol. 1993;115(1):97-104. https://doi.org/10.1016/ S0002-9394(14)73531-7. PMid:8420385.

6. Nagata S, Sawada K, Kitamura K. Chondrosarcoma arising from the falx cerebri. Surg Neurol. 1986;25(5):505-9. https://doi.org/10.1016/00903019(86)90092-3. PMid:3961667.

7. Safaee M, Clark AJ, Tihan T, Parsa AT, Bloch O. Falcine and parasagittal chondrosarcomas. J Clin Neurosci. 2013;20(9):1232-6. https://doi.org/10.1016/j.jocn.2013.01.004. PMid:23759737.

8. Chu J, Ma H, Wang Y, Li K, Liao C, Ding Y. CT and MRI findings of intracranial extraskeletal mesenchymal chondrosarcoma: a case report and literature review. Transl Cancer Res. 2022;11(9):3409-15. https://doi.org/10.21037/tcr-21-2547. PMid:36237268.

9. Oruckaptan HH, Berker M, Soylemezoglu F, Ozcan OE. Parafalcine chondrosarcoma: an unusual localization for a classical variant: case report and review of the literature. Surg Neurol. 2001;55(3):174-9. https://doi.org/10.1016/S0090-3019(01)00329-9. PMid:11311919.

10. Chandler JP, Yashar P, Laskin WB, Russell EJ. Intracranial chondrosarcoma: a case report and review of the literature. J Neurooncol. 2004;68(1):33-9. https://doi.org/10.1023/B:NEON.0000024728.72998.7d. PMid:15174519.

11. Bourgouin PM, Tampieri D, Robitaille Y, et al. Low-grade myxoid chondrosarcoma of the base of the skull: CT, MR, and histopathology. J Comput Assist Tomogr. 1992;16(2):268-73. https://doi.org/10.1097/00004728-199203000-00017. PMid:1545025.

12. Isaacson B, Kutz JW, Roland PS. Lesions of the petrous apex: diagnosis and management. Otolaryngol Clin North Am. 2007;40(3):479-519, viii. https://doi.org/10.1016/j.otc.2007.03.003. PMid:17544693.


1Department of Neurosurgery, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Türkiye.

2Department of Pathology, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Türkiye.

 

Received Aug 6, 2026 

Accepted Aug 13, 2026

JBNC  Brazilian Journal of Neurosurgery

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