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A complex case of skull base chondrosarcoma and an MCA aneurysm:case report
Author(s): ,
S. Melissaris
Affiliations:
Genera Hospital of Athens 'G.Gennimatas', Athens, Greece
,
A. Malli
Affiliations:
Genera Hospital of Athens 'G.Gennimatas', Athens, Greece
,
D. Charitos
Affiliations:
Genera Hospital of Athens 'G.Gennimatas', Athens, Greece
,
G. Georgoulis
Affiliations:
Genera Hospital of Athens 'G.Gennimatas', Athens, Greece
N. Georgakoulias
Affiliations:
Genera Hospital of Athens 'G.Gennimatas', Athens, Greece
EANS Academy. MELISSARIS S. Oct 21, 2018; 225970; EP4045
Dr. SAVVAS MELISSARIS
Dr. SAVVAS MELISSARIS
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Abstract
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Background: We present the management of a complex case of skull base chondrosarcoma with the coexistence of an MCA aneurysm.
Case presentation: A 62 year old woman with a mild ptosis of the right upper eyelid, was diagnosed with a middle cranial fossa tumor after a random computed tomography scan for a mild head injury.Further investigation with MRI of the brain revealed a parasellar intracavernous lesion extending to the right posterior clinoid process and the upper third of the clivus. Digital Subtraction Angiography was conducted in the setting of the preoperative planning and a right middle cerebral artery (MCA) aneurysm was identified. The patient was treated in two stages: First, an endoscopic transnasal transsphenoidal approach was used for debulking of a significant percentage of the parasellar and clival tumor. After a 10-day period of recovery, the patient underwent a right pterional craniotomy,which included the management of the MCA aneurysm with two straight clips and a transcavernous Dollenc's approach for the residual intracavernous tumor.
Results: The patient underwent a near total resection of the tumor and clipping of the MCA aneurysm. The histopathological diagnosis was indicative of a well defined chondrosarcoma . Postoperatively, the patient presented clinically with a transient right third nerve palsy and a transient central diabetes insipidus.After our 6-month follow-up,no recurrence of the lesion and the MCA aneurysm was reported.
Conclusion: Intracranial chondrosarcomas are very rare,accounting for 1/1000 of all intracranial tumors. In our case, the patient was treated in two stages,aiming a better neurological outcome and a near total resection was achieved.
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