Overview of Chordoma and Chondrosarcoma
Chordoma and Chondrosarcoma are tumors that arise in the bones of the midline and lateral aspects of the base of the skull, causing the bone to erode. They grow outside the lining of the brain but can penetrate through in advanced stages. Because they grow in the base of the skull, special surgical approaches are required to allow access to the tumor that reduce the chances of injury to the brain and nerves and blood vessels. Chordomas are more aggressive tumors and have a higher tendency to grow back or progress after treatment. For both tumors the primary treatment is surgery and every effort is made initially to gain a radical removal of tumor and involved bone.
The primary treatment for these tumors is aggressive surgical removal using a specialized skull base approach. If the tumor is extensive, often several approaches are required for maximal surgical resection. If some tumor cannot be safely removed then radiation is used in many cases to slow down the growth of any remaining tumor. Radiation is most often used for chordoma which are faster growing and more aggressive tumors. There are currently no effective medicines or chemotherapy to treat these tumors.
Symptoms of Chordoma and Chondrosarcoma
The symptoms of a chordoma or chondrosarcoma depend on the site of growth and extent of growth. They can produce dysfunction of a nerves that lead to double vision, hoarseness, dufficulty swallowing, tongue weakness. They can also produce pain in the head and neck. Destruction of the bony structures connecting the head and spine can produce neck pain and dangerous instability of this junction.
Causes of Chordoma and Chondrosarcoma
There are no known causes for these tumors although some chindrosarcomas arise in patients with rare genetic syndromes such as Ollier’s disease and Marfucci syndrome.
Diagnosis of Chordoma and Chondrosarcoma
Diagnosis is established first by CT scan and MR imaging of the skull base. The Ct scan shows the extent of bone destruction and the MR images show the amount of soft tissue tumor growth. If there is a question of involvement of the cranial-spine junction, plain spine x-rays are used to determine if this joint shows any instability.
Complications of Chordoma and Chondrosarcoma
If left untreated, these tumors will grow to produce compression and dysfunction of the brain stem, cranial nerves and the joint between the head and spine. This growth can produce difficulties with vision, hearing, swallowing, facial numbness, walking, paralysis and even death.