Chondroid Chordoma with Parasellar Extension

Abstract

A patient with the chondroid variant of chordomas at the skull base is presented. This 49-year-old female complained of diplopia. Examination revealed right abducens palsy only. The cause of the abducens palsy could not be demonstrated. 4.5 years later, she showed right abducens paralysis and mild dysesthesia in the distribution of the second division of the right trigeminal nerve. Pathological findings revealed physaliphorous cells, which indicated typical chordoma. A large amount of mucin was seen in the stroma. Typical cartilaginous cells were not proved. These findings indicated the transitional form between typical chordoma and chondroid chordoma. Dysesthesia of the right side of her face disappeared postoperatively. She has had a good clinical course for the ensuing year. It has been reported about chondroid chordoma that the more chondroid the tumor the longer the survival. To distinguish chondroid variants among chordomas is very important for prediction of the survival time. In cases with a chronic abducens paralysis, careful investigations should be performed to rule out a parasellar tumor. Reinvestigation is necessary immediately after the appearance of other neurological abnormalities.