CHORDOMAS AND CHONDROSARCOMAS INVOLVING THE CAVERNOUS SINUS - REVIEW OF SURGICAL-TREATMENT AND OUTCOME IN 31 PATIENTS

During the last 9 years, 31 patients with chordomas (20 cases) and cho ndrosarcomas (11 cases) involving the cavernous sinus have been treate d using an aggressive surgical approach. On the basis of postoperative magnetic resonance imaging (MRI), 17 patients were considered to have undergone total removal, whereas in the remaining 14 cases the tumor was either subtotally or partially removed. Surgical complications wer e most commonly encountered among patients who had undergone previous operations. One patient died 3 months after the operation as a result of pulmonary embolism. Significant disability occurred in one patient because of thalamic perforator occlusion and hemorrhage. Recovery of e xtraocular muscle function was gratifying, and correlated to the preop erative functional level. After a median follow-up of 24 months, three recurrences (21%) occurred among the 14 patients who had undergone in complete removal. No recurrence was observed among the 17 patients wit h total resection. This experience shows that gross radical removal of chordomas and chondrosarcomas involving the cavernous sinus can be ac complished with an acceptable surgical morbidity. However, much longer follow-up will be required to determine whether such aggressive surgi cal treatment results in cure or long-term control of these neoplasms.