Chondrosarcomas are in some ways similar to chordomas, described elsewhere in this website. Like chordomas, they arise from the skull base and invade it. Generally speaking, the principles of treatment are the same as those for chordomas, namely maximal surgical resection followed by a specialised form of radiotherapy, proton beam radiotherapy. The treatment requires highly specialised and individualised care by experts in the field. The surgery falls within the subspecialty area of neurosurgery called skull base surgery in which Andrew King and Scott Rutherford have great experience and expertise.
The principal of surgery is to achieve maximal surgical resection, in other words to remove as much of the tumour as is safely possible. Because the tumour arises from the skull base, it is often involving the cranial nerves that leave the brain through the base of the skull and supply the head and neck as well as the spinal cord and blood vessels both supplying blood to the brain (arteries) and draining blood from the brain (veins and venous sinuses).
The surgery is technically challenging both in terms of access to the tumour and its surgical removal. It usually involves a combined team of neurosurgeons and skull base ENT surgeons (neuro-otologists) and the surgeons of the Brain and Spine Clinic routinely work in such a team. Once surgical resection has been achieved, consideration is given to post-operative radiotherapy usually in the form of proton beam radiotherapy which is described below. It would be fair to say that given that chondrosarcomas are usually less aggressive tumours than chordomas, there is more of a decision to be made about the need for proton beam radiotherapy afterwards and occasionally a decision is made after successful surgical resection to simply monitor with serial scanning rather than proceeding directly to radiotherapy. This decision will invariably be individualised to the patient and will be part of the discussion management when you come to see your neurosurgeon.