gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Management of skull base chordomas

Chordome der Schädelbasis – Management und Ergebnisse

Meeting Abstract

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  • corresponding author C. Stüer - Klinik für Neurochirurgie, Universitätsklinikum Bonn
  • C. Schaller - Klinik für Neurochirurgie, Universitätsklinikum Bonn

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. DocP192

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Veröffentlicht: 4. Mai 2005

© 2005 Stüer et al.
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Growth patterns of skull base chordomas are related to neurovascular structures, i.e. carotid and vertebral arteries and the middle and lower cranial nerves and due to their locally invasiveness they tend to behave “clinically” malignant. Thus, a high rate of transient neurological deficits following radical surgery is reported in the literature. At our institution the principle of radical removal is not followed at any price. Therefore the goal of this study was to compare the results of our “management” with those published in the recent literature.


N=11 patients (5 f, 6 m) aged from 24-65 (mean: 41) years underwent microsurgical removal of a skull base chordoma. Tumor size was as follows: one <3 cm, N=5 3-5 cm, N=5 >> 5cm. The median preoperative Karnofsky score was 80. The operative approaches chosen were transsphenoidal in N=4 and transcondylar, frontotemporal and combined subtemporal/presigmoidal in the others. All patients were routinely referred for postoperative radiotherapy.


N=7 (64%) of the chordomas were subtotally or partially resected, N=4 (36%) were microscopically totally removed. Mortality was 0%. In N=6 (55%) neurological deterioration was due to transient cranial nerve deficits. In N=4 (36%) temporary surgical morbidity was observed. Postoperative median Karnofsky score at last follow-up was 90 after a median of 36 (range: 23-132) months. At this time significant neurological deficits were observed in 1 patient. Five patients underwent reoperation due to tumor recurrence after a median follow-up of 24 (range: 4-48) months.


The majority of patients undergoing microsurgical removal of skull base chordomas suffer from transient neurological deficits. These deficits are nonsignificant mainly, as is reflected by the fact that patients reach their preoperative functional status. The apparently high rate of incomplete tumor resection (64%) is due to the intrinsic infiltrative behaviour of these tumors and their relationship with important neurovascular structures. Thus, the operative strategy should not be excessively aggressive at any price, but rather take into account the option to apply additional radiotherapy and to observe residual tumor.