Chordomas and Chondrosarcomas Involving the Cavernous Sinus

Chordomas and chondrosarcomas are rare, infiltrative, and slow-growing tumors that arise in the skull base from clival and petroclival regions. Despite radiological similarities, the histological origin and prognosis are different. Gross total resection, preserving function and quality of life, followed by radiotherapy represents the gold standard for chordomas and high-grade chondrosarcomas. Considering the infiltrative nature and the involvement of cranial nerves and vessels, they still represent a surgical challenge. The introduction of endoscopic techniques has completely changed the surgical strategies, particularly in case of cavernous sinus invasion. Endoscopic techniques allow direct faster without crossing neurovascular structures, resulting in better functional and oncological outcome. Most often, radical primary surgery is the only chance of cure, and with that, it is of tremendous importance to refer those patients to specialized skull base centers with expertise in both microscopic and endoscopic techniques, supported by a multidisciplinary team.