Apparent diffusion coefficient and arterial spin labeling perfusion of conventional chondrosarcoma in the parafalcine region: a case report

Abstract

Intracranial chondrosarcoma is a very rare malignant tumor of the central nervous system, and is difficult to preoperatively distinguish from other tumors using conventional imaging techniques. Here, we report the case of a 24-year-old woman who presented with mild headache due to chondrosarcoma in the frontal lobe. Preoperative conventional images showed findings typical of an oligodendroglial tumor. However, high apparent diffusion coefficient (ADC) value and extreme hypoperfusion on arterial spin labeling (ASL) were inconsistent with oligodendroglial tumor characteristics. The tumor was completely removed using a standard surgical procedure. Histologic diagnosis was a conventional (classic) chondrosarcoma. High ADC and hypoperfusion on ASL represented low cellularity and low vascularity within conventional chondrosarcoma, respectively. We discuss the utility of ADC and ASL for the preoperative diagnosis of conventional chondrosarcoma.

Keywords: ADC; ASL; Intracranial chondrosarcoma; MRI.

Fig. 1

Demonstration of conventional imaging. (A) Plain CT; (B) T1WI; (C) T2WI; (D) Gd-T1WI. CT, computed tomography; T1WI, T1-weighted imaging; T2WI, T2-weighted imaging; Gd-T1WI, gadolinium-enhanced T1-weighted imaging.

Fig. 2

Demonstration of additional imaging. Left, ADC map; right, ASL. Circles show regions of interest within the tumor and apparent normal white matter of contralateral side. ADC, apparent diffusion coefficient; ASL, arterial spin labeling.

Fig. 3

Microscopic features of the tumor. H&E-stained preparations of weak magnification (10×) (A) and strong magnification (40×) (B). (C) Immunohistochemical staining of MIB-1. Arrows indicate the binucleated cells. H&E, hematoxylin and eosin.