Management of pure intracavernous chondroma: a case report with operative video and literature review

The cavernous sinus, often referred to as an "anatomic jewel box" due to its complex structure, presents significant challenges for neurosurgeons when performing tumor resections in this region. Tumors confined to the cavernous sinus are rare, with meningiomas and cranial nerve schwannomas being the most common. Pure intracavernous chondromas, however, are exceptionally rare, representing only a small fraction of intracranial chondromas. To date, only seven cases of pure intracavernous chondromas have been reported in the literature. Here, we report the case of a 37-year-old male who presented with a two-month history of double vision and radiological wor=90*--------up revealed a pure intracavernous sinus lesion. Gross total resection was achieved via a pterional craniotomy with a pretemporal transcavernous approach and extradural anterior clinoidectomy. The lesion was identified as a pure intracavernous sinus chondroma through a combination of radiological imaging, intraoperative observations, and histopathological analysis. At the most recent follow-up, the patient's preoperative symptoms had been resolved, and he remained recurrence-free. We also conducted a review of the literature on pure intracavernous chondromas, examining the number of reported cases, demographics, clinical presentations, surgical management, and outcomes. The review highlighted the rarity of these tumors, the challenges in diagnosing them due to their radiological overlap with other skull base lesions, and the favorable outcomes associated with gross total resection. This case report emphasizes the importance of considering pure intracavernous chondromas in the differential diagnosis of cavernous sinus tumors and provides insights into their optimal surgical management.