Overview
Chordoma and chondrosarcoma are rare tumors that arise from bone and cartilage at the base of the skull, often in the central region called the clivus. Although they are different tumors, both grow in this midline area near critical nerves, the brainstem, and major blood vessels, which makes their evaluation and treatment specialized.
Chordomas tend to grow slowly but can be locally aggressive and have a tendency to recur, while chondrosarcomas also arise in this region and are managed along similar lines. Symptoms often develop gradually and can include headache, double vision, or other cranial-nerve problems.
Care is multidisciplinary and individualized, typically combining surgery, which may be endoscopic, open, or a combination, with radiation therapy, often using specialized techniques. Long-term surveillance is essential because these tumors can recur. This page is educational and does not replace specialist evaluation.
Clival anatomy and tumor differences
Chordomas and chondrosarcomas arise at the base of the skull, often in the clivus, a central bone in front of the brainstem. Chordomas develop from remnants of the embryonic notochord, while chondrosarcomas arise from cartilage-forming cells, often slightly off the midline. Both sit near critical nerves and vessels, which shapes how they are treated.
Symptoms
Symptoms often develop gradually and depend on the tumor's location and size. Headache and double vision are common, and other cranial-nerve symptoms such as facial numbness, swallowing difficulty, or balance problems can occur as the tumor affects nearby nerves.
Living with chordoma and chondrosarcoma? The next step is a quiet, unhurried conversation.
MRI/CT and pathology
MRI defines the tumor and its relationship to the brainstem, nerves, and vessels, while CT shows the bony involvement. A biopsy and expert pathology review are important to distinguish chordoma from chondrosarcoma and from other tumors, because the diagnosis influences treatment and prognosis.
Endoscopic, open, and combined surgery
Surgery aims to remove as much tumor as safely possible while protecting vital structures. Depending on the location and extent, this may be done endoscopically through the nose, through an open approach, or with a combination. Complete removal is not always achievable because of the surrounding anatomy, which is one reason radiation is frequently part of treatment.
Radiation planning
Radiation therapy is often used after surgery to treat residual or microscopic tumor, frequently with specialized high-precision techniques that aim to spare nearby critical structures. The plan is individualized and made with radiation oncology.
Living with chordoma and chondrosarcoma? The next step is a quiet, unhurried conversation.
Long-term surveillance and recurrence
Because chordomas and chondrosarcomas can recur, sometimes years later, long-term imaging surveillance is essential. Ongoing follow-up allows recurrence to be detected and addressed as early as possible.
When to seek care
Seek prompt evaluation for new or worsening double vision, persistent headache, facial numbness, or swallowing or balance problems. Seek emergency care for sudden severe headache, vision loss, weakness, or confusion, which require immediate attention.
Medical review
This page is a patient-education resource reviewed by the responsible Norelle Health clinician before publication. It does not replace an in-person evaluation. If symptoms are severe or rapidly worsening, seek immediate medical care.
Living with chordoma and chondrosarcoma? The next step is a quiet, unhurried conversation.
Common Symptoms
Treatment Approach
Treatment for chordoma and chondrosarcoma is individualized based on the severity of symptoms, anatomical considerations, and patient goals. Our specialists may consider:
- 01Surgery by an endoscopic, open, or combined approach
- 02Radiation therapy, often with specialized techniques
- 03Coordinated, multidisciplinary planning
- 04Long-term imaging surveillance
- 05Second-opinion review for complex cases
Specialists who treat chordoma and chondrosarcoma
Dr. Adrian Ong
MD
Board-Certified Facial Plastic & Reconstructive and Head & Neck Surgeon
Dr. Adrian Ong is a board-certified surgeon who practices exclusively on the face, head, and neck, with expertise spanning rhinoplasty, sinus surgery, facial trauma, reconstruction, and sleep surgery.
- Functional and aesthetic rhinoplasty (including revision)
- Sinus surgery and complex revision sinus surgery
- Facial trauma and nasal fractures
- Head and neck cancer surgery and microvascular reconstruction
Also caring for this area
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(212) 444-8006Frequently Asked Questions
Clinical References
These independent resources from medical and professional organizations offer further reading. They are provided for general education and do not replace a consultation with a clinician.
Related Procedures
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