Intraspinal mesenchymal chondrosarcoma: An argument for aggressive local resection and adjuvant therapy based on review of the literature
- Department of Neurosurgery, Baylor College of Medicine, One Baylor Plaza, Houston, TX, United States.
- Department of Neurosurgery, Houston Methodist Hospital Neurological Institute, Houston, TX, United States.
Department of Neurosurgery, Baylor College of Medicine, One Baylor Plaza, Houston, TX, United States.
DOI:10.25259/SNI_130_2020Copyright: © 2020 Surgical Neurology International This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
How to cite this article: Sricharan Gopakumar, William J. Steele, Matthew Muir, Zain Bhogani, Gavin Britz. Intraspinal mesenchymal chondrosarcoma: An argument for aggressive local resection and adjuvant therapy based on review of the literature. 02-May-2020;:95
How to cite this URL: Sricharan Gopakumar, William J. Steele, Matthew Muir, Zain Bhogani, Gavin Britz. Intraspinal mesenchymal chondrosarcoma: An argument for aggressive local resection and adjuvant therapy based on review of the literature. 02-May-2020;:95. Available from: https://surgicalneurologyint.com/surgicalint-articles/9987/
Background: Mesenchymal chondrosarcoma is a rare cartilaginous neoplasm that typically involves the axial skeleton. Despite a well-circumscribed appearance, this tumor has a tendency to recur both locally and with distant metastases.
Case Description: A 17-year-old patient presented with numbness and paresthesias in the lower extremities attributed to a T10-T11 intradural extramedullary mesenchymal chondrosarcoma. The patient was treated with aggressive local resection and adjuvant therapy. Here, this case and present literature are appropriately reviewed.
Conclusion: Although uncommon, intraspinal mesenchymal chondrosarcomas warrant both radical local resection and aggressive adjuvant therapy with chemoradiation to provide the greatest chance of progression-free survival.
Keywords: Adjuvant therapy, Intradural tumor, Intraspinal, Mesenchymal chondrosarcoma
Mesenchymal chondrosarcomas are rare, primary malignant neoplasms of bone and soft tissues that arise from primitive cartilage forming mesenchymal tissue and are capable of distant metastasis.[
A 17-year-old male presented with a 5-week onset of progressive lower extremity numbness and hyperreflexia attributed to a primary T10-T11 intradural extramedullary mesenchymal chondrosarcoma. Contrast-enhanced T1-weighted magnetic resonance imaging (MRI) of the thoracic spine showed an intradural posterolateral right-sided lesion at the T10-11 level compressing the spinal cord anteriorly [
Due to the high risk of local tumor recurrence, the patient underwent a second operation with further resection of surrounding tissues.[
Mesenchymal chondrosarcomas are rare tumors, constituting 25% of all chondrosarcomas in children and adolescents.[
On MRI imaging, these tumors often have extraosseous extension, lytic lesions, poorly defined periosteal reaction, and mottled calcification.[
Mesenchymal chondrosarcoma is known to have a late recurrence, sometimes even more than 20 years after the primary tumor occurs.[
The use of chemotherapy in the treatment of mesenchymal chondrosarcomas in the literature is controversial.[
Intradural extramedullary mesenchymal chondrosarcomas are rare tumors that require prompt diagnosis, aggressive wide surgical excision, and adjuvant radiation and chemotherapy to achieve the best outcomes. Here, a 17-year- old male with a T10-T11 mesenchymal chondrosarcoma underwent a secondary operation with total en bloc resection, including dural removal with patch grafting plus adjuvant chemoradiation to avoid tumor recurrence.
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