Kotil Kadir, Bilge Turagay, Olagac Vakur
Department of Neurosurgery, Haseki Educational and Research Hospital, Istanbul, Turkey.
J Neurooncol. 2005 Nov;75(2):169-72. doi: 10.1007/s11060-005-1739-1.
Chondrosarcomas are extremely rare cartilaginous tumours that typically usually are associated with bone. Therapeutic experience with primary spinal mesenchymal chondrosarcomas is also extremely limited. The exact origin of rare intradural spinal chondrosarcomas remains obscure. We report the first case in the literature of a primary intradural myxoid chondrosarcoma.
This 40-year-old man experienced a 3 month history with back pain. The results of his neurological examination were normal. Magnetic resonance imaging (MRI)demonstrated at the T12 level intradural tumour. We could not identify this lesion as chondrosarcoma in preoperative period.
At surgery, a mass found attached solely to pia mater, with a normal arachnoid and dura mater overlying was seen. The mass was excised completely and microscopic examination identified a myxomatous chondrosarcoma. The postoperative course was unremarkable. But a histological examination revealed primary myxoid chondrosarcoma. Experience with primary spinal mesenchymal chondrosarcomas is also extremely limited. We especially discussed to the histological examination.
The differential diagnosis considered in the present case included meningioma, plasmacytoma, and non-neoplastic intradural spinal cord lesion. We emphasize the benefit of surgical resection without radiotherapy and/or chemotherapy. This case presents the first case in the literature of an primary spinal intradural myxoid chondrosarcoma.
软骨肉瘤是极为罕见的软骨肿瘤,通常与骨相关。原发性脊柱间叶性软骨肉瘤的治疗经验也极为有限。罕见的硬膜内脊髓软骨肉瘤的确切起源仍不清楚。我们报告了文献中首例原发性硬膜内黏液样软骨肉瘤病例。
该40岁男性有3个月背痛病史。神经系统检查结果正常。磁共振成像(MRI)显示T12水平硬膜内肿瘤。术前我们无法将此病变确定为软骨肉瘤。
手术中,发现一个仅附着于软脑膜的肿块,其上方蛛网膜和硬脑膜正常。肿块被完全切除,显微镜检查确定为黏液性软骨肉瘤。术后病程平稳。但组织学检查显示为原发性黏液样软骨肉瘤。原发性脊柱间叶性软骨肉瘤的经验也极为有限。我们特别讨论了组织学检查。
本例考虑的鉴别诊断包括脑膜瘤、浆细胞瘤和非肿瘤性硬膜内脊髓病变。我们强调手术切除而不进行放疗和/或化疗的益处。该病例是文献中首例原发性脊柱硬膜内黏液样软骨肉瘤。