Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
World J Surg Oncol. 2013 Feb 2;11:32. doi: 10.1186/1477-7819-11-32.
Dedifferentiated chondrosarcoma (DDCS) is a rare and aggressive bone tumor with poor prognosis. Primary DDCS of the mobile spine is extremely rare, particularly in the cervical spine. We herein describe a first case of cervical DDCS in an 81-year-old male presenting with a slowly growing mass. Radiographs showed an expansion of the cortical contour of the C2 lamina and a soft tissue mass with punctate calcification. Magnetic resonance imaging demonstrated a lobulated lesion expanding over the entire lamina and pedicles of C2 with the tumor protuberant to the adjacent soft tissue. A complete tumor resection was performed. Histologically, the majority of the tumor was a low-grade chondrosarcoma component. However, atypical spindle cells that had proliferated in a fascicular pattern with a collagenous stroma, mimicking fibrosarcoma, were focally observed without a transitional zone, and these features confirmed that the tumor was DDCS.
去分化软骨肉瘤(DDCS)是一种罕见且侵袭性强的骨肿瘤,预后不良。活动脊柱的原发性 DDCS 极为罕见,特别是在颈椎。我们在此描述了首例 81 岁男性颈椎 DDCS 的病例,其表现为缓慢生长的肿块。X 线片显示 C2 椎板皮质轮廓扩张和软组织肿块伴点状钙化。磁共振成像显示病变呈分叶状,累及 C2 的整个椎板和椎弓根,肿瘤向邻近软组织突出。行全肿瘤切除术。组织学上,大部分肿瘤为低级别软骨肉瘤成分。然而,局灶性观察到以束状模式增殖、伴有胶原基质的非典型梭形细胞,类似于纤维肉瘤,且无过渡区,这些特征证实该肿瘤为 DDCS。