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原发性椎管内哑铃形间充质软骨肉瘤伴大量钙化:病例报告及文献复习

Primary intraspinal dumbbell-shaped mesenchymal chondrosarcoma with massive calcifications: a case report and review of the literature.

作者信息

Chen Shudong, Wang Yufeng, Su Guoyi, Chen Bolai, Lin Dingkun

机构信息

Guangdong Provincial Hospital of Chinese Medicine, No. 111 Dade Road, Yuexiu District, Guangzhou, 510120, China.

Guangzhou University of Chinese Medicine, Guangzhou, China.

出版信息

World J Surg Oncol. 2016 Aug 3;14(1):203. doi: 10.1186/s12957-016-0963-9.

Abstract

BACKGROUND

Mesenchymal chondrosarcoma is a rare malignant tumor arising from bone or soft tissues. Instraspinal dumbbell-shaped mesenchymal chondrosarcoma is even rarer; however, it should not be neglected by clinicians.

CASE PRESENTATION

A 26-year-old female was referred to our hospital with a 1.5-month history of sciatic pain and numbness in the left leg. Computed tomography and magnetic resonance imaging scans revealed an intraspinal dumbbell-shaped mass which had distinguishing features of neurogenic tumors, surprisingly, with massive calcifications, and no tumor metastasis was found. Then the patient underwent a total resection of the tumor, and during the operation, we found that the right nerve root of the fifth lumbar almost disappeared. The tumor was diagnosed as mesenchymal chondrosarcoma by histopathological examination after operation. Adjuvant therapies were not performed. However, recurrence of the tumor occurred 5 months later, and she underwent a total resection again combined with radiotherapy after second surgery.

CONCLUSIONS

To the best of our knowledge, this case study presents the first report in literature about primary instraspinal dumbbell-shaped mesenchymal chondrosarcoma with massive calcifications, which may provide some evidence for clinical practice. As the clinical symptoms and radiographic findings of mesenchymal chondrosarcoma are usually not specific, clinicians should consider it as a possible case and diagnose it through careful histopathological examination. Sometimes, calcification could be seen in tumors, which may influence or reflect the growth of tumor and disease prognosis. Although prognosis in mesenchymal chondrosarcoma varies from person to person, generally, complete resection, adjuvant therapy, and regular examinations are recommended to perform for patients with mesenchymal chondrosarcoma.

摘要

背景

间叶性软骨肉瘤是一种起源于骨或软组织的罕见恶性肿瘤。椎管内哑铃形间叶性软骨肉瘤更为罕见;然而,临床医生不应忽视它。

病例报告

一名26岁女性因左腿坐骨神经痛和麻木1.5个月转诊至我院。计算机断层扫描和磁共振成像扫描显示椎管内有一个哑铃形肿块,具有神经源性肿瘤的特征,令人惊讶的是有大量钙化,未发现肿瘤转移。随后患者接受了肿瘤全切术,术中发现第五腰椎右侧神经根几乎消失。术后经组织病理学检查诊断为间叶性软骨肉瘤。未进行辅助治疗。然而,5个月后肿瘤复发,二次手术后她再次接受了全切术并联合放疗。

结论

据我们所知,本病例研究是文献中关于原发性椎管内哑铃形间叶性软骨肉瘤伴大量钙化的首例报告,可为临床实践提供一些依据。由于间叶性软骨肉瘤的临床症状和影像学表现通常不具有特异性,临床医生应将其视为可能的病例,并通过仔细的组织病理学检查进行诊断。有时肿瘤中可见钙化,这可能影响或反映肿瘤的生长及疾病预后。尽管间叶性软骨肉瘤的预后因人而异,但一般建议对间叶性软骨肉瘤患者进行完整切除、辅助治疗及定期检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b62c/4973031/ecddf115323a/12957_2016_963_Fig1_HTML.jpg

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