Bhardwaj Sandeep, Sharma Ashish, Sharma Akangsha
Department of Neurosurgery, SMS Hospital, Jaipur, Rajasthan, India.
Department of Plastic Surgery, BLK Super Speciality Hospital, New Delhi, India.
J Neurosci Rural Pract. 2020 Apr;11(2):344-348. doi: 10.1055/s-0040-1709355. Epub 2020 May 2.
Mesenchymal chondrosarcoma of the brain is one of the rarest tumors with dismal prognosis. A 26-year-old man presented with headache, vomiting, and diplopia. On evaluation, a moderately enhancing extra-axial lesion was seen in right temporal region involving right greater wing of sphenoid, adjacent right maxillary sinus, and lateral wall of right orbit. Patient underwent magnetic resonance imaging of the spine and computed tomography (CT) of the chest for possible metastasis which showed lesion in lumbar vertebrae and left lung. Patient was planned for CT-guided lung biopsy which proved inconclusive. The patient was further planned for craniotomy and underwent craniotomy with microscopic excision of the mass. Histoimmunochemistry was suggestive of extraskeletal mesenchymal chondrosarcoma. Mesenchymal chondrosarcoma of the brain is highly aggressive tumors which are difficult to differentiate radiologically. Radical excision followed by chemoradiotherapy is optimal treatment of choice.
脑间叶性软骨肉瘤是最罕见的肿瘤之一，预后很差。一名26岁男性出现头痛、呕吐和复视症状。经检查，在右侧颞区发现一个中等强化的轴外病变，累及右侧蝶骨大翼、相邻的右侧上颌窦和右侧眶外侧壁。患者接受了脊柱磁共振成像和胸部计算机断层扫描（CT）以排查可能的转移情况，结果显示腰椎和左肺有病变。计划对患者进行CT引导下的肺活检，但结果未明确。患者进一步计划进行开颅手术，并接受了开颅手术及肿块的显微切除术。组织免疫化学检查提示为骨外间叶性软骨肉瘤。脑间叶性软骨肉瘤是极具侵袭性的肿瘤，在影像学上难以鉴别。根治性切除后进行放化疗是最佳的治疗选择。
