Wada Kota, Sakamoto Akio, Kato Rei, Noguchi Takashi, Shimizu Takayoshi, Otsuki Bungo, Murata Koichi, Fujibayashi Shunsuke, Matsuda Shuichi
Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Shogoin, Kawahara-cho 54, Sakyo-ku, Kyoto 606-8507, Japan.
Case Rep Orthop. 2021 Jul 17;2021:5510075. doi: 10.1155/2021/5510075. eCollection 2021.
Chondrosarcoma is a malignant tumor characterized by the production of a cartilage matrix. Extension into the spinal canal from the extracannular space is seen mainly for neurogenic tumors, but it is rare in nonneurogenic tumors. A 75-year-old woman suffered from sciatic pain and numbness in her lower left extremity. The diagnosis was of a low-grade conventional chondrosarcoma, which originated from the posterior ilium with an intraspinal extension at the level of the sacrum, compressing the cauda equina. The tumor extended further into the S1 sacral anterior foramen, in the shape of a dumbbell. The tumor was resected in several blocks posteriorly, and the dumbbell-shaped tumor in the S1 foramen was resected by widening the S1 foramen from behind. The posterior extension of the iliac tumor seemed prevented by the posterior sacroiliac ligament, and the tumor extended into the canal. Here, we report that the iliac chondrosarcoma extending into the spinal canal is rare for this tumor type. An understating of the tumor extension is important for planning the surgical strategy.
软骨肉瘤是一种以产生软骨基质为特征的恶性肿瘤。从椎管外间隙延伸至椎管内主要见于神经源性肿瘤,而非神经源性肿瘤则较为罕见。一名75岁女性患者出现左下肢坐骨神经痛和麻木。诊断为低级别传统型软骨肉瘤,起源于髂骨后部,在骶骨水平向椎管内延伸,压迫马尾神经。肿瘤呈哑铃状进一步延伸至S1骶前孔。肿瘤分多个块在后方切除,通过从后方扩大S1孔切除S1孔内的哑铃状肿瘤。髂骨肿瘤的向后延伸似乎受到骶髂后韧带的阻挡,肿瘤延伸至椎管内。在此,我们报道髂骨软骨肉瘤延伸至椎管内对于该肿瘤类型来说较为罕见。了解肿瘤的延伸情况对于制定手术策略很重要。