Lin Maoqiang, Zhou Haiyu, Zhang Xiaobo, Hu Yicun, Guo Taowen, Shi Jintao
Department of Orthopedics, Lanzhou University Second Hospital, Lanzhou, China.
Key Laboratory of Bone and Joint Disease Research of Gansu Province, Lanzhou, China.
Transl Cancer Res. 2022 Sep;11(9):3363-3370. doi: 10.21037/tcr-22-122.
Primary mesenchymal chondrosarcoma (PMC) is a relatively rare malignancy that can occur in bone or soft tissue, but rarely in the lumbar spine; there is currently no unified treatment. We report a case of mesenchymal chondrosarcoma originating from the L1 vertebra.
A 47-year-old female patient was admitted to the hospital with intermittent low back pain for 20 years, accompanied by intermittent headache and radiating pain in both lower limbs. After admission, magnetic resonance imaging (MRI) showed bone destruction of the L1 vertebral body and accessories and a surrounding soft tissue mass. Enhanced MRI revealed significant enhancement of the L1 vertebral body and soft tissue mass. Technetium 99 m-methylene diphosphonate (99 m Tc-MDP) bone scan showed abnormally high metabolism in the L1 vertebral body, which is highly suspicious of malignancy, and vertebral biopsy revealed a soft tissue malignancy originating from the mesenchymal tissue. Total vertebrectomy combined with postoperative adjuvant radiotherapy was planned, but the patient refused radiotherapy for financial reasons. Intraoperative frozen sections indicated mesenchymal chondrosarcoma, as confirmed by postoperative pathological examination. After 1 year of outpatient follow-up, the patient had no related symptoms, and normal motor and sensory function, and her condition had improved.
Total tumor resection is an effective treatment for PMC, and increased attention to this disease in the clinic is essential.
原发性间叶性软骨肉瘤（PMC）是一种相对罕见的恶性肿瘤，可发生于骨或软组织，但很少发生于腰椎；目前尚无统一的治疗方法。我们报告一例起源于L1椎体的间叶性软骨肉瘤病例。
一名47岁女性患者因间歇性腰痛20年入院，伴有间歇性头痛及双下肢放射性疼痛。入院后，磁共振成像（MRI）显示L1椎体及附件骨质破坏，周围有软组织肿块。增强MRI显示L1椎体及软组织肿块明显强化。锝99m-亚甲基二膦酸盐（99mTc-MDP）骨扫描显示L1椎体代谢异常增高，高度怀疑为恶性肿瘤，椎体活检显示为起源于间叶组织的软组织恶性肿瘤。计划行全椎体切除术并术后辅助放疗，但患者因经济原因拒绝放疗。术中冰冻切片提示为间叶性软骨肉瘤，术后病理检查确诊。门诊随访1年后，患者无相关症状，运动及感觉功能正常，病情好转。
肿瘤全切是治疗PMC的有效方法，临床对此病增加关注至关重要。
