Carr Matthew T, Pain Margaret, Kay Kevin, Houten John K
1Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York; and.
2Department of Pathology, Mount Sinai South Nassau, Oceanside, New York.
J Neurosurg Case Lessons. 2024 Mar 4;7(10). doi: 10.3171/CASE23755.
Chondrosarcoma is an uncommon spinal tumor that can present as an extraskeletal mass. Rarely, these tumors present as dumbbell tumors through the neural foramina, mimicking schwannomas or neurofibromas.
A 46-year-old female presented with 2 years of worsening right-arm radiculopathy. Magnetic resonance imaging of the thoracic spine revealed a peripherally enhancing extramedullary mass through the right T1 foramen and compressing the spinal cord. Computed tomography showed the mass to be partially calcified. She underwent C7-T2 laminectomy and C6-T3 posterior instrumented fusion with gross-total resection of an extradural mass. Pathology revealed a grade I chondrosarcoma. Her symptoms improved postoperatively, with some residual right-arm radicular pain.
Intraspinal extradural dumbbell conventional chondrosarcoma is rare, with only 9 cases, including ours, reported. Patient ages range from 16 to 72 years old, and male sex is more common in these cases. The most common location is the thoracic spine, and our case is the only reported one in the cervicothoracic junction. These tumors often mimic schwannomas on imaging, but chondrosarcoma should remain in the differential diagnosis, because management of these tumors differs. Chondrosarcoma may benefit from more aggressive resection, including en bloc resection, and may require adjuvant radiotherapy.
软骨肉瘤是一种罕见的脊柱肿瘤，可表现为骨骼外肿块。这些肿瘤很少通过神经孔呈哑铃状肿瘤，类似神经鞘瘤或神经纤维瘤。
一名46岁女性因右臂神经根病加重2年就诊。胸椎磁共振成像显示通过右侧T1神经孔有一个外周强化的髓外肿块，压迫脊髓。计算机断层扫描显示肿块部分钙化。她接受了C7 - T2椎板切除术和C6 - T3后路器械融合术，并对硬膜外肿块进行了大体全切。病理显示为I级软骨肉瘤。术后她的症状有所改善，但仍有一些残留的右臂神经根性疼痛。
椎管内硬膜外哑铃状传统软骨肉瘤罕见，包括我们的病例在内仅报道了9例。患者年龄范围为16至72岁，这些病例中男性更为常见。最常见的部位是胸椎，我们的病例是颈胸交界处唯一报道的病例。这些肿瘤在影像学上常类似神经鞘瘤，但软骨肉瘤应保留在鉴别诊断中，因为这些肿瘤的治疗方法不同。软骨肉瘤可能受益于更积极的切除，包括整块切除，并且可能需要辅助放疗。
