Fitrah Ahmad, Pancaputri Btari Magistra, Wienanda Andreas Klemens, Kuntara Atta, Hadar Abdul Kadir, Budi Irawan Muhammad Naseh Sajadi, Ramdan Ahmad, Yantisetiasti Anglita
Department of Radiology, Faculty of Medicine Padjadjaran University. Dr. Hasan Sadikin Hospital, Bandung, West Java, Indonesia.
Department of Orthopedic, Faculty of Medicine Padjadjaran University. Dr. Hasan Sadikin Hospital, Bandung, West Java, Indonesia.
Radiol Case Rep. 2024 Nov 22;20(2):949-956. doi: 10.1016/j.radcr.2024.10.127. eCollection 2025 Feb.
Chondrosarcomas are one of malignant tumors in which cartilaginous matrix is produced. It is divided into 2 groups including primary or secondary. Primary chondrosarcomas are the third most common primary malignant tumors of the bone. Chondrosarcoma represents 20%-27% of all primary malignant bone tumors. Primary spinal chondrosarcoma is exceedingly rare among spinal tumors. A 36-year-old man presented to hospital with the swelling on the back accompanied with pain. Swelling and pain have been felt for approximately 3 years. The symptoms gradually worsened. On thoracolumbal X-ray a lytic sclerotic expansile lesion on the right posterior aspect of thoracal T5-T6. MRI showed the mass infiltrated intradural and intramedullary, reaching up to the level of vertebrae T4-T5. This infiltration resulted in stenosis of the spinal canal, obliterating the ligamentum flavum, supraspinous ligament, and interspinous ligament. Chondrosarcomas are uncommon malignant bone tumours that form cartilage; they rarely involve the spine, while most of them occur in young men. The thoracic spine is most commonly involved, but there is usually a long history of pain and possible neurological symptoms. Imaging techniques, such as conventional examination, CT, and MRI, are very important for diagnosis and classification and show typical bone destruction with matrix mineralization. Imaging revealed a lytic sclerotic lesion at the T5-T6 level. CT scans performed subsequently showed an expansile mass with a typical ``rings and arcs'' appearance of chondrosarcomas. MRI further delineated the extent of the mass and the surrounding tissue infiltration, and confirmation of low-grade chondrosarcoma, grade I was based on histological examination. The most effective treatment has been en bloc resection, and high-dose adjuvant radiotherapy might improve local control and survival rates. Recommended follow-ups are for the purpose of monitoring recurrence. Primary spinal chondrosarcoma is a rare malignant tumor that predominantly affects adolescents. The standard treatment typically involves surgical intervention, often supplemented with adjuvant radiotherapy. Many patients experience considerable improvements in neurological function following treatment. Long-term monitoring and follow-up are crucial for ensuring the best possible outcomes for individuals with primary spinal chondrosarcoma.
软骨肉瘤是产生软骨基质的恶性肿瘤之一。它分为两组，包括原发性或继发性。原发性软骨肉瘤是第三常见的原发性骨恶性肿瘤。软骨肉瘤占所有原发性骨恶性肿瘤的20%-27%。原发性脊柱软骨肉瘤在脊柱肿瘤中极为罕见。一名36岁男性因背部肿胀伴疼痛入院。肿胀和疼痛已持续约3年，症状逐渐加重。胸腰椎X线显示胸段T5-T6右侧后方有一个溶骨性硬化性膨胀性病变。MRI显示肿块浸润硬膜内和髓内，达T4-T5椎体水平。这种浸润导致椎管狭窄，黄韧带、棘上韧带和棘间韧带消失。软骨肉瘤是罕见的形成软骨的恶性骨肿瘤；它们很少累及脊柱，大多数发生在年轻男性中。胸椎最常受累，但通常有长期疼痛史和可能的神经症状。影像学技术，如传统检查、CT和MRI，对诊断和分类非常重要，显示典型的伴有基质矿化的骨质破坏。影像学显示T5-T6水平有一个溶骨性硬化性病变。随后进行的CT扫描显示一个膨胀性肿块，具有软骨肉瘤典型的“环和弧”外观。MRI进一步明确了肿块范围和周围组织浸润情况，并根据组织学检查确诊为低级别软骨肉瘤，I级。最有效的治疗方法是整块切除，高剂量辅助放疗可能会改善局部控制和生存率。推荐的随访是为了监测复发情况。原发性脊柱软骨肉瘤是一种罕见的主要影响青少年的恶性肿瘤。标准治疗通常包括手术干预，常辅以辅助放疗。许多患者在治疗后神经功能有显著改善。长期监测和随访对于确保原发性脊柱软骨肉瘤患者获得最佳预后至关重要。
