Radiology Case Reports (Feb 2025)
Rare malignant primary spinal chondrosarcoma: A case report
Abstract
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.
