Primary pulmonary chondrosarcoma and a fast-growing mass that accidentally mimicked teratoma

Primary pulmonary chondrosarcoma is a rare neoplasm that usually grows slowly, metastasizes late, and responds well to excision when localized. Herein, we present a 59-year-old man who manifested with hemoptysis, cough and dyspnea with a hemithorax mass. A chest computed tomography scan demonstrated a fast-growing mass in the right upper lobe, and the enhancement was partially heterogeneous. Bronchoscopy revealed a hemorrhagic neoplasm in the right upper bronchus. A bronchoscopy biopsy specimen revealed a variety of tissues, including mucoid cartilage, fibers, respiratory epithelium and squamous epithelium. Because malignancy was suspected, the patient underwent a right upper sleeve lobectomy with mediastinal lymphadenectomy. Macroscopically, we observed a firm white mass 9.5 cm in diameter with a central area of necrosis. Histopathology revealed neoplastic chondrocytes with enlarged and hyperchromatic nuclei in the myxoid matrix. The tumors were positive for S-100. The patient was diagnosed with tracheobronchial myxoid chondrosarcoma. Lymph node dissection indicated no metastasis. The tumor grows slowly in the initial symptom-free phase when localized. Then, a symptomatic phase ensues, during which the tumor progresses rapidly. The patient displayed pulmonary and subcutaneous skull metastases eight months after operation and was treated with adriamycin and ifosfamide chemotherapy.