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Intraspinal cervicothoracic junction chondrosarcoma: illustrative case.

Matthew T Carr1, Margaret Pain1, Kevin Kay2

  • 11Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York; and.

Journal of Neurosurgery. Case Lessons
|March 4, 2024
PubMed
Summary

This study reports a rare case of spinal chondrosarcoma presenting as a dumbbell tumor. Early diagnosis and aggressive resection are crucial for managing this uncommon spinal tumor.

Keywords:
MRI = magnetic resonance imagingcase reportcervicothoracic junctionchondrosarcomaextraduralintraspinalschwannomaspinal tumor

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Area of Science:

  • Neurosurgery
  • Orthopedic Oncology
  • Spinal Oncology

Background:

  • Chondrosarcoma is a rare spinal tumor, sometimes presenting as an extraskeletal mass.
  • Dumbbell-shaped chondrosarcomas can extend through neural foramina, mimicking other nerve tumors.
  • These tumors pose diagnostic challenges due to their rarity and similar appearance to schwannomas or neurofibromas.

Purpose of the Study:

  • To present a case of intraspinal extradural dumbbell conventional chondrosarcoma.
  • To highlight the diagnostic and management considerations for this rare tumor type.
  • To contribute to the limited literature on spinal chondrosarcomas.

Main Methods:

  • A 46-year-old female with a 2-year history of right-arm radiculopathy underwent imaging and surgical resection.
  • Magnetic resonance imaging (MRI) and computed tomography (CT) were used for diagnosis.
  • Surgical intervention involved C7-T2 laminectomy, C6-T3 posterior instrumented fusion, and gross-total resection.

Main Results:

  • Pathology confirmed a grade I chondrosarcoma.
  • The patient experienced symptom improvement post-surgery, with residual radicular pain.
  • The tumor was an extradural mass extending through the T1 neural foramen.

Conclusions:

  • Intraspinal extradural dumbbell chondrosarcomas are exceptionally rare, with only nine reported cases including this one.
  • The thoracic spine is the most common location; this case is unique to the cervicothoracic junction.
  • Chondrosarcoma should be considered in the differential diagnosis of spinal tumors mimicking schwannomas, as treatment strategies differ significantly.