Multidisciplinary approach for resection of an extremely large trunk chondrosarcoma: a case report

Chondrosarcoma, a malignant bone tumor arising from cartilaginous matrix, is the second most common primary malignant bone tumor. Giant chondrosarcomas, particularly those exceeding 30 cm, are extremely rare. This case report highlights the challenges and multidisciplinary approach required for resecting an extremely large trunk chondrosarcoma, emphasizing the importance of early diagnosis and treatment to improve patient outcomes.

A 62-year-old woman presented with a progressively enlarging left lumbar mass over 2 years without any family history of cancer or notable comorbidities. A multidisciplinary team conducted a segmented resection due to the tumor's size and invasion. Postoperative pathology confirmed high-grade chondrosarcoma with necrosis.

Chondrosarcomas are generally resistant to chemotherapy and radiotherapy, making surgical resection the primary treatment. For large tumors involving the axial skeleton, wide resection with negative margins is preferred. The surgical challenges in this case were mainly related to the tumor's enormous size and extensive invasion, requiring precise and complex surgical techniques. A multidisciplinary approach was crucial to address various aspects of the surgery, including blood preparation, intraoperative monitoring, spinal stability assessment, thoracic cage and abdominal wall integrity evaluation, tumor dissection, and protection of vital organs.

This case demonstrates the successful multidisciplinary resection of an extremely large trunk chondrosarcoma. It underscores the importance of a collaborative approach in managing such complex cases. Early detection and treatment are crucial to prevent tumor progression and improve patient outcomes. Further research is needed to explore more effective treatment strategies for giant chondrosarcomas.