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Clinical diagnostic and radiographic features of a primary intradural spinal chondrosarcoma in a young adult: illustrative case – Lumbar Fusion

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The article discusses a case of mesenchymal chondrosarcoma (MCS), an aggressive subtype of chondrosarcoma that rarely occurs in the central nervous system. The patient, a 22-year-old male, presented with back and leg pain and was found to have a mass in the lumbar spine. The mass was surgically removed, and radiation therapy was administered after the surgery. There was no evidence of recurrence two years later. The article highlights the challenges in diagnosing spinal MCS, the importance of complete resection, and the potential role of adjuvant radiation therapy in reducing local recurrence. Further studies are needed to better understand the role of chemotherapy in treating MCS

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : finest spine hospital in London

Published article

BACKGROUND: Mesenchymal chondrosarcoma (MCS) is an aggressive subtype of chondrosarcoma that occurs extremely rarely in the central nervous system. Patients often present with pain or sensorimotor deficits, and resection is considered the gold standard. The role of adjuvant radiation and/or chemotherapy is largely unknown.

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J Neurosurg Case Lessons. 2023 Aug 21;6(8):CASE23317. doi: 10.3171/CASE23317. Print 2023 Aug 21.ABSTRACTBACKGROUND: Mesenchymal chondrosarcoma (MCS) is an aggressive subtype of chondrosarcoma that occurs extremely rarely in the central nervous system. Patients often present with pain or sensorimotor deficits, and resection is considered the gold standard. The role of adjuvant radiation and/or chemotherapy is largely,

J Neurosurg Case Lessons. 2023 Aug 21;6(8):CASE23317. doi: 10.3171/CASE23317. Print 2023 Aug 21.

ABSTRACT

BACKGROUND: Mesenchymal chondrosarcoma (MCS) is an aggressive subtype of chondrosarcoma that occurs extremely rarely in the central nervous system. Patients often present with pain or sensorimotor deficits, and resection is considered the gold standard. The role of adjuvant radiation and/or chemotherapy is largely unknown.

OBSERVATIONS: A 22-year-old male presented with a 4-month history of progressive back and bilateral leg pain. He underwent imaging workup with magnetic resonance imaging of the lumbar spine and was found to have an intradural, extramedullary, heterogeneously enhancing mass spanning the L4-5 vertebral levels. Intraoperatively, a lobular, partially calcified mass with a ventral dural attachment displacing the nerve roots laterally was observed. The mass was removed en bloc, and the patient later underwent adjuvant radiotherapy, with no evidence of recurrence 2 years following surgery.

LESSONS: Spinal MCS is extremely rare and often presents with a more aggressive course than conventional chondrosarcoma. Radiological diagnosis is challenging, as the tumor mimics different pathologies. The presence of calcifications, heterogeneous enhancement, and a more rapid clinical course as well as the presence of HEY1::NCOA2 gene fusion, which can be detected by surrogate immunohistochemistry, aids in diagnosis. Resection is the standard of care, and adjuvant radiation may be considered to reduce local recurrence, although further studies are warranted.

PMID:37728306 | DOI:10.3171/CASE23317

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Clinical diagnostic and radiographic features of a primary intradural spinal chondrosarcoma in a young adult: illustrative case

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J Neurosurg Case Lessons. 2023 Aug 21;6(8):CASE23317. doi: 10.3171/CASE23317. Print 2023 Aug 21.ABSTRACTBACKGROUND: Mesenchymal chondrosarcoma (MCS) is an aggressive subtype of chondrosarcoma that occurs extremely rarely in the central nervous system. Patients often present with pain or sensorimotor deficits, and resection is considered the gold standard. The role of adjuvant radiation and/or chemotherapy is largely
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