Scapula chondrosarcoma: A case report

Rare Case of Scapular Body Chondrosarcoma Treated With Limb-Salvage Partial Scapulectomy: A Case Report Highlighting Surgical Technique

Chondrosarcomas are the second most malignant mesenchymal tumors that originate from neoplastic cells producing cartilage. It usually affects different sites in the body, such as the pelvis, humerus, and ribs, and rarely involves the scapula. The main modality of treatment of chondrosarcoma is surgery, while chemotherapy has been shown to be an ineffective treatment, and radiotherapy is only used in high-grade tumors. The present study reports a rare case of chondrosarcoma in a 34-year-old male patient who presented with a one-year history of a mass in the right scapula. The patient was managed by a multidisciplinary team, where surgery was the treatment of choice since the tumor was resistant to chemotherapy and radiotherapy. The postoperative pathological diagnosis was pleomorphic chondrosarcoma. The patient postoperatively received routine follow-up. Having chondrosarcoma in the scapula is rare since few studies are found in the literature. Many surgical approaches for chondrosarcoma were mentioned, but wide surgical excision has the best clinical outcome when compared with others.

Total Scapular Prosthesis, an Option for the Treatment of Scapular Chondrosarcoma

Introduction

Chondrosarcoma has the highest prevalence among the primary malignant bone tumors in adults over the age of 50, and the scapular region is the most affected anatomical site.

Case Report

We report the case of a 66-year-old female patient, with no previous medical history, who consulted for aggravating mixed, non-specific, and atraumatic pain in the right shoulder, evolving for a year. The radiological assessment, including a computed tomography (CT) scan, a magnetic resonance imaging, and a tumor CT-guided biopsy, confirmed the diagnosis of a Grade 2 chondrosarcoma. A curative surgical treatment was performed, by an extended tumor resection and simultaneous joint reconstruction by a reversed total shoulder prosthesis with a custom-made total scapular prosthesis. This option allows to maintain survival prognosis, associated with the preservation of upper limb function.

Conclusion

The results were conclusive at the curative level and very encouraging from the functional point of view with progressive and partial recovery of the articular amplitudes, allowing the preservation of patient's autonomy and quality of life. No complications such as scapular dislocation or tumor recurrence were documented at 3-year postoperative follow-up.

Multi-modality management of chondrosarcoma of scapula: A case report and review of literature

Chondrosarcoma are malignant tumours in which neoplastic cells produce cartilage. The most commonly affected sites are pelvis, femur, humerus and ribs. Scapula involvement is relatively rare. Surgery remains the primary modality of treatment for chondrosarcoma. Radiotherapy is used as an adjuvant therapy in high grade tumours and in cases of residual disease. Present study reports a rare case of scapular chondrosarcoma in a 37 year old male, managed with multimodality treatment and discusses briefly the prognostic parameters and treatment modalities. Only few studies have discussed about scapular chondrosarcoma and more studies with larger number of patients are needed to develop an evidence-based treatment and follow-up protocol for these patients.

Tumors of the Acromion Process—A Pictorial Review

Introduction  Acromion is essential for stabilizing the shoulder complex. Tumors of the acromion are rare. We report the largest series of acromion tumor and tumor-like lesion.

Materials and Methods  A retrospective review of the oncology and radiology database within our tertiary center for orthopaedic oncology was performed to identify all tumors of the acromion over the past 30 years and imaging was reviewed.

Results  We identified a total of 31 lesions arising in the acromion and chondrosarcoma was the commonest.

Conclusion  One needs to be aware of tumor and tumor-like lesions of acromion.

Innovative chest wall reconstruction with a locking plate and cement spacer after radical resection of chondrosarcoma in the sternum: A case report

BACKGROUND

Chondrosarcoma, a cartilage matrix producing tumor, is the second most commonly observed primary bone tumor after osteosarcoma, accounting for 15% of all chest wall malignancies. We herein report the case of a patient with chondrosarcoma of the sternum and our management of the chest wall defects that presented following radical tumor resection.

CASE SUMMARY

A 31-year-old patient presented to our hospital with dull pain and a protruding mass overlying the chest for 3 mo. The presence of nocturnal pain and mass size progression was reported, as were overhead arm elevation-related limitations. Computed tomography showed a focal osteoblastic mass in the sternum with bony exostosis and adjacent soft tissue calcification. Positron emission tomography-computed tomography revealed hypermetabolic activity with a mass located over the upper sternum. Magnetic resonance imaging showed a focal ill-defined bony mass of the sternum with cortical destruction and periosteal reaction. Preoperative biopsy showed a consistent result with chondrosarcoma with immunohistochemical positivity for S100 and focal positivity for IDH-1. The grade II chondrosarcoma diagnosis was confirmed by postoperative pathology. The patient underwent radical tumor resection and chest wall reconstruction with a locking plate and cement spacer. The patient was discharged 1 wk after surgery without any complications. At the 1-year follow-up, there was no local recurrence on imaging. The functional scores, including Constant Score, Nottingham Clavicle Score, and Oxford Shoulder Score, showed the absence of pain in the performance of daily activities or substantial functional disabilities.

CONCLUSION

The diagnosis of chondrosarcoma must be considered when chest wall tumors are encountered. The surgical reconstructive materials, with a locking plate and cement spacer, used in our study are cost-effective and readily-available for the sternum defect.