1
|
Chu B, Jiang S, Sun Q, Chen Q, Peng X. Extraskeletal mesenchymal chondrosarcoma of the distal thumb: A case report. Int J Surg Case Rep 2023; 103:107903. [PMID: 36652820 PMCID: PMC9860411 DOI: 10.1016/j.ijscr.2023.107903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 01/06/2023] [Accepted: 01/11/2023] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Chondrosarcoma is the most common primary malignant bone tumor of the hand, Mesenchymal chondrosarcoma (MCS) is a rare subtype of chondrosarcoma, extraosseous mesenchymal chondrosarcoma (EMCS) is even rarer. CASE PRESENTATION We presented a case of primary EMCS involving the distal thumb in a 59-year-old man. The patient had abnormally grown nails and a higher skin temperature than the contralateral finger. After admission to our hospital, we found that the tumor has the possibility of malignant transformation, but imageological examinations did not reveal invasive bone lesions and calcification. Finally, due to the patient's strong desire to preserve the thumb, a conservative surgical approach was selected to preserve the patient's finger function, and histological examination indicated MCS. CONCLUSION EMCS is a highly malignant tumor with strong tendency of invasion and metastasis. Imaging is sometimes difficult to diagnose, and pathology is a necessary part of distinguishing between benign and malignant tumors. Operation is the major treatment to EMCS, meanwhile, adjuvant radiotherapy and chemotherapy also be effective. The overall prognosis is poor.
Collapse
Affiliation(s)
- Bin Chu
- Department of Orthopedics, Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei, Anhui, China
| | - Shifeng Jiang
- Department of Orthopedics, Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei, Anhui, China
| | - Quanqiu Sun
- Department of Orthopedics, Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei, Anhui, China
| | - Qi Chen
- Department of Radiology, Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei, Anhui, China
| | - Xin Peng
- Department of Orthopedics, Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei, Anhui, China.
| |
Collapse
|
2
|
Saito R, Senbokuya N, Yagi T, Yoshioka H, Kanemaru K, Kinouchi H. Primary Spinal Intradural Extramedullary Mesenchymal Chondrosarcoma. World Neurosurg 2020; 145:376-380. [PMID: 33049384 DOI: 10.1016/j.wneu.2020.10.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 10/02/2020] [Accepted: 10/03/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Among chondrosarcomas arising from bones and soft tissues, mesenchymal chondrosarcoma (MCS), especially primary spinal intradural extramedullary MCS, is extremely rare, and only 18 cases have been reported to date. We report an adult case of this rare condition mimicking meningioma. CASE DESCRIPTION A 42-year-old woman presented with paraplegia and sensory disturbance associated with right-sided Brown-Séquard syndrome following back pain. Magnetic resonance imaging showed an intradural mass in the right dorsal spinal canal with homogeneous enhancement and dural tail sign at the T8 level. Computed tomography demonstrated a calcified portion in the mass. Following T7-8 laminectomies, an intradural extramedullary tumor was completely removed after detaching the tumor from the dura mater. The histopathologic diagnosis was MCS, and positron emission tomography showed no metastatic lesions at other sites. The patient did not receive adjuvant therapy, and magnetic resonance imaging revealed no evidence of recurrence during 2-year follow-up. CONCLUSIONS Primary spinal intradural extramedullary MCS has been reported to have a better prognosis than MCS occurring in other regions. In a case with early complete surgical resection, adjuvant therapy should be considered at the time of recurrence.
Collapse
Affiliation(s)
- Ryu Saito
- Department of Neurosurgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan
| | - Nobuo Senbokuya
- Department of Neurosurgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan
| | - Takashi Yagi
- Department of Neurosurgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan.
| | - Hideyuki Yoshioka
- Department of Neurosurgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan
| | - Kazuya Kanemaru
- Department of Neurosurgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan
| | - Hiroyuki Kinouchi
- Department of Neurosurgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan
| |
Collapse
|
3
|
Pinheiro TN, Leite MGM, Bindá FA, Dutra ALT, Sarmento N, Cabral LN, Consolaro A, Bacchi CE. Metastatic Biphasic Primitive Tumor in the Mandible of a Child. Eur J Dent 2020; 14:502-510. [PMID: 32542629 PMCID: PMC7440943 DOI: 10.1055/s-0040-1713306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Pediatric mandibular tumors present an aggressive biological behavior and difficult diagnosis. A wide range of odontogenic and nonodontogenic tumors comprise the spectrum of these lesions. We report a case of a 1-year-old male child patient showing facial asymmetry symptomatic of an expansive lesion extending throughout the body and ramus of the left hemimandible with a diameter of 8 cm. The histopathological report suggested a high-grade mucoepidermoid carcinoma (MEC), recommending further immunohistochemical investigation of the ectomesenchymal or neuroectodermal origin of the tumor cells. The patient evolved with extensive bilateral pleural effusion followed by metastasis in the middle third of the right humerus, and died 2 months after the first biopsy procedure by acute renal failure with tubular necrosis, before a final inconclusive immunohistochemical report was reached. The lack of resources for less-favored regions of Brazil impairs rapid biomolecular examinations such as immunohistochemical resulting in delay of appropriate therapeutic procedures.
Collapse
Affiliation(s)
- Tiago Novaes Pinheiro
- Department of Oral Pathology and Oral Medicine, Surgical Pathology and Oral and Maxillofacial Pathology Service, Amazonas State University, Cachoeirinha, Manaus-AM, Brazil
| | - Milena Gomes Melo Leite
- Department of Oral Pathology and Oral Medicine, Surgical Pathology and Oral and Maxillofacial Pathology Service, Amazonas State University, Cachoeirinha, Manaus-AM, Brazil
| | - Fábio Arruda Bindá
- Department of Head and Neck Oncology, Fundação Centro de Controle de Oncologia do Estado do Amazonas, Planalto, Manaus-AM, Brazil
| | - André Luiz Tannus Dutra
- Department of Pediatric Dentistry, Amazonas State University, Cachoeirinha, Manaus-AM, Brazil
| | - Naelka Sarmento
- Department of Pediatric Dentistry, Amazonas State University, Cachoeirinha, Manaus-AM, Brazil
| | - Lioney Nobre Cabral
- Department of Oral Pathology and Oral Medicine, Amazonas State University, Cachoeirinha, Manaus-AM, Brazil
| | - Alberto Consolaro
- Department of Oral Pathology, Bauru School of Dentistry, University of São Paulo, Bauru-SP, Brazil
| | | |
Collapse
|
4
|
Rossetto A, Saccomano E, Zompicchiatti A, Avellini C, Toffoli S, Miolo G, Frustaci S, Uzzau A. Mesenchymal chondrosarcoma of the spleen: Report of a case. TUMORI JOURNAL 2018; 97:e10-5. [DOI: 10.1177/030089161109700423] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background Chondrosarcoma is a malignant tumor of chondrogenic origin and the mesenchymal type is a very rare finding. Mesenchymal chondrosarcoma tends to develop mostly in the skeleton but may also occur as a primary tumor in periosteal nervous and muscular tissues, the anterior cerebral falx, meninges, brain, maxillary sinus, eyelid, thyroid, pleura and mediastinum, while in the abdomen the most frequent locations are the kidney, retroperitoneum and even the perineum and the anogenital area. Apparently, the only splenic mesenchymal chondrosarcoma in the literature occurred in a dog. Methods and study design Our paper reports the case of a patient who had a diagnosis of mesenchymal chondrosarcoma of the spleen. Results We adopted surgery as the main therapeutic procedure without achieving complete recovery but preserving a good quality of life for our patient, minimizing the repercussions of the disease on her working and relational life. Conclusions The absence of important or invalidating symptoms and the persistence of good general conditions before and after each surgical operation encouraged us to adopt the surgical option as the most rational.
Collapse
Affiliation(s)
- Anna Rossetto
- Department of Surgery & Transplantation, University Hospital of Udine, Udine
| | - Enrico Saccomano
- Department of Surgery & Transplantation, University Hospital of Udine, Udine
| | - Aron Zompicchiatti
- Department of Surgery & Transplantation, University Hospital of Udine, Udine
| | - Claudio Avellini
- Department of Surgical Pathology, University Hospital of Udine, Udine
| | - Silvia Toffoli
- Department of Surgical Pathology, University Hospital of Udine, Udine
| | - GianMaria Miolo
- Department of Medical Oncology, Centro di Riferimento Oncologico, Aviano, Italy
| | - Sergio Frustaci
- Department of Medical Oncology, Centro di Riferimento Oncologico, Aviano, Italy
| | - Alessandro Uzzau
- Department of Surgery & Transplantation, University Hospital of Udine, Udine
| |
Collapse
|
5
|
Cesari M, Bertoni F, Bacchini P, Mercuri M, Palmerini E, Ferrari S. Mesenchymal Chondrosarcoma. An Analysis of Patients Treated at a Single Institution. TUMORI JOURNAL 2018; 93:423-7. [DOI: 10.1177/030089160709300503] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background We analyzed clinical and treatment-related factors influencing the outcome of patients with mesenchymal chondrosarcoma (MC). Twenty-six patients (median age, 31 years) were identified using the Tumor Center and Chemotherapy Department database of the study institute. Methods Patients received surgery (24 patients) and/or radiotherapy (5 patients), and chemotherapy (12 patients). Results After a median follow-up of 48 months (7-237 months) 10 patients were alive. The 10-year overall survival (OS) was 27% in those who achieved complete surgical remission and 0% in those who did not (P = 0.0007). A worse 10-year probability of OS was observed in patients who were metastatic at presentation (metastatic 0%, localized 31%, P = 0.02), in patients with soft tissue MC (soft tissue MC 0%, bone MC 29%, P = 0.06) and in hemangiopericytoma-like MC (hemangiopericytoma-like MC 0%, Ewing's-like MC 33.5%, P = 0.9). In those patients who achieved complete surgical remission, the 10-year DFS was 76% for those who received chemotherapy and 17% for those who did not (P = 0.008). Conclusions Our experience confirmed the importance of complete surgical remission in MC treatment and suggests that the addition of chemotherapy should offer a benefit in terms of DFS. Due to the rarity of MC, multicentrer studies are needed to identify the most active chemotherapy regimen.
Collapse
Affiliation(s)
- Marilena Cesari
- Chemotherapy, Department of Musculoskeletal Oncology, Istituti Ortopedici Rizzoli, Bologna, Italy
| | - Franco Bertoni
- Pathology, Department of Musculoskeletal Oncology, Istituti Ortopedici Rizzoli, Bologna, Italy
| | - Patrizia Bacchini
- Pathology, Department of Musculoskeletal Oncology, Istituti Ortopedici Rizzoli, Bologna, Italy
| | - Mario Mercuri
- 5th Division of Orthopedic Surgery, Department of Musculoskeletal Oncology, Istituti Ortopedici Rizzoli, Bologna, Italy
| | - Emanuela Palmerini
- Chemotherapy, Department of Musculoskeletal Oncology, Istituti Ortopedici Rizzoli, Bologna, Italy
| | - Stefano Ferrari
- Chemotherapy, Department of Musculoskeletal Oncology, Istituti Ortopedici Rizzoli, Bologna, Italy
| |
Collapse
|
6
|
Derenda M, Borof D, Kowalina I, Wesołowski W, Kloc W, Iżycka-Świeszewska E. Primary Spinal Intradural Mesenchymal Chondrosarcoma with Several Local Regrowths Treated with Osteoplastic Laminotomies: A Case Report. Surg J (N Y) 2017; 3:e117-e123. [PMID: 28825035 PMCID: PMC5553510 DOI: 10.1055/s-0037-1604159] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Accepted: 05/30/2017] [Indexed: 12/26/2022] Open
Abstract
Mesenchymal chondrosarcomas (MCSs) are rare malignant tumors of the bone and soft tissues. Only a few cases of such tumors originating from the spinal canal meninges have been described in the literature. The authors report on a case of a 22-year-old woman with MCS of the arachnoid at the T12-L1 level with a 14-year-long observation. The tumor was totally resected using osteoplastic laminotomy with reconstruction of laminar roof. This small spindle cell tumor was initially microscopically suspected of synovial sarcoma, but correctly verified with widened immunophenotyping and molecular studies as MCS. At its first recurrence, the neoplasm showed microscopically a typical bimorphic pattern of small round cell component with foci of hyaline cartilage. The patient experienced three local recurrences: 4, 6, and 10 years after the initial resection, respectively. The techniques of laminotomy and relaminotomy were also used during three following operations. The repeated surgical removal, radiotherapy, and chemotherapy were the methods of complex oncological treatment. The patient remains now in complete remission, fully self-dependent with slight motor disturbance, and mild sensory deficits. Current views on the clinicopathological characteristics and treatment modalities of the chondrosarcomas of the spinal canal are discussed.
Collapse
Affiliation(s)
- Marek Derenda
- Department of Neurosurgery, Regional Hospital, Elblag, Poland
| | - Damian Borof
- Department of Neurosurgery, Regional Hospital, Elblag, Poland
| | | | | | - Wojciech Kloc
- Departments of Neurology & Neurosurgery, University of Varmia & Masuria University, Olsztyn, Poland
| | | |
Collapse
|
7
|
Ali N, Vanel D, Righi A, Colangeli M, Manfrini M. Imaging features of extraskeletal mesenchymal chondrosarcoma of the hand. Diagn Interv Imaging 2015; 96:965-7. [DOI: 10.1016/j.diii.2015.02.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 02/12/2015] [Accepted: 02/16/2015] [Indexed: 10/23/2022]
|
8
|
Xu J, Li D, Xie L, Tang S, Guo W. Mesenchymal chondrosarcoma of bone and soft tissue: a systematic review of 107 patients in the past 20 years. PLoS One 2015; 10:e0122216. [PMID: 25849226 PMCID: PMC4388572 DOI: 10.1371/journal.pone.0122216] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2014] [Accepted: 02/19/2015] [Indexed: 12/27/2022] Open
Abstract
Background Mesenchymal chondrosarcoma(MCS) is a rare high-grade variant of chondrosarcoma. Consensus has not been reached on its optimal management. Resection with wide margins is usually recommended, but the effect of margins has been demonstrated by little positive evidence. Moreover, the effectiveness of adjuvant chemo- and/or radiotherapy remains controversial. Objectives To describe the clinical characteristics and outcomes of MCS of bone and soft tissue, to assess the efficacies of surgery, chemotherapy and radiation, and finally to deliver a more appropriate therapy. Materials and Methods We reviewed EMBASE-, MEDLINE-, Cochrane-, Ovid- and PubMed-based to find out all cases of MCS of bone and soft tissue described between April 1994 and April 2014. Description of treatment and regular follow-up was required for each study. Language was restricted to English and Chinese. Issues of age, gender, location, metastasis, and treatment were all evaluated for each case. Kaplan-Meier Method and Cox Proportional Hazard Regression Model were used in the survival analysis. Results From the 630 identified publications, 18 meeting the inclusion criteria were selected, involving a total of 107 patients. Based on these data, the 5-, 10-and 20-year overall survival are 55.0%, 43.5% and 15.7% respectively. The 5-, 10-, 20- year event-free survival rates are 45.0%, 27.2% and 8.1%, respectively. Treatment without surgery is associated with poorer overall survival and event-free survival. Negative surgical margins could significantly bring down the local-recurrence rate and are associated with a higher event-free survival rate. Chemotherapy regime based on anthracyclines does not benefit the overall survival. The addition of radiation therapy is not significantly associated with the overall or event-free survival. However, we recommend radiation as the salvage therapy for patients with positive margin so as to achieve better local control. Conclusions This review shows that surgery is essential in the management of MCS of bone and soft tissue. Appropriate adjuvant therapy may reduce local recurrence, but cannot benefit the overall survival.
Collapse
Affiliation(s)
- Jie Xu
- Musculoskeletal Tumour Centre, People’s Hospital, Peking University, Beijing, China
| | - Dasen Li
- Musculoskeletal Tumour Centre, People’s Hospital, Peking University, Beijing, China
| | - Lu Xie
- Musculoskeletal Tumour Centre, People’s Hospital, Peking University, Beijing, China
| | - Shun Tang
- Musculoskeletal Tumour Centre, People’s Hospital, Peking University, Beijing, China
| | - Wei Guo
- Musculoskeletal Tumour Centre, People’s Hospital, Peking University, Beijing, China
- * E-mail:
| |
Collapse
|
9
|
A rare case of extraskeletal mesenchymal chondrosarcoma with dedifferentiation arising from the buccal space in a young male. J Maxillofac Oral Surg 2013; 14:293-9. [PMID: 25838713 DOI: 10.1007/s12663-013-0500-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Accepted: 03/13/2013] [Indexed: 12/23/2022] Open
Abstract
Extraskeletal mesenchymal chondrosarcoma (EMCS) is a rare and aggressive pathological variant of chondrosarcoma arising from soft tissues of mainly the extremities, meninges/dura, trunk, and orbits. EMCS comprises only 2 % of all soft tissue sarcomas and only 6 % of them arise from soft tissue in the head and neck region. It usually affects in the second and third decade of life and is common in women. It runs a very rapid clinical course with distant metastases and has poor prognosis and survival rates. Histologically it has a dimorphic presentation of small round mesenchymal cells interspersed with foci of cartilaginous differentiation. Radiographically it appears as a soft tissue lobulated mass with various patterns of calcification. This is the first case of primary and recurrent EMCS originating in the buccal space with unusual features of dedifferentiation. The diagnostic challenges in this case were the inconclusive FNAC results, lack of radiographic evidence of characteristic calcifications and presence of areas of myxoid material and dedifferentiation on histopathology. The clinical, cytological, histological, immunohistochemical, radiographic, PET-CT findings and management with review of literature is presented. The diagnostic and management pitfalls of this extremely rare tumor are also discussed.
Collapse
|
10
|
Abstract
Mesenchymal chondrosarcoma (MSC) is a very rare sarcoma that is highly malignant with frequent local recurrences and distant metastases leading to a very poor long-term outcome. It differs from classical chondrosarcomas in that it occurs more often in children and commonly in extraskeletal locations. Hardly any evidence-based recommendations for treatment exist. We present the case of a 9-year old boy (pre- and intraoperative findings and histopathological details) who was initially admitted with the diagnosis of a jugular paraganglioma and discuss this case in the light of the recent literature.
Collapse
|
11
|
Seo CY, Jung ST, Byun JW. Extraskeletal mesenchymal chondrosarcoma in the axillary region: reports of two cases. KOREAN JOURNAL OF PATHOLOGY 2012; 46:483-8. [PMID: 23136576 PMCID: PMC3490122 DOI: 10.4132/koreanjpathol.2012.46.5.483] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2011] [Revised: 12/01/2011] [Accepted: 12/02/2011] [Indexed: 11/24/2022]
Abstract
Extraskeletal mesenchymal chondrosarcomas (EMCs) are relatively uncommon, and a location in the upper extremity, especially in the shoulder or axillary region, is rare. Furthermore, the radiographic findings of EMCs do not show any features that distinguish them from other neoplasms, and therefore, definitive diagnoses are made based on histological features. EMC is an aggressive tumor with a poor prognosis, and requires wide surgical excision. However, its treatment may involve peculiarities such as a difficulty in obtaining a proper surgical margin in the axillary region or shoulder. In this report, the authors present two rare cases of EMCs in the axillary region.
Collapse
Affiliation(s)
- Chang-Young Seo
- Department of Orthopedic Surgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | | | | |
Collapse
|
12
|
Cates JMM, Coffin CM. Extraskeletal cartilaginous, osseous, and chordoid tumors in children and adolescents. Pediatr Dev Pathol 2012; 15:255-66. [PMID: 22420731 DOI: 10.2350/10-07-0875-pb.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Extraskeletal cartilaginous, osseous, and chordoid tumors are extraordinarily rare in children and adolescents. These lesions are diagnostically challenging due to their rarity and their overlap with metastatic osteosarcoma, reactive or metabolic calcifying and bone-forming masses, various pseudosarcomatous proliferations such as myositis ossificans, and other rare genetic or metabolic disorders. This article reviews the clinicopathologic features and differential diagnosis of extraskeletal cartilaginous, osseous, and chordoid neoplasms in the first two decades of life and highlights the use of diagnostic adjuncts.
Collapse
Affiliation(s)
- Justin M M Cates
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, TN, USA
| | | |
Collapse
|
13
|
Bae GS, Choi SW, Youm JY, Kim SH. Primary spinal dumbbell-shaped mesenchymal chondrosarcoma located intradurally and extradurally. J Korean Neurosurg Soc 2011; 50:468-71. [PMID: 22259697 DOI: 10.3340/jkns.2011.50.5.468] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2010] [Revised: 04/12/2011] [Accepted: 11/09/2011] [Indexed: 11/27/2022] Open
Abstract
Mesenchymal chondrosarcomas are rare malignant tumors of the bone and soft tissue. Spinal mesenchymal chondrosarcomas are even rarer and, to the best of our knowledge those that are concomitantly located in the intradural and extradural regions, have never been reported. We report a case of a 25-year-old man with back pain and bilateral progressive weakness of the lower extremities. Magnetic resonance imaging revealed a markedly enhanced dumbbell-shaped mass at the T7 level. The lesion was intradurally located at the left side of the spinal cord, and extended extradurally to the extraforminal space through the T7-8 intervertebral foramen. The tumor was completely excised through a posterior approach. Microscopic examination and immunohistochemical studies confirmed mesenchymal chondrosarcoma. Postoperative radiation therapy and chemotherapy were also performed to prevent local recurrence and metastasis. The patient has been symptom-free for two years after surgery. Herein, we reviewed and discussed the clinical characteristics, treatments, and outcomes of primary intraspinal mesenchymal chondrosarcomas in the literature.
Collapse
Affiliation(s)
- Gyu-Seong Bae
- Department of Neurosurgery, School of Medicine, Chungnam National University, Daejeon, Korea
| | | | | | | |
Collapse
|
14
|
Kurotaki H, Tateoka H, Takeuchi M, Yagihashi S, Kamata Y, Nagai K. Primary Mesenchymal Chondrosarcoma of the Lung: A Case Report with lmmunohistochemical and Ultra structural Studies. Pathol Int 2008. [DOI: 10.1111/j.1440-1827.1992.tb02887.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
15
|
Dantonello TM, Int-Veen C, Leuschner I, Schuck A, Furtwaengler R, Claviez A, Schneider DT, Klingebiel T, Bielack SS, Koscielniak E. Mesenchymal chondrosarcoma of soft tissues and bone in children, adolescents, and young adults: experiences of the CWS and COSS study groups. Cancer 2008; 112:2424-31. [PMID: 18438777 DOI: 10.1002/cncr.23457] [Citation(s) in RCA: 114] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Mesenchymal chondrosarcoma (MCS) is a rare tumor with a strong tendency toward late recurrences leading to reported 10-year survival rates below 50%. The recommended treatment is resection with wide margins; the effectiveness of chemo- and radiotherapy remain poorly defined. As reports about MCS in young patients are scarce, treatment and outcomes of children/adolescents/young adults in the CWS and COSS studies were investigated. METHODS Since 1977, 15 of >7000 CWS and COSS patients <or=25 years had a confirmed diagnosis of MCS. RESULTS The median age was 16.6 (range, 1-25) and median follow-up 9.6 years (range, 1-22). Four MCS were osseous and 11 extraosseous. All but 1 patient had nonmetastatic disease. Tumor sites were head/neck (n = 6), paravertebral (n = 3), pelvis (n = 3), limbs (n = 2), and kidney (n = 1). All tumors were resected, but only 8 completely. Thirteen individuals received chemotherapy, 6 were irradiated. Actuarial 10-year event-free and overall survival rates were 53% and 67%, respectively. Four recurrences occurred, all within 4 years from diagnosis (3 local, 1 combined; 2 of these in irradiated patients). One of these patients survived after surgery and radiation for local recurrence. Seven of 8 patients whose tumors were completely resected during primary treatment, but only 4 of 7 patients with incomplete surgery survived disease-free. CONCLUSIONS This series of 15 MCS differs from others: the median age was young, most tumors were extraosseous, most patients received chemotherapy, and the outcome was better than published. Despite long-term follow-up, characteristic late metastatic recurrences were not observed. Treating MCS according to standard multimodal soft tissue/bone sarcoma regimens is proposed.
Collapse
Affiliation(s)
- Tobias M Dantonello
- Pediatrics 5 - Oncology, Hematology, Immunology, Olgahospital, Klinikum Stuttgart, Stuttgart, Germany.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Oh BG, Han YH, Lee BH, Kim SY, Hwang YJ, Seo JW, Kim YH, Cha SJ, Hur G, Joo M. Primary extraskeletal mesenchymal chondrosarcoma arising from the pancreas. Korean J Radiol 2008; 8:541-4. [PMID: 18071285 PMCID: PMC2627457 DOI: 10.3348/kjr.2007.8.6.541] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
We report here on a case of primary extraskeletal mesenchymal chondrosarcoma that arose from the pancreas. A 41-year-old man was evaluated by CT to find the cause of his abdominal pain. The CT scans showed a heterogeneously enhancing necrotic mass with numerous areas of coarse calcification, and this was located in the left side of the retroperitoneal space and involved the body and tail of the pancreas. Portal venography via the celiac axis also showed invasion of the splenic vein. Following excision of the mass, it was pathologically confirmed to be primary extraskeletal mesenchymal chondrosarcoma that arose from the pancreas.
Collapse
Affiliation(s)
- Bae-Geun Oh
- Department of Radiology, Ilsan Paik Hospital, Inje University, School of Medicine, Goyang-si, Gyeonggi-do, Korea
| | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Li YH, Yao XH. Primary intradural mesenchymal chondrosarcoma of the spine in a child. Pediatr Radiol 2007; 37:1155-8. [PMID: 17849111 DOI: 10.1007/s00247-007-0576-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2007] [Revised: 06/14/2007] [Accepted: 07/02/2007] [Indexed: 11/28/2022]
Abstract
We report a primary intradural mesenchymal chondrosarcoma of the spine in a 3-year-old girl. MRI revealed a markedly enhancing oval mass associated with focal areas of low signal intensity extending from T11 to L1. The lesion was located posterolateral to the right side of the spinal cord, pushing the conus medullaris and cauda equina anteriorly and to the left. The adjacent spinal cord also showed serpiginous areas of flow void. The mass was completely removed. Microscopic examination and immunohistochemical studies confirmed the diagnosis of mesenchymal chondrosarcoma. The patient was free of symptoms after surgery.
Collapse
Affiliation(s)
- Yu-Hua Li
- Department of Radiology, Xin Hua Hospital, School of Medicine, Shanghai Jiao Tong University, 1665 Kong Jiang Road, Shanghai, China.
| | | |
Collapse
|
18
|
Anderson JT, Lucas GL. Extraskeletal mesenchymal chondrosarcoma of the forearm: a case report. J Hand Surg Am 2007; 32:389-92. [PMID: 17336849 DOI: 10.1016/j.jhsa.2007.01.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2005] [Revised: 12/26/2006] [Accepted: 01/02/2007] [Indexed: 02/02/2023]
Abstract
Mesenchymal chondrosarcomas represent less than 10% of all chondrosarcomas. The majority of these tumors arise from the skeleton; only 22% have an extraosseous origin. Of the extraskeletal locations, the meninges, brain, and thigh are the most common. Involvement of the forearm is a rare occurrence. This case report describes an extraskeletal mesenchymal chondrosarcoma involving the forearm.
Collapse
Affiliation(s)
- John T Anderson
- Department of Surgery, Section of Orthopaedics, University of Kansas School of Medicine-Wichita, Wichita, KS, USA.
| | | |
Collapse
|
19
|
Hannachi-Sassi S, Mekni A, Sassi B, Mrad K, Ben Romdhane K. [Extraskeletal mesenchymal chondrosarcoma: a case report and review of the literature]. ACTA ACUST UNITED AC 2004; 90:265-8. [PMID: 15211276 DOI: 10.1016/s0035-1040(04)70103-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
We report a new case of mesenchymal chondrosarcoma in a 25-Year-old woman who presented a tumefaction of the anteromedial aspect of the mid left leg which had developed over two Years. Computed tomography of the lower left limb demonstrated the presence of a soft tIssue tumor limited to the gastrocnemus medial. The 7.5 x 5 cm tumor was centered on a zone of calcification. Histological examination confirmed the diagnosis of malignant mesenchymatous proliferation with two components: a well differentiated cartilaginous component and a totally undifferentiated component. Surgical resection was performed but tumor recurrence was observed in the popliteal fossa as well as a pulmonary metastasis with a unique parenchymal nodule. Amputation of the left lower limb and metastasectomy were performed. At last follow-up, the patient presented permeation nodules on the scalp.
Collapse
Affiliation(s)
- S Hannachi-Sassi
- Service d'Anatomie et de Cytologie Pathologiques, Institut Salah Azaiez-Bab Saadoun, 1006 Tunis, Tunisie.
| | | | | | | | | |
Collapse
|
20
|
Trembath DG, Dash R, Major NM, Dodd LG. Cytopathology of mesenchymal chondrosarcomas: a report and comparison of four patients. Cancer 2003; 99:211-6. [PMID: 12925982 DOI: 10.1002/cncr.11300] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Mesenchymal chondrosarcoma (MC) is an infrequent neoplasm, representing approximately 1% of all chondrosarcomas. Cytologic descriptions of MCs have been confined to rare case reports. In the current report, the authors describe their experience with the cytologic features of four MCs: two primary tumors and two metastatic lesions. METHODS Four patients were diagnosed with MC at the authors' institution from 1994 to 2002. Three of four patients underwent fine-needle aspiration (FNA) biopsy as part of their diagnosis; in the fourth patient, imprint cytology was performed. Each tumor also received histologic confirmation. RESULTS The patients studied included three females and one male. In three patients, the tumor presented initially as a soft tissue mass; whereas, in the remaining patient, the MC presented in the tibia. FNA results demonstrated small, oval-to-spindled cells with high nuclear-to-cytoplasmic ratios. Cells occurred singly and in clumps in a background of basophilic extracellular matrix. Histologic examination of each lesion demonstrated biphasic tumors, including focal areas of relatively mature cartilage formation as well as a small cell population. CONCLUSIONS MC is a rare soft tissue tumor that occurs frequently in extraskeletal locations. FNA of these tumors can be diagnostic if the tumor is sampled appropriately and of critical features, such as the background extracellular matrix, are recognized. Given the propensity of these tumors to metastasize and the poor prognosis of patients with MC, early identification by FNA biopsy may allow earlier, more aggressive interventions.
Collapse
Affiliation(s)
- Dimitri G Trembath
- Department of Pathology, Duke University Medical Center, Durham, North Carolina 27710, USA
| | | | | | | |
Collapse
|
21
|
White DW, Ly JQ, Beall DP, McMillan MD, McDermott JH. Extraskeletal mesenchymal chondrosarcoma: case report. Clin Imaging 2003; 27:187-90. [PMID: 12727057 DOI: 10.1016/s0899-7071(02)00538-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This is a case report of an extraskeletal mesenchymal chondrosarcoma (ESMC) that originally occurred in the retroperitoneum of a 24-year-old female and later metastasized to the left proximal humerus. Mesenchymal chondrosarcomas are very rare in comparison to conventional chondrosarcomas and even more so when arising from an extraskeletal location. In this report, we discuss the major characteristics of ESMC and offer a review of the current knowledge regarding this rare disease entity.
Collapse
Affiliation(s)
- Douglas W White
- Department of Radiology and Nuclear Medicine, Wilford Hall Medical Center, 2200 Bergquist Drive, Ste. 1, Lackland AFB, TX 78236-5300, USA.
| | | | | | | | | |
Collapse
|
22
|
Abstract
This article retains the conventional approach to the classification of soft tissue sarcomas, dividing them into several major histogenetic categories based on their overall microscopic appearance, tissue differentiation pattern, and biologic potential. The author advocates a multimodal approach, in which four distinctive data sets--clinical, radiographic, microscopic, and, in some cases, molecular--are considered to establish the diagnosis and treatment plan. Such step-wise analysis is more likely to lead to consistency and accuracy as compared with an intuitive approach based on fragmentary data. The author describes individual lesions of soft tissue as clinicopathologic entities and believes that they can be more accurately diagnosed and appropriately treated with the help of data generated by a multidisciplinary team. In addition, this article emphasizes the need to use emerging molecular techniques that can provide important clues for both diagnosis and prognosis.
Collapse
Affiliation(s)
- Bogdan Czerniak
- Department of Pathology, University of Texas M.D. Anderson Cancer Center, Box 085, 1515 Holcombe Boulevard, Houston, TX 77030, USA.
| |
Collapse
|
23
|
Abstract
Mesenchymal chondrosarcoma is a rare variant of chondrosarcomas characterized by a bimorphic pattern with areas of the undifferentiated malignant small cells and well differentiated cartilaginous islands.(1) It occurs most commonly in the bone but can also occur in the extraskeletal soft tissues, the brain, and the meninges. This type of tumor has also been described in the eyelids, parapharyngeal space, mediastinum, and the kidney.(1-5) An origin from the large vessels has not been reported in the medical literature. The authors report a case of mesenchymal chondrosarcoma originating from the femoral vein in a 28-year-old female patient, treated by the wide-margin resection.
Collapse
Affiliation(s)
- Geun Eun Kim
- Division of Vascular Surgery and Department of Pathology, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.
| | | | | | | |
Collapse
|
24
|
Affiliation(s)
- R E Leggon
- Department of Orthopaedic Surgery, Geisinger Medical Center, Danville, PA 17822, USA
| | | | | |
Collapse
|
25
|
|
26
|
Bingaman KD, Alleyne CH, Olson JJ. Intracranial Extraskeletal Mesenchymal Chondrosarcoma: Case Report. Neurosurgery 2000. [DOI: 10.1093/neurosurgery/46.1.207] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Kimberly D. Bingaman
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia
| | - Cargill H. Alleyne
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia
| | - Jeffrey J. Olson
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia
| |
Collapse
|
27
|
Campanacci M. Extraskeletal Chondrosarcomas. BONE AND SOFT TISSUE TUMORS 1999:1181-1188. [DOI: 10.1007/978-3-7091-3846-5_87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
|
28
|
Jacobs JL, Merriam JC, Chadburn A, Garvin J, Housepian E, Hilal SK. Mesenchymal chondrosarcoma of the orbit. Report of three new cases and review of the literature. Cancer 1994; 73:399-405. [PMID: 8293407 DOI: 10.1002/1097-0142(19940115)73:2<399::aid-cncr2820730227>3.0.co;2-g] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Extraskeletal mesenchymal chondrosarcoma is a rare tumor characterized by undifferentiated mesenchymal cells with islands of mature hyaline cartilage. Considering all sites, long-term survival is approximately 30%. Only seven cases of orbital mesenchymal chondrosarcoma have been reported. METHODS The records of three cases of orbital mesenchymal chondrosarcoma treated at the Columbia-Presbyterian Medical Center, and the seven previously reported cases of this tumor were reviewed to determine clinical characteristics and appropriate therapy. RESULTS Nine of the 10 patients were female; age of onset ranged from 10 to 35 years. Of eight patients with at least 2 years of observation, five survived 5 or more years after resection, or after resection plus adjuvant therapy. Two patients died of metastatic disease 2 and 5 years, respectively, after the initial treatment, and one died of pneumonia 6 months after surgery. Review of the histology of the three cases treated at Columbia-Presbyterian Medical Center did not identify distinct histologic types that might guide therapy. Presenting symptoms were typical of symptoms of an orbital mass: proptosis, pain, diplopia, change in visual acuity, ptosis, and tearing. CONCLUSION The small number of reported cases of mesenchymal chondrosarcoma of the orbit prevents definitive conclusions, but it appears that resection is adequate therapy in some cases. Extraskeletal mesenchymal chondrosarcoma of the orbit may have a better prognosis than tumors in other sites.
Collapse
Affiliation(s)
- J L Jacobs
- College of Physicians and Surgeons, Columbia University, New York, New York
| | | | | | | | | | | |
Collapse
|
29
|
Abstract
A case is presented of a 3-year-old boy with a mesenchymal chondrosarcoma extending from the 1st to the 5th lumbar vertebra. This is the youngest case of a mesenchymal chondrosarcoma located outside the skeleton or in the C.N.S. After assumed total excision with subsequent radiotherapy and chemotherapy, local tumor recurrence and (later) systemic metastases were detected. Standard therapy should include radical excision because of the high incidence of local recurrence and subsequent radiotherapy because of the expected high incidence of tumor cells in the CSF. The value of chemotherapy cannot be assessed, as it has been applied in only one other case found in the literature.
Collapse
Affiliation(s)
- J Reif
- Neurosurgical Clinic, Saarland University, Homburg/Saar, West Germany
| | | |
Collapse
|