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Zhu ZY, Wang YB, Li HY, Wu XM. Primary intracranial extraskeletal myxoid chondrosarcoma: A case report and review of literature. World J Clin Cases 2022; 10:4301-4313. [PMID: 35665108 PMCID: PMC9131214 DOI: 10.12998/wjcc.v10.i13.4301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/04/2022] [Accepted: 03/06/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Primary intracranial extraskeletal myxoid chondrosarcoma (EMC) is an extremely rare low- to intermediate-grade malignant soft tissue sarcoma, and only 15 cases have been reported in the literature. Due to its rarity, clinical data and research on this tumor type are extremely limited, the pathogenesis and histological origin are still unclear, and the diagnostic and standard clinical treatment strategies for intracranial EMC remain controversial and undefined.
CASE SUMMARY We reported a case of a 52-year-old male who was admitted to the hospital with headache and dizziness for 1 mo, and his health status deteriorated during the last week. CT of the head showed a well-defined low-density lesion situated in the left cavernous sinus. Brain magnetic resonance imaging (MRI) showed a 3.4 cm × 3.0 cm sized, well-defined, round-shaped and heterogeneously enhanced lesion located in the left cavernous sinus. The entire lesion was removed via supratentorial craniotomy and microsurgery. Postoperative pathological diagnosis indicated primary intracranial EMC. Subsequently, the patient underwent 45 Gy/15 F stereotactic radiotherapy after discharge. At present, it is 12 mo after surgery, with regular postoperative follow-up and regular MRI examinations, that there are no clinical symptoms and radiographic evidence indicating the recurrence of the tumor, and the patient has returned to normal life.
CONCLUSION Currently, the most beneficial treatment for primary intracranial EMC is gross total resection combined with postoperative radiotherapy. Long-term follow-up is also necessary for patients.
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Affiliation(s)
- Zi-You Zhu
- Department of Neurosurgery, The First Hospital Affiliated to Jilin University, Changchun 130021, Jilin Province, China
| | - Yu-Bo Wang
- Department of Neurosurgery, The First Hospital Affiliated to Jilin University, Changchun 130021, Jilin Province, China
| | - Han-Yi Li
- Department of Orthodontics, Hospital of Stomatology of Jilin University, Changchun 130021, Jilin Province, China
| | - Xin-Min Wu
- Department of Neurosurgery, The First Hospital Affiliated to Jilin University, Changchun 130021, Jilin Province, China
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Hong YG, Yoo J, Kim SH, Chang JH. Intracranial Extraskeletal Myxoid Chondrosarcoma in Fourth Ventricle. Brain Tumor Res Treat 2021; 9:75-80. [PMID: 34725988 PMCID: PMC8561226 DOI: 10.14791/btrt.2021.9.e10] [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: 03/30/2021] [Revised: 04/22/2021] [Accepted: 05/03/2021] [Indexed: 11/22/2022] Open
Abstract
We present an extremely rare case of intracranial extraskeletal myxoid chondrosarcoma. A 36-year-old male presented with dizziness persisting for 2 weeks. MRI of the patient showed well-enhanced mass of fourth ventricle. The tumor was totally removed under telovelar approach. Pathology results confirmed an intracranial extraskeletal myxoid chondrosarcoma. Adjuvant radiotherapy was initiated one month after the surgery, and MRI followed 3 months after initial operation and showed no evidence of tumor recurrence.
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Affiliation(s)
- Yun Gi Hong
- Department of Neurosurgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jihwan Yoo
- Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Se Hoon Kim
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.,Department of Brain Tumor Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Hee Chang
- Department of Neurosurgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.,Department of Brain Tumor Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
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Selvaraj VK, Gudipudi DK, Khera R, Murthy S. Primary intracranial extra-skeletal myxoid chondrosarcoma of right lateral ventricle with EWSR1 gene fusion: a case report and review of literature. Ecancermedicalscience 2021; 15:1257. [PMID: 34567242 PMCID: PMC8426030 DOI: 10.3332/ecancer.2021.1257] [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: 12/10/2020] [Indexed: 11/06/2022] Open
Abstract
Background Primary intracranial malignancies with extra-skeletal myxoid chondrosarcoma (EMC) features are extremely rare. EMC constitutes a distinct genomic entity characterised by reciprocal translocation of fusion genes, most commonly EWS RNA Binding Protein 1 (EWSR1) in 22q12 with Nuclear Receptor Subfamily 4 Group A Member 3 (NR4A3) in 9q2-q31.1. It is reported to have a high propensity for local recurrence and has potential for metastasis. So far in 28 years since its first description, only 17 cases of primary intracranial EMC were reported in literature. This would be the second case of intraventricular origin and first case from lateral ventricle. Case presentation A 27-year-old male presenting with complaints of headache, seizures and pain in neck was diagnosed to have a mass lesion in right lateral ventricle in Magnetic Resonance Imaging of brain. He underwent right parieto-occipital craniotomy with total excision of the lesion. Initial histopathological examination was reported as Ependymoma, WHO grade II. However, blocks and slides review with immunohistochemistry (IHC) markers revealed neoplastic aetiology with extensive myxoid changes. Hence, fluorescent in-situ hybridisation (FISH) testing was done with EWSR1 break apart probe, which demonstrated EWSR1 break apart signals. Therefore, correlating the clinical findings with morphology, IHC and FISH, the diagnosis of primary intracranial EMC was rendered. Patient received adjuvant external beam radiation of 54 Gy in 30 fractions to the post-op region. At 29-month follow-up, there was no evidence of disease recurrence. Conclusions Owing to the rarity of the condition, there are no standard treatment guidelines available for primary intracranial EMC. A combined treatment approach with surgery followed by adjuvant radiotherapy provides good local control with less morbidity.
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Affiliation(s)
- Vinodh Kumar Selvaraj
- Department of Radiation Oncology, Basavatarakam Indo-American Cancer Hospital and Research Institute, Road number 10, Banjara Hills, Hyderabad-500034, Telangana, India
| | - Deleep Kumar Gudipudi
- Department of Radiation Oncology, Basavatarakam Indo-American Cancer Hospital and Research Institute, Road number 10, Banjara Hills, Hyderabad-500034, Telangana, India
| | - Rachna Khera
- Department of Pathology, Basavatarakam Indo-American Cancer Hospital and Research Institute, Road number 10, Banjara Hills, Hyderabad-500034, Telangana, India
| | - Sudha Murthy
- Department of Pathology, Basavatarakam Indo-American Cancer Hospital and Research Institute, Road number 10, Banjara Hills, Hyderabad-500034, Telangana, India
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Hussain NS, Ahmed SH. Metastatic Intracerebral Chondrosarcoma: Case Report and Literature Review of Endocrine Effects and Management Paradigms. Cureus 2020; 12:e8417. [PMID: 32642333 PMCID: PMC7336601 DOI: 10.7759/cureus.8417] [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] [Indexed: 11/09/2022] Open
Abstract
The most common underlying diagnosis of intracranial tumor pathology is metastatic disease, followed by primary brain tumors. Chondrosarcomatous metastatic disease of the brain is a rare subtype of this disease process. The patient presented with right-sided weakness. Her history was significant for femur chondrosarcoma which was resected and treated. Laboratory analysis revealed persistent hypercalcemia and hyperglycemia. MRI of the brain was completed, which revealed a left parietal-occipital lesion with smaller lesions in the left frontal and right parietal lobe. Multidisciplinary tumor board recommended surgery for lesion resection and pathology. Surgical pathologic diagnosis after lesion resection was metastatic chondrosarcoma. The patient’s preoperative arm and leg weakness improved after surgery. Our paper delineates this unique case of intracranial spread of femur chondrosarcoma.
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Affiliation(s)
- Namath S Hussain
- Neurological Surgery, Loma Linda University Medical Center, Loma Linda, USA
| | - Sara H Ahmed
- Endocrinology, Anaheim Regional Medical Center, Anaheim, USA
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Velz J, Agaimy A, Frontzek K, Neidert MC, Bozinov O, Wagner U, Fritz C, Coras R, Hofer S, Bode-Lesniewska B, Rushing E. Molecular and Clinicopathologic Heterogeneity of Intracranial Tumors Mimicking Extraskeletal Myxoid Chondrosarcoma. J Neuropathol Exp Neurol 2018; 77:727-735. [DOI: 10.1093/jnen/nly050] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Affiliation(s)
- Julia Velz
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Abbas Agaimy
- Department of Pathology, University Hospital Erlangen, Erlangen, Germany
| | - Karl Frontzek
- University of Zurich, Zurich, Switzerland
- Department of Neuropathology, Clinical Neuroscience Center
| | - Marian Christoph Neidert
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Oliver Bozinov
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Ulrich Wagner
- University of Zurich, Zurich, Switzerland
- Institute of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Christine Fritz
- University of Zurich, Zurich, Switzerland
- Institute of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Roland Coras
- Department of Neuropathology, University Hospital Erlangen, Erlangen, Germany
| | - Silvia Hofer
- Department of Oncology, Hospital Lucerne, Lucerne, Switzerland
| | - Beata Bode-Lesniewska
- University of Zurich, Zurich, Switzerland
- Institute of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Elisabeth Rushing
- University of Zurich, Zurich, Switzerland
- Department of Neuropathology, Clinical Neuroscience Center
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Qin Y, Zhang HB, Ke CS, Huang J, Wu B, Wan C, Yang CS, Yang KY. Primary extraskeletal myxoid chondrosarcoma in cerebellum: A case report with literature review. Medicine (Baltimore) 2017; 96:e8684. [PMID: 29381948 PMCID: PMC5708947 DOI: 10.1097/md.0000000000008684] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
RATIONALE Extraskeletal myxoid chondrosarcoma (EMC) is a rare malignant neoplasm of which intracranial EMC is the rarest. PATIENT CONCERNS We present an unusual case report of a 41-year-old woman who was sent to the emergency department for a sudden headache and other symptoms related to increased intracranial pressure. INTERVENTIONS Emergent CT revealed an occupying lesion in the left cerebellum with surrounding edema. A complete surgical excision of the lesion through a transcortical approach was performed. After the operation, this patient received adjuvant radiotherapy and temozolomide treatment. DIAGNOSES Pathology diagnosis was an intracranial EMC. OUTCOMES The patient survives with no tumor recurrence as of the last follow-up. Progression-free survival exceeded 20 months. LESSONS We have reviewed the literature and here summarize the diagnosis and treatment options for intracranial EMC. Diagnosis and treatment options of this rare disease are discussed.
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Affiliation(s)
- You Qin
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei
| | - Hai-bo Zhang
- Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang
- People's Hospital of Hangzhou medical college, Hangzhou, Zhejiang Province
| | - Chang-Shu Ke
- Department of Pathology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jing Huang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei
| | - Bian Wu
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei
| | - Chao Wan
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei
| | - Chen-Su Yang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei
| | - Kun-Yu Yang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei
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Kojima D, Beppu T, Saura H, Sato Y, Fujiwara S, Ogasawara K. Apparent diffusion coefficient and arterial spin labeling perfusion of conventional chondrosarcoma in the parafalcine region: a case report. Radiol Case Rep 2017; 13:220-224. [PMID: 29487660 PMCID: PMC5826694 DOI: 10.1016/j.radcr.2017.09.021] [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: 06/26/2017] [Revised: 09/12/2017] [Accepted: 09/25/2017] [Indexed: 11/30/2022] Open
Abstract
Intracranial chondrosarcoma is a very rare malignant tumor of the central nervous system, and is difficult to preoperatively distinguish from other tumors using conventional imaging techniques. Here, we report the case of a 24-year-old woman who presented with mild headache due to chondrosarcoma in the frontal lobe. Preoperative conventional images showed findings typical of an oligodendroglial tumor. However, high apparent diffusion coefficient (ADC) value and extreme hypoperfusion on arterial spin labeling (ASL) were inconsistent with oligodendroglial tumor characteristics. The tumor was completely removed using a standard surgical procedure. Histologic diagnosis was a conventional (classic) chondrosarcoma. High ADC and hypoperfusion on ASL represented low cellularity and low vascularity within conventional chondrosarcoma, respectively. We discuss the utility of ADC and ASL for the preoperative diagnosis of conventional chondrosarcoma.
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Affiliation(s)
- Daigo Kojima
- Department of Neurosurgery, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505 Japan
| | - Takaaki Beppu
- Department of Neurosurgery, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505 Japan
| | - Hiroaki Saura
- Department of Neurosurgery, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505 Japan
| | - Yuichi Sato
- Department of Neurosurgery, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505 Japan
| | - Shunrou Fujiwara
- Department of Neurosurgery, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505 Japan
| | - Kuniaki Ogasawara
- Department of Neurosurgery, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505 Japan
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Primary intracranial extraosseus myxoid chondrosarcoma of dominant frontal lobe. ROMANIAN NEUROSURGERY 2015. [DOI: 10.1515/romneu-2015-0044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Park JH, Kim MJ, Kim CJ, Kim JH. Intracranial extraskeletal myxoid chondrosarcoma : case report and literature review. J Korean Neurosurg Soc 2012; 52:246-9. [PMID: 23115670 PMCID: PMC3483328 DOI: 10.3340/jkns.2012.52.3.246] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2012] [Revised: 06/04/2012] [Accepted: 09/17/2012] [Indexed: 01/04/2023] Open
Abstract
Intracranial extraskeletal myxoid chondrosarcoma is extremely rare, with only seven patients previously reported. We present a case report of a 21-year-old woman admitted for weakness in her right extremities and symptoms of increased intracranial pressure. Magnetic resonance imaging (MRI) revealed hydrocephalus and a well-enhanced large mass around her left thalamus. A left parietal craniotomy and a cortisectomy at the superior parietal lobule were performed. Total surgical resection was also performed, and pathology results confirmed an extraskeletal myxoid chondrosarcoma. Postoperative MRI showed no residual tumor, and the patient underwent radiotherapy. After six months of radiotherapy, the patient's headache and weakness had improved to grade IV. This malignant tumor showed high rates of recurrence in previous reports. We here report another occurrence of this highly malignant and rare tumor in a patient treated using total surgical excision and adjuvant radiotherapy.
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Affiliation(s)
- Jin Hoon Park
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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