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Chondrosarcoma Apoplexy in Thoracic Spine

  • Kim, Sang Woo (Department of Neurosurgery, College of Medicine, Yeungnam University) ;
  • Kim, Min Su (Department of Neurosurgery, College of Medicine, Yeungnam University) ;
  • Jung, Young Jin (Department of Neurosurgery, College of Medicine, Yeungnam University)
  • 투고 : 2012.06.21
  • 심사 : 2013.01.07
  • 발행 : 2013.01.28

초록

Chondrosarcoma is a very uncommon malignant primary bone tumor, especially, it occurs extremely rare in the spine. A 52-year-old man was admitted to the emergency room with sudden paraplegia. Twelve hours prior to a paraplegic event, he visited an outpatient clinic with discomfort and tenderness around the medial border of the right scapular, and his neurologic status was absolutely intact. Magnetic resonance imaging showed a lobulated soft tissue mass from T3 to T5, which extended to the epidural space. Computed tomography scans showed soft tissue mass on the spinal posterior arch and osteolytic change of the adjacent bony structures. Emergent surgery was performed and the lesion was removed. Dark reddish blood and gel-like material were encountered around the dura and posterior arch during the operation. Multiple pulmonary nodules were found on a chest CT scan and a biopsy of one of them had been proven to be a metastasis of chondrosarcoma. The histologic examination showed dedifferentiated chondrosarcoma. The patient's neurologic deficit was improved slowly from ASIA A to ASIA D. Chondrosarcoma in the spine is extremely rare, even more with acute hemorrhage and sudden expansion into the epidural space. We named it chondrosarcoma apoplexy. We should consider the possibility of a hemorrhagic event when the patient's neurologic deficit worsens suddenly with spinal bone tumor.

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참고문헌

  1. Anract P, Tomeno B, Forest M : [Dedifferentiated chondrosarcoma. A study of 13 clinical cases and review of the literature]. Rev Chir Orthop Reparatrice Appar Mot 80 : 669-680, 1994
  2. Boriani S, De Iure F, Bandiera S, Campanacci L, Biagini R, Di Fiore M, et al. : Chondrosarcoma of the mobile spine : report on 22 cases. Spine (Phila Pa 1976) 25 : 804-812, 2000 https://doi.org/10.1097/00007632-200004010-00008
  3. Chow WA : Update on chondrosarcomas. Curr Opin Oncol 19 : 371-376, 2007 https://doi.org/10.1097/CCO.0b013e32812143d9
  4. Collins MS, Koyama T, Swee RG, Inwards CY : Clear cell chondrosarcoma : radiographic, computed tomographic, and magnetic resonance findings in 34 patients with pathologic correlation. Skeletal Radiol 32 : 687-694, 2003 https://doi.org/10.1007/s00256-003-0668-3
  5. Foweraker KL, Burton KE, Maynard SE, Jena R, Jefferies SJ, Laing RJ, et al. : High-dose radiotherapy in the management of chordoma and chondrosarcoma of the skull base and cervical spine : part 1--Clinical outcomes. Clin Oncol (R Coll Radiol) 19 : 509-516, 2007 https://doi.org/10.1016/j.clon.2007.04.004
  6. Gelderblom H, Hogendoorn PC, Dijkstra SD, van Rijswijk CS, Krol AD, Taminiau AH, et al. : The clinical approach towards chondrosarcoma. Oncologist 13 : 320-329, 2008 https://doi.org/10.1634/theoncologist.2007-0237
  7. Gwak HS, Yoo HJ, Youn SM, Chang U, Lee DH, Yoo SY, et al. : Hypofractionated stereotactic radiation therapy for skull base and upper cervical chordoma and chondrosarcoma : preliminary results. Stereotact Funct Neurosurg 83 : 233-243, 2005 https://doi.org/10.1159/000091992
  8. Katonis P, Alpantaki K, Michail K, Lianoudakis S, Christoforakis Z, Tzanakakis G, et al. : Spinal chondrosarcoma : a review. Sarcoma 2011 : 378957, 2011
  9. McLoughlin GS, Sciubba DM, Wolinsky JP : Chondroma/Chondrosarcoma of the spine. Neurosurg Clin N Am 19 : 57-63, 2008 https://doi.org/10.1016/j.nec.2007.09.007
  10. Quiriny M, Gebhart M : Chondrosarcoma of the spine : a report of three cases and literature review. Acta Orthop Belg 74 : 885-890, 2008
  11. Riedel RF, Larrier N, Dodd L, Kirsch D, Martinez S, Brigman BE : The clinical management of chondrosarcoma. Curr Treat Options Oncol 10 : 94-106, 2009 https://doi.org/10.1007/s11864-009-0088-2
  12. Sandberg AA : Genetics of chondrosarcoma and related tumors. Curr Opin Oncol 16 : 342-354, 2004 https://doi.org/10.1097/01.cco.0000129678.72521.e5
  13. Shives TC, McLeod RA, Unni KK, Schray MF : Chondrosarcoma of the spine. J Bone Joint Surg Am 71 : 1158-1165, 1989 https://doi.org/10.2106/00004623-198971080-00006
  14. Tarkkanen M, Wiklund T, Virolainen M, Elomaa I, Knuutila S : Dedifferentiated chondrosarcoma with t(9;22)(q34;q11-12). Genes Chromosomes Cancer 9 : 136-140, 1994 https://doi.org/10.1002/gcc.2870090210
  15. York JE, Berk RH, Fuller GN, Rao JS, Abi-Said D, Wildrick DM, et al. : Chondrosarcoma of the spine : 1954 to 1997. J Neurosurg 90 : 73-78, 1999

피인용 문헌

  1. Surgical treatment of metastatic mesenchymal chondrosarcoma to the spine : A case report vol.99, pp.5, 2013, https://doi.org/10.1097/md.0000000000018643