Dumbbell chondrosarcoma of lumbar spine with intradural extension

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Chondrosarcomas are very rare tumors of the spine constituting for only 10% of all bony tumors and 12% of primary malignant tumors of the spine. It is the third most common primary malignant bone tumor after osteosarcoma and Ewing's sarcoma, and the third most common primary malignant tumor of the spine after chordoma and osteosarcoma. The thoracic vertebrae are the most commonly affected, followed by the cervical and lumbar. These are slow-growing tumors and are usually asymptomatic until late in their course when they cause neurological deficits by compression on the thecal sac, spinal cord, or nerve roots. As is the case for all malignant spinal tumors, en bloc resection without contamination or violation of the reactive zone (pseudocapsule) is the most appropriate surgical strategy, but in some cases, this is impossible due to unacceptable morbidity because of close proximity to critical neurovascular structures or multicompartmental location of the tumor. Here, we describe a case of L5 chondrosarcoma arising from the left pedicle with significant intradural and extraspinal components. Intradural extension of chondrosarcomas, or for that matter any malignant spinal tumor, has never been reported in literature.