Total Excision of a Recurrent Chondrosarcoma of the Thoracic Spine

Abstract

A case report is presented. To describe the surgical procedure for removal of the recurrent tumor. Marginal or wide en bloc excision for recurrent chondrosarcoma is extremely difficult because of the postsurgical adhesion with surrounding soft tissues such as the dural tube. This case report includes a chart review, an examination of the patient, and a literature search. RESULTS.: A 7-year-old boy had difficulty with ambulation because of a tumor recurrence 18 months after posterior curettage of the primary chondrosarcoma of the T6 and T7. The spinal cord was severely compressed by the epidural mass, which was located anterior and to the left side of the spinal canal. The epidural tumor including the tumor capsule on the left side of the dural tube was excised piecemeal fashion. En bloc corpectomy of T6 and T7 including the capsulated epidural tumor that was located ventrally to the spinal cord was performed. A fresh iliac crest strut allograft from the patient's father was grafted to the anterior defect, and in addition, H-shape allograft was placed over the posterior side. At 15-year follow-up, the patient is ambulating with the aid of a cane, and there is no sign of recurrence on computed tomography scan or magnetic resonance imaging. His spinal alignment was maintained. Total excision (en bloc corpectomy with partially piecemeal removal) including the tumor margin has given local control and survival for 15 years in this patient who had recurrent chondrosarcoma. Anteroposterior biologic spinal reconstruction has maintained spinal alignment.