Abstract
We present a case of a 30-year-old man who had a 3-year history of low back pain. MRI demonstrated an infiltrative mass, affecting the vertebral body and pedicles of L4, with some extension to the vertebral canal. There was also tumor invasion in the inferior vena cava and in the left iliopsoas muscle. The anatomopathological examination of the resected L4 vertebral body was of a malignant neoplasia compatible with mesenchymal chondrosarcoma (high histological grade). About 2 months after surgery, he developed a progressive bladder incontinence, bilateral leg weakness and severe back pain. A new MRI was obtained, confirming progression of the disease. An occipital scalp lesion was detected and biopsy confirmed cutaneous metastasis. Primary malignant bone tumors are rare but should be ruled out in young patients with persistent low back pain. We present a case of a confirmed mesenchymal chondrosarcoma affecting lumbar spine, with MRI and pathological illustrations. Early diagnosis may improve the chances of local disease control and even cure.
Highlights
Metastases are the most frequent bone tumors.[1]
No expression was found for epithelial markers (CKs; EMA) and for lymphocytic neoplastic elements. These morphological findings and immunophenotype of the tumor cells are consistent with mesenchymal chondrosarcoma
Epidemiologically, spinal chondrosarcoma is more common in Caucasians, young, with a peripheral and lumbar spine location.[6,7]
Summary
Metastases are the most frequent bone tumors (reaching about 25% of cases).[1]. Spinal column is the most common bone affected by metastases of many primary malignant tumors, corresponding to the third most frequent site after liver and lung.[1]. The patient underwent a needle transpedicular biopsy of the vertebral lesion and a malignant infiltrative bone neoplasm was diagnosed, with chondroid differentiation and several areas of necrosis. No expression was found for epithelial markers (CKs; EMA) and for lymphocytic neoplastic elements These morphological findings and immunophenotype of the tumor cells are consistent with mesenchymal chondrosarcoma (high histological grade). Patient was discharged after 10 days of the main procedure with controlled pain and able to walk without assistance. With chondroid areas, occupying the dermis and hypodermis, compatible with cutaneous metastasis (Figure 3) He received local radiotherapy, systemic chemotherapy, and was able to walk with sticks after 2 months, with mild back pain.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
