scholarly journals P.107 Primary clear cell chondrosarcoma of the thoracic spine

2016 ◽  
Vol 43 (S2) ◽  
pp. S45-S45
Author(s):  
S Mcgregor ◽  
M Kurdi ◽  
R Hammond ◽  
F Siddiqi ◽  
B Wehrli
Keyword(s):  
Radiation Therapy ◽  
Thoracic Spine ◽  
Clear Cell ◽  
Stable Condition ◽  
Giant Cells ◽  
En Bloc Resection ◽  
Low Grade ◽  
En Bloc ◽  
Clear Cell Chondrosarcoma ◽  
Bloc Spondylectomy

Background: Clear cell chondrosarcoma (CCC) is a rare, low-grade, subtype of chondrosarcoma. It arises most commonly in the epiphyses of the certain longbones. Spinal involvement is extremely rare, but when present it most frequently involves the thoracic spine. Complete surgical resection is the best curative treatment, with radiation therapy being a consideration for inoperable tumours. Methods: We report a case of a 70-year-old gentleman with CCC of the T7-8 thoracic spine. Gross en-bloc spondylectomy of the T6-8 vertebral bodies with expandable cage reconstruction and T3-11 instrumented fusion were performed. Results: Histological examination revealed a cellular neoplasm composed of well-defined, round to oval cells with abundant clear cytoplasm embedded in a loose cartilaginous matrix with large numbers of admixed osteoclast-type giant cells and scattered bone trabeculae between the lesional cells. The patient experienced significant improvement in neurological function and was discharged from hospital in stable condition seven days after surgery. Conclusions: CCC is a rare variant of chondrosarcoma that rarely involves the osseous spine. In this location, treatment may be challenging given the presence of spinal cord and nerve roots. Given the lack of effective chemotherapy and radiation therapy for CCC, en-bloc resection of CCC involving the spine should be considered.

Clear Cell Chondrosarcoma With Chondroblastoma-Like Features: A Case for Team Diagnosis

2018 ◽  
Vol 26 (8) ◽  
pp. 766-771
Author(s):  
Ryan M. Kiefer ◽  
John Wojcik ◽  
Kumarasen Cooper ◽  
Kristy L. Weber ◽  
Ronnie Sebro
Keyword(s):  
Clear Cell ◽  
Osteolytic Lesion ◽  
Bone Lesion ◽  
Final Diagnosis ◽  
En Bloc Resection ◽  
Low Grade ◽  
Adjacent Area ◽  
En Bloc ◽  
Left Femur ◽  
Clear Cell Chondrosarcoma

Clear cell chondrosarcoma (CCCS) is a rare variant of conventional chondrosarcoma with low-grade malignant features that may be confused radiographically and histologically with chondroblastoma. We report a case of a 50-year-old female who presented with 6 months of left hip pain. Initial radiographs demonstrated an osteolytic lesion with adjacent area of sclerosis in the proximal left femur. Magnetic resonance imaging demonstrated a marrow-infiltrative lesion with periosteal reaction and thickened enhancing periosteum. Biopsy of the sclerotic area demonstrated chondroblastoma-like findings, whereas biopsy of the lytic area showed features suggestive of CCCS. The patient eventually underwent en bloc resection and reconstruction with a proximal femoral megaprosthesis. The final diagnosis was CCCS. We present this unusual case with review of the radiographic and histologic features of CCCS with attention to its ability to mimic chondroblastomas. This case highlights the importance of sampling radiographically heterogeneous areas within a bone lesion to facilitate accurate diagnosis and appropriate management.

scholarly journals Successful en Bloc Resection for Femoral Head Clear Cell Chondrosarcoma Without Biopsy: A Case Report

2021 ◽  
Author(s):  
Manabu Hoshi ◽  
Naoto Oebisu ◽  
Yoichi Ohta ◽  
Ayaka Tomimoto ◽  
Hiroaki Nakamura
Keyword(s):  
Femoral Head ◽  
Clear Cell ◽  
Surgical Margin ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Wide Resection ◽  
Low Grade ◽  
En Bloc ◽  
Postoperative Function ◽  
Clear Cell Chondrosarcoma

Abstract Background: Clear cell chondrosarcoma (CCCS) is a rare, low-grade, malignant chondrogenic bone tumour. This tumour commonly occurs at the epiphysis of long bones, particularly in the proximal femur. Case presentation: This report describes a 58-year-old man with right hip pain since 5 months. Plain radiography, magnetic resonance imaging (MRI), and computed tomography (CT) revealed the characteristic appearance of chondroid mineralisation in the right femoral head, suggesting typical CCCS. Although a biopsy is the gold standard for definite diagnosis before treatment, wide resection with removal of the biopsy tract is thought to affect negatively affect surgical margin and postoperative hip function. En bloc resection without a biopsy and a hip hemiarthroplasty were performed instead. The pathological diagnosis was CCCS, and an adequate surgical margin was obtained. No local recurrence or distant metastases were found, and postoperative function was excellent at the final follow-up. Conclusion: The femoral head is a typical location of CCCS. Wide resection with adequate margins is the main treatment strategy for CCCS. When radiological features are typical, performing an en bloc resection without performing a biopsy is an acceptable treatment that may improve patient outcomes.

scholarly journals Leptomeningeal dissemination of a low-grade lumbar paraganglioma: case report

2017 ◽  
Vol 26 (4) ◽  
pp. 501-506 ◽  
Author(s):  
Nick Thomson ◽  
Karel Pacak ◽  
Meic H. Schmidt ◽  
Cheryl A. Palmer ◽  
Karen L. Salzman ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Ct Scanning ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Chemotherapeutic Agents ◽  
Low Grade ◽  
Leptomeningeal Dissemination ◽  
Mri Findings ◽  
En Bloc ◽  
Pet Scanning

Leptomeningeal dissemination of paraganglioma is rare, with only 2 prior cases in the literature. The authors present the case of a metastatic low-grade lumbar paraganglioma via leptomeningeal dissemination. This report emphasizes the utility of 3,4-dihydroxy-6-18F-fluoro-l-phenylalanine (18F-FDOPA) PET scanning for diagnosis, as well as the combination of radiation therapy and alkylating chemotherapeutic agents for the treatment of this rare phenomenon. The patient was a 61-year-old woman who presented with low-back pain and was found to have an isolated L-3 intrathecal tumor on MRI. Sixteen months after gross-total en bloc resection of the paraganglioma, the patient again became symptomatic with new neurological symptoms. MRI findings revealed enhancing leptomeningeal nodules throughout the spine. 18F-FDOPA PET/CT scanning was used to confirm the diagnosis of disseminated paraganglioma. Intrathecal thiotepa, radiation therapy, and systemic therapy with capecitabine and temozolomide have been used sequentially over a 2-year period, with each able to stabilize tumor growth for several months. The authors also summarize the 2 other reports of leptomeningeal dissemination of paragangliomas in the literature and compare the course and management of the 3 cases.

Clear-Cell Chondrosarcoma of the Lumbar Spine: Case Report and Review of the Literature

Neurosurgery ◽  
2011 ◽  
Vol 68 (4) ◽  
pp. E1160-E1164 ◽  
Author(s):  
Wesley Hsu ◽  
Edward McCarthy ◽  
Ziya L. Gokaslan ◽  
Jean-Paul Wolinsky
Keyword(s):  
Clear Cell ◽  
Thoracolumbar Spine ◽  
Compression Fracture ◽  
Pedicle Screws ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Clear Cell Chondrosarcoma ◽  
Vertebral Bodies ◽  
L1 And L2

Abstract BACKGROUND AND IMPORTANCE: Clear-cell chondrosarcoma is a rare subtype of chondrosarcoma. These osseous tumors are most commonly found in the end of long bones. We report a rare case of clear-cell chondrosarcoma of the osseous spine. CLINICAL PRESENTATION: A 52-year-old man presented to another institution with a pathologic L1 compression fracture. Intraoperatively, this fracture was discovered to be secondary to a chondrosarcoma involving T12, L1, and L2. He was then referred to our institution for further evaluation and treatment. A 2-stage operation was performed with successful en bloc resection of residual chondrosarcoma with negative margins. The first stage using a posterior approach resulted in placement of pedicle screws from T9 to L4, laminectomies from T12 to L2, and placement of Tomita saws between the thecal sac and the vertebral body at both the T11-12 and L2-3 disc levels. The second stage of the procedure involved a transthoracic, retroperitoneal approach to the thoracolumbar spine. Osteotomies between T11-12 and L2-3 were completed, and the vertebral bodies of T12, L1, and L2 were delivered as an en bloc specimen. The final pathology of the specimen was clear-cell chondrosarcoma with negative margins. CONCLUSION: This report discusses a rare occurrence of clear-cell chondrosarcoma in the osseous spine. Aggressive surgical intervention with the goal of en bloc resection of tumor is recommended to promote tumor-free survival.

scholarly journals A Case Report of Clear Cell Chondrosarcoma (CCC) Sparing the Epiphysis and Literature Review of CCC

2019 ◽  
Vol 2 (1-3) ◽  
pp. 54-60
Author(s):  
Suraj Hindiskere ◽  
Yong Sung Kim ◽  
Han-Soo Kim ◽  
Ilkyu Han
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Clear Cell ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Rare Tumour ◽  
Clear Cell Chondrosarcoma ◽  
Femoral Metaphysis ◽  
The Right

Clear cell chondrosarcoma (CCC) is a rare subtype of chondrosarcoma with a relatively low malignant potential, mainly diagnosed by its characteristic location in the epiphysis of long bones. We report the case of a 33-year-old gentleman who presented with pain, difficulty in walking and restricted range of motion of the right hip joint, with a lesion located in the proximal femoral metaphysis and completely sparing the epiphysis. Needle biopsy was consistent with CCC, which was extremely unusual considering the location of the tumour. The patient was treated by “en bloc” resection of the tumour along with femoral head and reconstruction with hemiarthroplasty. The final histopathology report confirmed the diagnosis with clear surgical margins. The aim of this case report and literature review was to highlight the unusual location of this rare tumour, as such an isolated case of CCC completely sparing the epiphysis has never been reported.

scholarly journals Contralateral osteotomy of the pedicle and posterolateral elements for en bloc resection: a technique for oncological resection of posterolateral spinal tumors

2017 ◽  
Vol 26 (3) ◽  
pp. 275-281 ◽  
Author(s):  
Viren S. Vasudeva ◽  
Alexander E. Ropper ◽  
Samuel Rodriguez ◽  
Kyle C. Wu ◽  
John H. Chi
Keyword(s):  
Spinal Column ◽  
Progression Free Survival ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Spinal Tumors ◽  
High Morbidity ◽  
Low Grade ◽  
En Bloc ◽  
Bloc Spondylectomy ◽  
Pars Interarticularis

En bloc resection of tumors involving the spinal column is technically challenging and is associated with high morbidity to the patient due to the proximity of critical neurological and vascular structures and the destabilizing nature of this surgery. Nevertheless, evidence has shown improved progression-free survival with en bloc resection for certain low-grade malignant and aggressive benign musculoskeletal tumors. To avoid the morbidity of en bloc spondylectomy in patients with tumors localized to the lateral and posterolateral spinal column, the authors have found that the goals of surgery can be accomplished through a contralateral osteotomy of the pedicle and posterolateral elements for en bloc resection (COPPER). They reviewed their series of 5 patients who underwent successful tumor removal through a COPPER approach. These patients were all found to harbor spinal column tumors involving the posterolateral elements that, based on pathology, would benefit from en bloc resection. Tumor pathology included chondrosarcoma, leiomyosarcoma, osteoblastoma, and liposarcoma. Resections were performed by completing ipsilateral facetectomies above and below the lesion and ipsilateral pedicle osteotomies from a contralateral approach following hemilaminectomy. By disarticulating the posterolateral elements while carefully protecting the thecal sac, the tumors were removed en bloc along with the affected lamina, pedicles, pars interarticularis, and spinous processes, allowing tumor-free margins. This technical report suggests that the COPPER approach is safe and effective for en bloc resection of tumors involving the posterolateral aspect of the spinal column with tumor-free margins and that it eliminates the need for anterior column reconstruction.

scholarly journals Successful en bloc resection for femoral head clear cell chondrosarcoma without biopsy: A case report

2021 ◽  
Vol 16 (2) ◽  
Author(s):  
Manabu Hoshi ◽  
Naoto Oebisu ◽  
Yoichi Ohta ◽  
Ayaka Tomimoto ◽  
Hiroaki Nakamura
Keyword(s):  
Case Report ◽  
Femoral Head ◽  
Clear Cell ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Clear Cell Chondrosarcoma

scholarly journals MET-05 Clinical investigation of treatment results and recurrence patterns of metastatic brain tumors from the viewpoint of postoperative irradiation

2020 ◽  
Vol 2 (Supplement_3) ◽  
pp. ii19-ii19
Author(s):  
Tetsuo Hashiba ◽  
Haruka Kawano ◽  
Katsuya Ueno ◽  
Qiang Lee ◽  
Haruna Isozaki ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Brain Tumors ◽  
Clinical Investigation ◽  
Postoperative Radiotherapy ◽  
En Bloc Resection ◽  
Metastatic Brain Tumors ◽  
Treatment Results ◽  
En Bloc ◽  
Postoperative Radiation Therapy ◽  
Observation Period

Abstract While whole brain radiation therapy (WBRT) had been the standard postoperative radiation therapy for metastatic brain tumors for long time, recently local radiation therapy (LRT) has be become to be a new standard due to the accumulation of clinical evidences. Treatment results and pattern of recurrence were retrospectively analyzed from view point of postoperative radiotherapy. In this study, totally 69 patients were included and they were divided into WBRT group or LRT group. We analyzed the number of lesions, treated era, overall survival after diagnosis of metastasis (OS), recurrence free survival after RT (RFS), and patterns of recurrences. The subjects consisted of 37males and 32 females and average age was 61.7 years old. There were 49 cases in the WBRT group and 20 cases in the LRT group. While all cases before November 2017 had WBRT performed, LRT was adopted mainly in cases with a small number of metastases since December 2017. Although there was a difference in the observation period between the two groups, OS tended to be longer in the LRT group (P=0.08), while RFS tended to be shorter in the LRT group (P=0.08). Radiological recurrence after RT was observed in 7 cases in both groups, and in WBRT group, all cases were local recurrence, whereas in LRT group, all cases were new lesions or disseminated recurrence. Although there are biases such as the difference in observation period between the two groups and the tendency to adopt WBRT in cases with a large number of metastases, there is a possibility that postoperative LRT is not inferior to WBRT, especially for cases with a small number of metastases. However, we have experienced some cases of disseminated recurrence, and so it is necessary to consider the resection fashion such as whether en-bloc resection or piece meal resection when selecting postoperative RT.

Monostotic fibrous dysplasia of the thoracic spine: clinopathological description and follow up

2004 ◽  
Vol 100 (4) ◽  
pp. 378-381 ◽  
Author(s):  
Mehmet Arazi ◽  
Onder Guney ◽  
Mustafa Ozdemir ◽  
Omer Uluoglu ◽  
Nuket Uzum
Keyword(s):  
Fibrous Dysplasia ◽  
Thoracic Spine ◽  
Histopathological Examination ◽  
En Bloc Resection ◽  
Spinal Tumors ◽  
En Bloc ◽  
Content Type ◽  
Thoracic Spinal ◽  
Fine Print

✓ The authors report the case of a 53-year-old woman with monostotic fibrous dysplasia of the thoracic spine. The patient presented with a 1-month history of pain in the thoracic spinal region. En bloc resection of the lesion was successfully performed via a transthoracic approach, and a histopathological examination confirmed the diagnosis of fibrous dysplasia. At 24-month follow-up examination, pain and vertebral instability were absent. The findings in this case illustrate that, although very rare, monostotic fibrous dysplasia of the thoracic spine should be considered in the differential diagnosis of spinal tumors. Although a consensus for management of this disease has not been achieved, the authors recommend radical removal of all involved bone as well as internal fixation or bone graft—assisted fusion to achieve long-term stabilization.

Sign in / Sign up

Export Citation Format

Share Document