Case ReportSecondary Chondrosarcoma of the Upper Thoracic Costovertebral Junction with Neural Foraminal Extension and Compressing the Spinal Cord
Introduction
Chondrosarcoma is a malignant cartilage-forming bone neoplasm that accounts for 10% of all primary bone tumors with usually poor prognosis.1 Secondary chondrosarcoma arising from a benign solitary costal osteochondroma is extremely rare and has been reported to be 1% in patients.2 Osteochondromas represent 8% of rib tumors and they are usually found in the anterior region at the costochondral junction.3
Chondrosarcoma of the rib in the posterior mediastinum are very rare.4
The following study describes the first case, to our knowledge, of osteochondroma malignant transformation located at the upper thoracic costovertebral junction in a 61-year-old man.
The clinical manifestation, imaging, pathologic findings, management, and outcome associated with such lesion were discussed in this report.
Section snippets
Case report
A 55-year-old man was admitted in 2008 with progressive weakness in his lower limbs with right intercostal pain irradiated from the back. Two months before admission he started with gait difficulties and frequent falls, progressing to a severe paraparesis and inability to walk.
Neurological examination showed spastic paraparesis. Hypoesthesia with partial loss of pain and temperature and diminished proprioception and vibration were seen below the T4 level, in addition to severe spasticity.
Discussion
Osteochondroma is considered a developmental lesion and it is defined as an osteochondral exostosis with cortical and marrow continuity.5, 6
Osteochondroma can arise in any bone that develops from endochondral ossification,5 and the most common age at presentation is 11–20 years. There is no sex predilection in case of solitary osteochondromas.7
About 3% of solitary osteochondromas have costal origin and always involve the ribs in the region of the costochondral junction.8 Generally, posterior
Conclusion
Although it is rare in solitary osteochondromas of rib, malignant transformation must always be considered. Changes of clinical features and in radiologic appearance of an osteochondroma must be viewed with suspicion. The diagnosis is based on histopathologic examination.
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2019, Medicine (United States)Chondrosarcoma arising in solitary osteochondroma: A case study
2019, Pan African Medical Journal
Conflict of interest statement: The authors declare that the article content was composed in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.