Large enchondroma of the thoracic spine: a rare case report and review of the literature

Abstract

BackgroundEnchondroma, a subtype of chondroma, originates from the medullary cavity of the bone and produces an expansile growth pattern. Enchondroma located in the spine is rare and a few cases of large thoracic enchondroma have been reported. The authors document a rare case of large enchondroma in the thoracic spine of a 49-year-old woman, and discuss its clinical, radiological and histopathological characteristics.Case presentationThe patient presented with rapidly progressive and severe pain on her upper back. Magnetic resonance imaging revealed an expansile lesion at the posterior elements of T3 that was hypointense on T1-weighted images and mixed iso- to hyperintense on T2-weighted images. Administration of gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA) resulted in heterogeneous enhancement. During surgery, a large tumor of 4.2cm × 4.7cm × 2.1cm was resected along with the lamina and spinous process. Histological examination revealed that the tumor consisted of mature hyaline cartilage with typical chondrocytes, indicating that it was an enchondroma.ConclusionsDespite its benign-growing nature, enchondroma should be examined closely for signs of enchondromatosis and enchondrosarcoma. Complete surgical resection is the treatment of choice for immediate relief of symptoms and avoidance of recurrence.

Osteochondrome und andere knorpelbildende benigne Tumoren der Wirbelsäule

“…Grundsätzlich sollten Knorpelkappen mit einer Dicke > 2 cm bei Erwachsenen als malginitätsverdächtig gelten. Eine Entartung sollte auch bei schneller Zunahme des Größenwachstums und beim Auftreten neuer Symptome bei schon bekanntem Osteochondrom [20] abgeklärt werden. Die Rate maligner Transformationen wird mit 3-11% beschrieben, ist allerdings für das Achsenskelett aufgrund relativ niedriger Fallzahlen nicht ausreichend belastbar.…”

Is the IDH Mutation a Good Target for Chondrosarcoma Treatment?

“…Both Maffucci syndrome and Ollier disease interfere with the normal development of tissues leading to physical deformities, and predisposing those affected to secondary neoplasms, such as chondrosarcomas, gliomas, and pancreatic and ovarian cancers, observed in up to 25% of patients with Ollier disease and Maffucci syndrome [55][56][57][58]. Apart from secondary neoplasms, malignant transformation of enchondromas to chondrosarcomas occurs in > 30% of these patients [59][60][61].…”

Sacral Tumours on MRI: A Pictorial Essay

“…Regions of calcification and osseous content translate as a low signal on T2-weighted images with either high, intermediate or low signal on T1-weighted images. Enhancement along the fibrovascular septa surrounding the cartilaginous lobules may be observed after administration of gadolinium [11] (Figure 5). Bone or soft tissue oedema are rare, as well as soft tissue masses, cortical destruction or solid enhancement.…”