ArticleJournal of spine surgery (Hong Kong)2025
A 3D navigation-guided surgical resection of a rare case of sacral spine mesenchymal chondrosarcoma: a case report.
Article in Journal of spine surgery (Hong Kong), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Chondrosarcomas are a group of heterogeneous malignant cartilaginous neoplasms that arise from preexisting benign precursors. They can be divided into conventional (primary) chondrosarcomas, which account for 90% of cases, and nonconventional chondrosarcomas, which account for the remaining 10%. Mesenchymal chondrosarcoma (MCS) is a rare high-grade soft tissue tumor variant of nonconventional chondrosarcoma that is histologically characterized by a biphasic pattern of atypical cartilage with small round cells. Case Description: A 23-year-old female known case of ovarian cyst presented with a two-year history of low back pain and constitutional symptoms. Pelvic magnetic resonance imaging (MRI) with contrast showed a well-defined lesion with intermediate to high signals located at the right wing of the upper sacrum, at the level of S1-S2. The patient underwent a combined ultrasound and computed tomography-guided biopsy under local anesthesia and the immunochemical profile was positive for CD99 and S100 biomarkers. The patient underwent a two-stage procedure for a wide marginal tumor resection. Stage 1 was performed with an anterior approach; identification of the tumor margins was done followed by designing the cuts of the sacrum to achieve wide margins around the tumor. Stage 2 was performed with a posterior approach exposing L3 vertebrae down to the sacrum. Utilizing O-Arm Navigation for posterior margin allocation in addition to instrumentation. After 12 months post-operation, follow up revealed no evidence of recurrence. Conclusions: Limitation in accessibility to the axial skeleton and the neurovascular component, poses a challenge to treatment. Therefore, using neuro-navigation system and optimal adjuvant therapy should be studied further to improve the prognosis.
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