case_images: PMC11625115_01
case_images: Clinical pictures of a 36-year-old man with complaints of swelling and pain. (A) Posterior right lateral view, (B) Posterior view lesion with post biopsy scar, (C) Left lateral view.
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case_images: The neurological examination also revealed hypoesthesia at the T4 level (Fig. 1).
case_images: Conventional x-ray examination of the thoracolumbar spine (X- ray Carestream DRX Ascend 2018 with (A) Anterior-posterior and (B) Lateral view revealed a lytic sclerotic expansile lesion on the right posterolateral aspect of the thoracic vertebrae 5-6 (yellow arrow).
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case_images: T5-T6 (Fig. 2).
case_images: Computerized tomography scan of column vertebrae region with 3D construction (CT- Scan Hitachi Scenaria 2017). A mass located in the right posterolateral aspect of the thoracic vertebrae T5-T6 (yellow arrow).
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case_images: T5-T6, extending to the transverse process, costovertebral junction, and posterior costae 5-6. The dimensions of the mass were 4.85 x 5.03 x 11.87 cm, accompanied by soft tissue swelling and calcification in the surrounding area (Fig. 3, Fig. 4). The spinal cord (medulla spinalis) and other components of the spinal canal were within normal limits (Fig. 3).
case_images: CT image in soft-tissue window (A, B) Axial and coronal view revealed in coronal and axial view the mass extending to the transverse process, costovertebral junction, and right posterolateral aspect of the thoracic vertebrae 5-6 (yellow arrow). (C, D) Axial and sagital view revealed an expansile sclerotic mass with a chondroid matrix located in the right posterolateral aspect of the thoracic vertebrae 5-6 (red arrow).. MRI of the thoracolumbar region (MRI 1.5 T siemens Magnetom Essenza 2012). (A) T1-weighted imaging showed low signal intensity mass extending into the subcutaneous tissue in the bilateral posterior region of the vertebrae on axial image, (B) The mass infiltrated intradurally and intramedullary, reaching up to the level of vertebrae T4-T5, also stenosis of the spinal canal on sagittal image, on the left side, it directly bordered the aortic arch (yellow arrow) and the mass extended into the thoracic cavity (orange arrow), (C) T2-weighted showed high signal intensity partial mass with enhanced septations after intravenous injection of contrast media.
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case_images: T5-T6, extending into the subcutaneous tissue in the bilateral posterior region of the vertebrae, spanning from T4-T8. The mass caused destruction of the spinous processes, transverse processes of the vertebrae, costovertebral junction, and posterior costae 5-6 (Fig. 4). These findings are consistent with chondrosarcoma (Fig. 4).
case_images: Histopathological examination of chondrosarcoma grade I. (A) Lobulated hyaline cartilage neoplasm (yellow head arrow), magnification H&E 20x, (B) Moderately cellular and contain hyperchromatic, pale, plump nuclei of uniform size (red arrow), magnification H&E 200x.
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case_images: Hematopoietic tissue (marrow) appeared between the lobes (Fig. 5).
case_images: Postsurgery (A) Thoracolumbal X-ray imaging, the T5-T6 thoracic vertebrae bodies are not visualized due to corpectomy. (B) Thorax X-ray imaging, showed no complication from surgery.
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case_images: T4-T7. There are no narrowing discs and other intervertebral foramina. The pedicles of the other vertebral bodies were within normal limits (Fig. 6A). The thoracic x-ray reveals no signs of pneumothorax, pneumomediastinum, or any postoperative complications (Fig. 6B). The patient's clinical condition and vital signs are good and stable, with minimal bleeding.