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DOI: 10.1055/s-0045-1811246
Rare Presentation of a Giant Paraspinal Chondrosarcoma: Case Report and Review of Literature

Abstract
Chondrosarcomas are malignant chondrogenic neoplasms that primarily affect the bones of the pelvis and appendicular skeleton. Approximately 15% of these tumors occur in the chest wall. They most commonly originate anteriorly from the costochondral junction or sternum. Posterior thoracic chondrosarcomas frequently arise from the costal angle and vertebral arch of the thoracic spine, and only rarely do they originate at the costovertebral junction. A total of 30 patients with chondrosarcoma arising from the costovertebral junction have been previously reported in the English literature. We report a case of giant costovertebral chondrosarcoma presenting as a large paraspinal mass and review the current literature on the topic. A 42-year-old female with no comorbidities presented with a 3-month history of chest pain and dry cough. Radiologic imaging revealed a massive irregularly calcified paraspinal mass extending from the T5 to T7 vertebral levels. A microsurgical excision of the lesion was performed using a posterolateral thoracic approach, and intraoperatively, the mass was seen arising from the right T5 costovertebral junction with extension into the T4-T5 neural foramen. Histological examination confirmed a diagnosis of grade 2 chondrosarcoma. The uniqueness of our case report lies in the size and location of the chondrosarcoma, with only one other case being as large as ours. Chondrosarcoma must be considered in the differential diagnosis of partly calcified paraspinal masses arising from the costovertebral junction.
Keywords
chondrosarcoma - costovertebral - thoracic spine - paraspinal mass - posterolateral approachAuthors' Contributions
All authors contributed to the preparation of this manuscript.
Ethical Approval
This case report was written in accordance with the principles of the Declaration of Helsinki.
Patients' Consent
Written informed consent for publication was obtained from the affected individual prior to inclusion in the report. Details that might disclose their identity were omitted.
Publikationsverlauf
Artikel online veröffentlicht:
29. August 2025
© 2025. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 Brito IM, Teixeira S, Paupério G, Choupina M, Ribeiro M. Giant chondrosarcoma of the chest wall: a rare surgical challenge. Autops Case Rep 2020; 10 (03) e2020166
- 2 Rascoe PA, Reznik SI, Smythe WR. Chondrosarcoma of the thorax. Sarcoma 2011; 2011: 342879
- 3 Bodin F, Dissaux C, Steib JP, Massard G. Complex posterior thoracic wall reconstruction using a crossover combined latissimus dorsi and serratus anterior free flap. Eur J Cardiothorac Surg 2016; 49 (03) 1008-1009
- 4 Murphey MD, Walker EA, Wilson AJ, Kransdorf MJ, Temple HT, Gannon FH. From the archives of the AFIP: imaging of primary chondrosarcoma: radiologic-pathologic correlation. Radiographics 2003; 23 (05) 1245-1278
- 5 Shimoyama T, Suzuki R, Yoshiya K, Yamato Y, Koike T. Chondrosarcoma of the rib. Jpn J Thorac Cardiovasc Surg 2003; 51 (04) 167-171
- 6 Abdullah L, Alsulaiman SS, Alsalhani OM, Alkheder A, Al-Sulaiman IA. A rare case of chondrosarcoma at the posterior costovertebral junction: a case report. Ann Med Surg (Lond) 2023; 85 (06) 3129-3132
- 7 Le HV, Wadhwa R, Theodore P, Mummaneni P. Excision of thoracic chondrosarcoma: case report and review of literature. Cureus 2016; 8 (07) e708
- 8 McAfee MK, Pairolero PC, Bergstralh EJ. et al. Chondrosarcoma of the chest wall: factors affecting survival. Ann Thorac Surg 1985; 40 (06) 535-541
- 9 Creze M, Ghaouche J, Missenard G. et al. Understanding a mass in the paraspinal region: an anatomical approach. Insights Imaging 2023; 14 (01) 128
- 10 Rong HT, Fan YS, Li SP. et al. Management of dumbbell and paraspinal tumors of the thoracic spine using a single-stage posterolateral approach: case series. Orthop Surg 2018; 10 (04) 343-349
- 11 Gelderblom H, Hogendoorn PC, Dijkstra SD. et al. The clinical approach towards chondrosarcoma. Oncologist 2008; 13 (03) 320-329
- 12 Sundaresan N, Rosen G, Fortner JG, Lane JM, Hilaris BS. Preoperative chemotherapy and surgical resection in the management of posterior paraspinal tumors. Report of three cases. J Neurosurg 1983; 58 (03) 446-450
- 13 Fitrah A, Pancaputri BM, Wienanda AK. et al. Rare malignant primary spinal chondrosarcoma: a case report. Radiol Case Rep 2024; 20 (02) 949-956
- 14 Lu Y, Zhang R. Giant posterior mediastinum dumbbell schwannoma: a case report. Transl Cancer Res 2020; 9 (03) 2060-2063
- 15 Tang X, Cai Z, Wang R, Ji T, Guo W. En bloc resection and reconstruction of a huge chondrosarcoma involving multilevel upper thoracic spine and chest wall: case report. BMC Musculoskelet Disord 2021; 22 (01) 348
- 16 Vertzyas N, Cummine J, Biankin S, Bilows M. Chondrosarcoma of the thoracic spine in an 8-year-old child with 12 years follow-up: a case report. J Orthop Surg (Hong Kong) 2000; 8 (01) 89-92
- 17 Bartalena T, Rimondi E, Rossi G, Bianchi G, Alberghini M. Low grade central chondrosarcoma of the fifth costotransverse joint. Australas Radiol 2007; 51 (Spec No): B122-B125
- 18 Upadhyaya S, Nair R, Kumar V, Aadhav S, Shetty A. Rib head chondrosarcoma associated with Ollier's disease – a rare differential for paraparesis. Biomed Rev J Basic Appl Med Sci 2021; 8: 119-122
- 19 Briccoli A, Campanacci L, Biagini R, Rocca M, Malaguti C, Mercuri M. Chondrosarcoma of the ribs and sternum. Considerations on 20 cases treated. Chir Organi Mov 2002; 87 (01) 17-23
- 20 Bouali S, Bouhoula A, Maatar N. et al. Secondary chondrosarcoma of the upper thoracic costovertebral junction with neural foraminal extension and compressing the spinal cord. World Neurosurg 2016; 92: 588.e1-588.e5