Das extraskelettale mesenchymale Chondrosarkom: Seltene Differenzialdiagnose pleuraler Verkalkungen

Zusammenfassung

Wir berichten über einen 78-jährigen Patienten, bei dem im Rahmen der Abklärung eines einseitigen Pleuraergusses zunächst keine eindeutige Ursache gefunden werden konnte. Im Verlauf traten bei dem Patienten kräftig verkalkte pleurale Tumoren auf, die nach CT-navigierter transthorakaler Punktion histopathologisch und immunhistochemisch als mesenchymales Chondrosarkom charakterisiert werden konnten. Neben einer kurzen Literaturübersicht zu den seltenen extraossären Chondrosarkomen wird der Fall unter besonderer Berücksichtigung andersartiger Pleuraverkalkungen diskutiert. Unseres Wissens handelt es sich bei dem geschilderten Patienten um den ersten, bei dem die Diagnose eines mesenchymalen, wahrscheinlich von der Pleura ausgehenden Chondrosarkoms mittels CT-gesteuerter transthorakaler Biopsie gestellt werden konnte.

Abstract

We report on a 78-year-old male patient with unilateral pleural effusion who underwent multiple diagnostic tests including thoracoscopy without establishing a final diagnosis. In the course of time, the patient developed multiple pleural tumors with calcifications. A CT-guided transthoracic biopsy was performed; the specimen revealed histopathological and immunohistochemical evidence for an extraosseous mesenchymal chondrosarcoma. Besides a short review of the literature, the case is discussed as an extremely rare differential diagnosis of pleural calcifications. To the best of our knowledge, this is the first patient in whom the diagnosis of an extraosseous chondrosarcoma, most likely of the pleura, could be established by CT-guided transthoracic biopsy.

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