Chondroblastoma of the lumbar spine with cauda equina syndrome

Case report. To describe the clinical presentations, radiological features and clinical progress of a rare case of chondroblastoma of the lumbar spine. Regional Hospital, Hong Kong, China. A 54-year-old male patient presented with low back pain and left sciatica. X-ray and MRI revealed tumour infilt...

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Bibliographic Details
Published in:Spinal cord 2003-06, Vol.41 (6), p.359-364
Main Authors: CHUNG, O. M, YIP, S. F, NGAN, K. C, NG, W. F
Format: Article
Language:English
Subjects:
Biological and medical sciences
Bone Neoplasms - complications
Bone Neoplasms - mortality
Bone Neoplasms - pathology
Bone Neoplasms - surgery
Cauda Equina Syndrome
Chondroblastoma - complications
Chondroblastoma - mortality
Chondroblastoma - pathology
Chondroblastoma - surgery
Diseases of the osteoarticular system
Diseases of the spine
Humans
Lumbar Vertebrae
Magnetic Resonance Imaging - methods
Male
Medical sciences
Middle Aged
Neoplasm Recurrence, Local
Polyradiculopathy - complications
Polyradiculopathy - mortality
Polyradiculopathy - pathology
Postoperative Complications - mortality
Spinal Fusion - methods
Tomography, X-Ray Computed - methods
Tropical medicine
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Summary:Case report. To describe the clinical presentations, radiological features and clinical progress of a rare case of chondroblastoma of the lumbar spine. Regional Hospital, Hong Kong, China. A 54-year-old male patient presented with low back pain and left sciatica. X-ray and MRI revealed tumour infiltration of the fifth lumbar vertebrae and left paraspinal muscles, which was found to be a chondroblastoma by repeated open biopsies. The tumour was removed surgically by combined anterior and posterior approaches, followed by spinal fusion and instrumentation. The anterior tricortical bone graft was complicated with fracture and nonunion. Surgical re-exploration confirmed local recurrence of tumour macroscopically and histologically. The patient developed symptoms and signs of cauda equina syndrome gradually despite repeated surgery and irradiation. The patient eventually died of complications of local recurrence and neurological deficit at 3 years and 8 months after the first operation. This is the first case report of chondroblastoma of the lumbar spine. The clinical profile of this patient and the evidence from the literature review suggests that spinal chondroblastoma has a very aggressive behaviour with high recurrence and mortality rate.
ISSN:1362-4393
1476-5624
DOI:10.1038/sj.sc.3101458