Surgical treatment of thoracic vertebral chondrosarcoma with total en bloc spondylectomy: a case report
Yudha M Sakti, Zikrina A Lanodiyu, Thomas E Prasetyo, Muhammad I Nurfadhilah, Dyah A P Sari, Muchtar Ridha, Wiwid Santiko, Abirafdi A Darutama, Vylomonicca Anggunio, Ilham A Pratama, Andika S Aji, Kadek E Calisto, Zahra N Adamina, Tedjo RukmoyoAbstract
Spinal chondrosarcoma is a rare malignant cartilage-forming tumor that is largely resistant to chemotherapy and radiotherapy, making complete surgical resection the cornerstone of treatment. We report a 60-year-old man with recurrent thoracic chondrosarcoma involving the T4–T6 vertebrae following previous intralesional decompression, spinal stabilization, chemotherapy, and radiotherapy. Revision surgery was performed through a posterior approach with implant removal, wide tumor excision, total en bloc spondylectomy (TES), spinal reconstruction using an expandable cage, posterior instrumentation, and spinal fusion. Histopathological examination confirmed recurrent grade II conventional chondrosarcoma. The patient remained neurologically stable after surgery without major perioperative complications. The present case indicates the limitations of intralesional surgery and adjuvant therapy in conventional chondrosarcoma and supports TES as the treatment for complete tumor excision and optimal local control, despite its technical difficulty.