We present a case of a 30-year-old man who had a 3-year history of low back pain.
MRI demonstrated an infiltrative mass, affecting the vertebral body and pedicles
of L4, with some extension to the vertebral canal. There was also tumor invasion
in the inferior vena cava and in the left iliopsoas muscle. The
anatomopathological examination of the resected L4 vertebral body was of a
malignant neoplasia compatible with mesenchymal chondrosarcoma (high
histological grade). About 2 months after surgery, he developed a progressive
bladder incontinence, bilateral leg weakness and severe back pain. A new MRI was
obtained, confirming progression of the disease. An occipital scalp lesion was
detected and biopsy confirmed cutaneous metastasis. Primary malignant bone
tumors are rare but should be ruled out in young patients with persistent low
back pain. We present a case of a confirmed mesenchymal chondrosarcoma affecting
lumbar spine, with MRI and pathological illustrations. Early diagnosis may
improve the chances of local disease control and even cure.
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