Extraskeletal myxoid chondrosarcoma arising from the clavicle

Abstract

This report presents an extremely rare case of extraskeletal myxoid chondrosarcoma (EMC) arising from the clavicular periosteum. To the best of our knowledge, this may be the first detailed report of its clinicopathological findings. The patient was a 48-year-old man. Plain radiography and CT did not demonstrate any osteolytic lesion or periosteal reaction in the right clavicle. However, MRI showed an isosignal-intensity mass on T1-weighted images and a homogeneous high signal intensity lesion on T2-weighted images. The histological findings of the widely resected tumor were consistent with the diagnosis of extraskeletal myxoid chondrosarcoma. Preoperative diagnosis of extraskeletal myxoid chondrosarcoma at an unusual location, as in this case, is difficult not only with imaging examinations alone, but sometimes even after histological examination of biopsy specimens.

Juxtacortical Clavicular Chondrosarcoma: Diagnostic Dilemmas: Case Report and Review of Literature

“…Low signal foci can be seen on both T1 and T2-WI, and hemorrhagic or myxoid changes may sometimes be recognized on T1-weighted MR images as areas of high signal intensity1, as in our case.…”

“…A review of the published data revealed that there are two detailed case reports and two case series of clavicular chondrosarcoma, but only the case reported by Nakazora et al1 refers to a primary myxoid extraskeletal chondrosarcoma arising from the clavicle 1,2,6,7. Deik et al8 also reported a case of extraskeletal myxoid chondrosarcoma arising supraclavicularly, causing an interesting clinical presentation.…”

“…4,9 However, in cases that a wide margin cannot be obtained, the rate of recurrence is very high with poor response to chemotherapy and radiotherapy. 1…”

“…Clavicular primary chondrosarcoma is extremely rare and to our knowledge, there is only one detailed report discussing its radiologic and clinicopathological findings. 1…”

Latissimus dorsi flap closure of the irradiated clavicular wound

“…(J Shoulder Elbow Surg 2008; 17:875-880. ) Whereas primary bone tumors of the clavicle are rare, 1,6,16,26,27,35 radiation-related damage to the clavicle is fairly common, making it somewhat surprising that there are so few reports 33 regarding reconstructive options after wide resection of the clavicle. In a review by Zietz et al 35 from 1954 to 1995 of 312 pediatric patients treated with high-dose radiation therapy to the head and neck, 3 cases of clavicle sarcoma and 2 cases of osteoradionecrosis were found.…”