Extraskeletal Myxoid Chondrosarcoma of the Orbit

A Rare Entity of the Anterior Chest Cage Rib Chondrosarcoma: A Case Report and Review of Literature

Primary bone cancers, also called bone sarcomas, can arise anywhere in the body. Less than 1% of cancers are identified as primary bone cancers annually, and they are correlated with high rates of morbidity and death. Twenty to twenty-seven percent of primary malignant osseous neoplasms are chondrosarcomas, the rarest subtype of bone sarcomas. The incidence of chondrosarcomas in Saudi Arabia was less common than globally discovered chondrosarcomas, and only a few cases have been recorded. The most common presentation of the primary chondrosarcoma (CS) is to encompass the bony skeleton of the long bones of the lower extremities and the axial skeleton. Detecting primary CS in the anterior chest wall and the rib cage is rare. To our knowledge, chondrosarcomas of the ribs encroaching on the anterior chest are rare and have never been documented in Saudi Arabian or Middle East medical or surgical literature. We describe a case of a 32-year-old female with chondrosarcoma of the left anterior seventh rib, with no other medical or surgical histories. Further work-up at the tertiary care center, including computed tomography-scan, magnetic resonance imaging, and detailed triple bone scan (nuclear scan) imaging and histological biopsy, revealed features of chondrosarcoma arising from the ribs and involving the surrounding soft tissue. The patient underwent en masse surgical resection with a 4 cm margin, including the sixth rib and partial resection of the left hemidiaphragm and a small piece of the diaphragm. The patient was discharged without any inauspicious consequences. In the current work, we comprehensively discussed a scarce case of the anterior chest wall chondrosarcoma affecting the rib. This case highlights the importance of early detection of a rare tumor using a toolkit diagnostic approach to provide successful management and caring of the patient. Consequently, this will guarantee encouraging outcomes and thus stress the fruitful role of the surgery as the best curative modality in chondrosarcoma patients.

Extraskeletal Chondrosarcoma: Long-term Follow-up of a Patient with Metastatic Disease

Extraskeletal myxoid chondrosarcoma (EMC) is a rare soft tissue sarcoma with an indolent course and poor response to systemic treatment. We present a case of a 53-year-old male who presented with right gluteal extraskeletal myxoid chondrosarcoma. He was treated with wide local excision after receiving 50 Gray of neoadjuvant radiation therapy. Three years later he was found to have a left lower lobe lung nodule that was slowly increasing in size. He underwent a left lower lobectomy and the nodule was confirmed to be consistent with the patient’s history of EMC. One year later, lung imaging showed multiple small nodules bilaterally consistent with metastatic disease. The patient opted for watchful waiting approach. Routine follow-up imaging for four years shows a very slow progression of his disease burden. He continues to be asymptomatic. This case demonstrates the natural course of EMC and argues in favor of the watchful waiting approach in treating this disease.