Condrosarcoma mesenquimal extraesquelético en región escapular. A propósito de un caso y revisión de la literatura

Resumen

Paciente femenino de 27 años, que posteriormente a trauma en región escapular izquierda, nota un crecimiento en la zona, con dolor y limitación de movimiento. En la resección parcial se diagnostica como condrosarcoma mesenquimal extraesquelético. Se procede a quimioterapia neoadyuvante con 5 ciclos. Hubo reducción del tumor primario un 30%. Se efectúa tratamiento quirúrgico (tumor de 10 × 9 × 5 cm, bordes libres) y se suministran dos ciclos más de quimioterapia, sin respuesta, evolucionando la enfermedad y falleciendo. Este tipo de sarcomas son agresivos con altas recurrencias locales y metástasis, más frecuentemente a pulmón y a hueso.

Summary

A 27 year old woman developed a painful swelling in the left scapular region accompanied by a limitation in movement following trauma. She underwent partial resection of the mass which was diagnosed histologically as an extraskeletal mesenchymal chondrosarcoma. She was treated with 5 cycles of neoadjuvant chemotherapy which reduced the primary tumour by 30% and the metastases by 60%. Subsequently, a three dimensional resection was carried out and a 10 × 9 × 5 cm tumour with free edges was removed. She was treated with a further 2 cycles of adjuvant chemotherapy, but with no response, after which she died. This aggressive type of sarcomas has a high risk of both local recurrence and metastases, predominately to the lungs and bones.