Spinal chondrosarcoma following adenocarcinoma of the breast: case report.
BACKGROUND
Chest wall chondrosarcomas have been reported rarely in breast cancer patients treated with chest wall radiation therapy. However, there are no prior reports of spinal chondrosarcomas arising in patients with a history of breast adenocarcinoma.


METHODS
A neurologically intact 53-year-old woman with breast adenocarcinoma and new onset back pain was evaluated. Magnetic resonance imaging of the spine revealed a tumor of the posterior elements of T7, impinging upon the spinal cord. A computed tomography guided needle biopsy of the spinal mass failed to yield diagnostic results. The patient underwent an open surgical biopsy and complete excision of a low-grade chondrosarcoma. The patient's thoracic pain resolved after surgical excision of her thoracic tumor. She remained neurologically intact. Pathological examination of the tumor revealed a low-grade chondrosarcoma.


CONCLUSIONS
We present the first reported case of chondrosarcoma of the spine arising in a patient with a history of breast adenocarcinoma without prior irradiation. Solitary spinal tumors in patients with breast adenocarcinoma should not be assumed to be metastatic lesions, and chondrosarcoma should be included in the differential diagnosis of spinal lesions in this patient population. Experimentally, chondrosarcomas have been shown to be sensitive to circulating levels of estrogens, and this might explain an association with adenocarcinoma of the breast treated with tamoxifen.
Neurospinal Disorders Program, Department of Neurological Surgery, School of Medicine, University of California, San Francisco 94143, USA.
P V
PV
Mummaneni
W S
WS
Rosenberg
D000230:Adenocarcinoma / Q000188:drug therapy*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy*; D002813:Chondrosarcoma / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000175:diagnosis*; D013125:Spinal Neoplasms / Q000175:diagnosis*; D013629:Tamoxifen / Q000627:therapeutic use
D018931:Antineoplastic Agents, Hormonal; D013629:Tamoxifen