title: Vertebral synovial chondromatosis. Report of two cases and review of the literature.
abstract: Synovial chondromatosis is an uncommon disorder characterized by the formation of multiple cartilaginous nodules within the synovium, most commonly affecting large joints. Its involvement with the spine is rare; only six cases have been reported. The authors describe two patients with synovial chondromatosis involving the cervical spine. In the first case, synovial chondromatosis arose from the left C1-2 facet joint. This patient underwent a two-stage procedure including a posterior approach for tumor resection and occipitocervical fusion as well as a transmandibular circumglossal approach to the anterior craniocervical junction to complete the tumor removal. Interestingly, on histopathological examination, scattered foci of low-grade chondrosarcoma were intermixed within the synovial chondromatosis. To the authors' knowledge, this is the first report of secondary low-grade chondrosarcoma arising in vertebral synovial chondromatosis. In the second case, synovial chondromatosis involved the left C4-5 facet joint. Tumor resection and cervical fusion were performed via a posterior approach. In this report, the authors describe the clinical presentation, radiographic findings, operative details, histopathological features, and clinicoradiological follow-up data obtained in these two patients and review the literature pertaining to this rare entity.
authors.affiliation: Departments of Neurosurgery, Pathology, and Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.
authors.forename: Gary L
authors.initials: GL
authors.lastname: Gallia
authors.forename: Nirit
authors.initials: N
authors.lastname: Weiss
authors.forename: James N
authors.initials: JN
authors.lastname: Campbell
authors.forename: Edward F
authors.initials: EF
authors.lastname: McCarthy
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Tufaro
authors.forename: Ziya L
authors.initials: ZL
authors.lastname: Gokaslan
mesh_terms: D000328:Adult; D001269:Atlanto-Occipital Joint / Q000473:pathology / Q000601:surgery; D001368:Axis, Cervical Vertebra / Q000473:pathology; D001270:Cervical Atlas / Q000473:pathology; D002574:Cervical Vertebrae / Q000473:pathology* / Q000601:surgery; D015838:Chondromatosis, Synovial / Q000175:diagnosis* / Q000601:surgery; D002813:Chondrosarcoma / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013122:Spinal Diseases / Q000175:diagnosis* / Q000601:surgery; D013123:Spinal Fusion; D013125:Spinal Neoplasms / Q000473:pathology