Scapula chondrosarcoma: a case report
A 42-year-old female presented to our hospital with complaints of a growth of a tumor on her right scapula persisting for 3 months. This was her first episode of such tumor which had gradually increased in volume, beginning with pain. Physical examination revealed a large 5.0 × 5.0 cm soft-tissue mass with areas of maceration. The mass was firm and tender on palpation. There was no dilatation of the superficial vein or swelling of the ipsilateral limb.

Further checks were performed after admission. The results of laboratory tests, including complete blood count, electrolytes, biochemical profile, and coagulation function, were all normal. Subsequent computerized tomography (CT) scan of the right shoulder showed irregularities with cystic low density areas, and the lesion had expansive developing tendency. The shoulder joint and space appeared normal, with no interruption of bone continuity. Emission computed tomography (ECT) scanning indicated a clear bone image, while anomalous concentration of radioactivity was observed in the right scapula.

The chest radiograph exhibited a normal appearance. However, incisional biopsy was not performed before the surgery. The operation proceeded with a posterior approach to the right shoulder joint. A horizontal incision was first performed, and the soft tissue was separated until the upper end of the scapula appeared. The bone wall was destroyed; thus, bone was curetted. The intraoperative pathological diagnosis was cartilage derived lesion. Subsequently bone grafting was performed. Macroscopically, the tumor presented as a pale amyloid tissue, and histologically, it was characterized by the presence of large amounts of chondrocytes and the nuclear atypia was mild with normal cartilage lacuna. Besides, there was no mitotic activity and no mucoid degeneration. Anatomopathological examination indicated that this was a chondrosarcoma, grade IIa. Safe margins were confirmed negative by multiple border frozen sections. The patient's vital signs and other monitored parameters were normal after returning to the ward, and she was discharged 7 days after surgery in stable condition. There was no recurrence or tumor metastasis at a follow-up of 5 years.

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