Spinal epidural calcified chondroid mesenchymal neoplasm mimicking epidural abscess: a case report

Vollständiger Abstract

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Abstract Calcified chondroid mesenchymal neoplasm (CCMN) is a rare chondroid matrix-producing tumour characterized by distinctive histopathology and recurrent FN1-receptor tyrosine kinase gene fusions. Reported cases have predominantly involved the distal extremities and temporomandibular joint, with no previously reported spinal cases. We present the first reported spinal epidural lesion morphologically consistent with CCMN. A 40-year-old male presented with progressive mid-thoracic back pain after a self-reported febrile illness. Imaging demonstrated a T10-T12 posterior/right calcified epidural lesion causing severe canal stenosis and cord compression. The patient underwent T9-T12 laminectomy and decompression. Intraoperatively, a white, highly adherent epidural mass rather than purulent material was encountered. Histopathology revealed a calcified spindle cell lesion with chondroid differentiation morphologically consistent with CCMN. Follow-up magnetic resonance imaging at 12 months demonstrated no significant residual canal stenosis, and the patient remained asymptomatic at 18-month clinical follow-up. Recognition of CCMN in this location is important when more common spinal pathologies are suspected.