Chondrosarcoma
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Chondrosarcoma | |
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Synonyms | |
Pronounce | N/A |
Specialty | N/A |
Symptoms | Bone pain, swelling, fracture |
Complications | Metastasis, pathological fracture |
Onset | Typically in adults aged 20-60 |
Duration | Chronic |
Types | Conventional chondrosarcoma, dedifferentiated chondrosarcoma, clear cell chondrosarcoma, mesenchymal chondrosarcoma |
Causes | Unknown, but may involve genetic mutations |
Risks | Ollier disease, Maffucci syndrome, multiple hereditary exostoses |
Diagnosis | Imaging studies (e.g., X-ray, MRI, CT scan), biopsy |
Differential diagnosis | Osteosarcoma, enchondroma, fibrosarcoma |
Prevention | None known |
Treatment | Surgery, chemotherapy, radiation therapy |
Medication | |
Prognosis | Varies by type and stage; generally poor for high-grade tumors |
Frequency | Rare |
Deaths | N/A |
Chondrosarcoma is a type of cancer that arises in the cartilage cells. It's the second most common type of primary bone malignancy, following osteosarcoma. The management and prognosis of chondrosarcoma differ significantly from other bone sarcomas and depend on its grade.
Classification
Chondrosarcomas can be classified into several subtypes:
- Primary Chondrosarcoma
- Conventional
- Grade I
- Grade II
- Grade III
- Dedifferentiated
- Mesenchymal
- Clear cell
- Conventional
- Secondary Chondrosarcoma
- Arising from osteochondroma
Etiology
The exact cause is unknown, but several risk factors have been identified:
- Previous radiation exposure
- Ollier disease and Maffucci syndrome (enchondromatosis)
- Multiple exostoses
- Pre-existing benign cartilage lesions
Clinical Presentation
Patients with chondrosarcoma typically present with:
- Pain, which is often insidious in onset and gradually worsening
- Swelling or palpable mass
- Pathological fracture (rarely)
Diagnosis
Imaging plays a crucial role in diagnosis:
- X-ray: Typically shows a lytic lesion with stippled, calcified matrix
- MRI and CT scan: Useful in defining the extent of the tumor
- Biopsy: Necessary to confirm the diagnosis and grade
Treatment
The mainstay of treatment is surgery. Chondrosarcoma is usually resistant to chemotherapy and radiotherapy. The type and extent of surgery depend on the grade:
- Low-grade tumors (Grade I): Wide local excision
- High-grade tumors (Grade II and III): En bloc resection with negative margins
Prognosis
- Low-grade chondrosarcomas have a favorable prognosis with a 10-year survival rate of about 90%.
- High-grade tumors have a poorer prognosis, with a 10-year survival rate of 40-60%.
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Contributors: Prab R. Tumpati, MD