Chondrosarcoma

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[edit] Chondrosarcoma

Introduction:

This is a malignant tumor of cartilage. It tends to occur at the end of long bones and is most frequent in adults. About 10% develop in patients with multiple osteochondromas. These are mushroom like benign growths with a cartilage cap. One type runs in families and has multiple such osteochondromas, which occur most often in teenagers between 10 and 20.

About 10% of these will turn malignant in adult life. The other 90 % of chondrosarcomas are primary, meaning that they occur spontaneously in anybody.

Symptoms and tests:

Bone pain at the area of the tumor is the first symptom. X-rays may not show anything as the tumor consists of cartilage and is invisible on plain X-rays. CT and MRI scans, however will depict the tumor. These tests cannot distinguish between benign osteochondroma and the malignant chondrosarcoma. Only a biopsy will make the diagnosis. The surgeon will have to be extremely careful that cells are not breaking loose and contaminate the surrounding soft tissue as in the case of a chondrosarcoma this cancer will immediately form local metastases.

Treatment:

There are 4 pathological grades from the slow growing grade I to the more rapidly growing grade IV. Treatment consists of surgery where the entire tumor is removed. If any tumor tissue is left behind, it will seed itself and regrow more of the mushroom like cartilage tissue. Without spillage of tumor during the surgery the cure rate is more than 50% , but it depends on the tumor grade. Both radiotherapy and chemotherapy will not show any benefit with this bone cancer. Recurrences will have to be treated more aggressively with surgery including amputation of the affected limb.

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References:

1. Cancer: Principles &Practice of Oncology. 4th edition. Edited by Vincent T. DeVita, Jr. et al. Lippincott, Philadelphia,PA, 1993. Chapter on Sarcomas of the soft tissues and bone.

2. Cancer: Principles&Practice of Oncology. 5th edition, volume 2. Edited by Vincent T. DeVita, Jr. et al. Lippincott-Raven Publ., Philadelphia,PA, 1997. Chapter on Sarcomas of the soft tissues and bone.

3. Conn's Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier

4. Ferri: Ferri's Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc