Chondrosarcoma

Background

• Third most common primary bone malignancy after multiple myeloma and osteosarcoma
• Around ninety percent of chondrosarcomas are of low metastatic potential
• Osteochondromas and enchondromas can be precursors lesions

Pathophysiology

• Overproduction of chondroid matrix in the medullary cavity

Clinical Features

• Lesions commonly in the pelvis and central skeleton
• Occurs in patients over 40 years-old with a male predominance
• Often will present with local swelling and pain or a pathologic fracture
• Very slow growing tumors

Differential Diagnosis

Bone tumors and their mimics

Malignant

• Multiple myeloma
• Chondrosarcoma
• Paget disease
• Osteosarcoma
• Adamantinoma
• Chordoma
• Primary bone lymphoma
• Fibrosarcoma
• Myosarcoma

Benign

• Giant cell tumor
• Chrondroblastoma
• Enchondroma
• Langerhans cell histiocytosis of bone
• Osteoblastoma
• Osteochondroma
• Osteoid osteoma

Other

• Septic joint
• Fracture
• Abscess

Evaluation

[File:Mrichondrosarcoma.jpg|thumb|MRI of a left-pelvis with chondrosarcoma]]

• Plain radiographs reveal punctate calcifications and cortical bone destruction
• CT or MRI to assess extent of bone involvement
• Bone biopsy for definitive diagnosis

Management

• Surgery is the definitive treatment
• Radiation and chemotherapy are ineffective as tumor is very slow growing

Disposition

• Home with outpatient follow up