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

Malignant

• Multiple myeloma
• Osteosarcoma
• Paget disease
• Ewing sarcoma
• Giant cell tumor
• Adamantinoma
• Chordoma
• Primary bone lymphoma
• Fibrosarcoma
• Myosarcoma

Benign

• Chrondroblastoma
• Enchondroma
• Langerhans cell histiocytosis of bone
• Osteoblastoma
• Osteochondroma
• Osteoid Osteoma

Evaluation

• 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