Dedifferentiated chondrosarcoma of the thumb: a case report
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Dedifferentiated chondrosarcoma (DDCS) comprises approximately 10% of all chondrosarcomas and has the worst outcome with 5-year survival of 10%. The preferred localizations are femur, humerus and pelvis. We report a case of DDCS that arose in proximal phalanx of left-hand thumb of a 66-year-old man. He was admitted with a 2-month history of pain and swelling in his thumb. He had experienced a fracture 15 years ago in the same localization with a history of suspected preexisting enchondroma. Plain radiographs showed an expansive osteolytic lesion with milimetric calcifications while magnetic resonance imaging revealed intraosseous focal globular hyperintense spots consistent with chondroid areas as well as a surrounding soft tissue mass with intermediate signal intensity. In biopsy specimen we observed a low-grade chondrosarcoma next to a spindle cell sarcoma with an abrupt transition. He was treated with amputation and died of the disease within 9 months following the surgery. The presence of dedifferented chondrosarcoma in bones of hands was not previously reported. The presented case was provided with the macroscopic and microscopic features observed in amputation specimen in comparison with radiological findings.
KeywordsDedifferentiated chondrosarcoma MRI Scintigraphy Histology Outcome Hand
The authors would like thank Prof. Dr. Gulsen Kandiloglu from Ege University Faculty of Medicine, Department of Pathology for her contribution to the case.
- 9.Donati D, Yin JQ, Colangeli M, Colangeli S, Bella CD, Bacchini P, Bertoni F (2007) Clear cell chondrosarcoma of bone: long time follow-up of 18 cases. Arch Orthop Trauma Surg May 24; [Epub ahead of print]Google Scholar
- 11.Fechner RE, Mills SE (1993) Tumors of the bones and joints. Armed Forces Institute of Pathology, BethesdaGoogle Scholar
- 20.Patil S, de Silva MV, Crossan J, Reid R (2003) Chondrosarcoma of small bones of the hand. J Hand Surg [Br] 28:602–608Google Scholar
- 27.Sopta J, Dordevic A, Tulic G, Mijucic V (2007) Dedifferentiated chondrosarcoma: our clinico-pathological experience and dilemmas in 25 cases. J Cancer Res Clin Oncol [Epub ahead of print]Google Scholar
- 30.Unni KK (1996) Dahlin’s bone tumors: general aspects and data on 11,087 cases, 5th edn. Lippincott-Raven Publishers, Philadelphia, pp 71–108Google Scholar