Skip to main content

Advertisement

SpringerLink
Log in

Knorpelbildende Knochentumore

Diagnose und Therapie

Cartilage tumours of the bone

Diagnosis and therapy

  • CME Weiterbildung · Zertifizierte Fortbildung
  • Published:
Der Orthopäde Aims and scope Submit manuscript

Zusammenfassung

Maligne primäre Knochentumoren sind unter den Neoplasien eine Seltenheit. Die jährliche Inzidenz der malignen Knochentumoren beträgt in etwa 10 Fälle pro 1 Mio. Einwohner. Unter den primären Knochentumoren machen die chondrogenen Malignome etwa 30% an der Gesamtzahl aus. Die Häufigkeit der gutartigen chondrogenen Läsionen lässt sich nur schwer abschätzen, da sie in der Regel klinisch inapparent verlaufen und vielfach nur als Zufallsbefunde erkannt werden. Das Spektrum der Tumoren reicht von gutartigen Läsionen (z. B. Enchondrom) über sog. Borderline-Tumoren (proliferierendes Enchondrom, Differenzialdiagnose: G-I-Chondrosarkom) bis hin zu „High-grade-Chondrosarkomen“ (z. B. dedifferenziertes Chondrosarkom). Entsprechend dieser Vielfalt sowie deren fließenden Übergängen bezüglich ihrer Dignität existieren auch verschiedenste klinische Verläufe und Therapien der einzelnen Tumoren. In diesem Beitrag werden insbesondere aus orthopädisch/chirurgischer Sicht die Thematik und Problemstellungen näher beleuchtet, die sich dem behandelnden Orthopäden in der Therapie der Chondrosarkome stellen.

Abstract

Primary malignant bone tumours are rare. The annual incidence of these tumours is 10 per 1 million. Nearly 30% of the primary malignant bone tumours are malignant cartilage tumours. The frequency of benign cartilage tumours cannot be definitely estimated because these tumours are normally clinically inapparent and therefore often diagnosed as an incidental finding. The cartilage tumours appear as benign lesions (e.g. chondroma), as borderline tumours (proliferative chondroma vs grade I chondrosarcoma) or as highly malignant chondrosarcoma (e.g. dedifferentiated chondrosarcoma). Commensurate with the different clinical and oncological manifestations of the cartilage tumours, there are wide differences in the treatment and clinical course of the individual tumour. This article discusses the problems in the diagnosis and treatment of cartilage tumours from an orthopaedic point of view.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1a–c
Abb. 2
Abb. 3
Abb. 4a, b
Abb. 5

Literatur

  1. Ahmed AR, Tan TS, Unni KK et al. (2003) Secondary chondrosarcoma in osteochondroma: report of 107 patients. Clin Orthop Relat Res 411: 193–206

    Article  PubMed  Google Scholar 

  2. Bjornsson J, McLeod RA, Unni KK et al. (1998) Primary chondrosarcoma of long bones and limb girdles. Cancer 83(10): 2105–2119

    Article  PubMed  Google Scholar 

  3. Bloem JL, Mulder JD (1985) Chondroblastoma: a clinical and radiological study of 104 cases. Skeletal Radiol 14(1): 1–9

    Article  PubMed  Google Scholar 

  4. Canella P, Gardini F, Boriani S (1981) Exostosis: development, evolution and relationship to malignant degeneration. Ital J Orthop Traumatol 7(3): 293–298

    PubMed  Google Scholar 

  5. Delling G, Jobke B, Burisch S, Werner M (2005) Cartilage tumors. Classification, conditions for biopsy and histologic characteristics. Orthopade 34(12): 1267–1281

    Article  PubMed  Google Scholar 

  6. Dickey ID, Rose PS, Fuchs B et al. (2004) Dedifferentiated chondrosarcoma: the role of chemotherapy with updated outcomes. J Bone Joint Surg Am 86-A(11): 2412–2418

    Google Scholar 

  7. Erlemann R (2001) Benign cartilaginous tumors. Radiologe 41(7): 548–559

    Article  PubMed  Google Scholar 

  8. Fiorenza F, Abudu A, Grimer RJ et al. (2002) Risk factors for survival and local control in chondrosarcoma of bone. J Bone Joint Surg Br 84(1): 93–99

    Article  PubMed  Google Scholar 

  9. Frassica FJ, Unni KK, Beabout JW, Sim FH (1986) Dedifferentiated chondrosarcoma. A report of the clinicopathological features and treatment of seventy-eight cases. J Bone Joint Surg Am 68(8): 1197–1205

    PubMed  Google Scholar 

  10. Freyschmidt J, Ostertag H, Jundt G (2003) Knochentumoren, 2nd edn. Springer, Berlin Heidelberg New York Tokyo

  11. Garrison RC, Unni KK, McLeod RA et al. (1982) Chondrosarcoma arising in osteochondroma. Cancer 49(9): 1890–1897

    Article  PubMed  Google Scholar 

  12. Geirnaerdt MJ, Hogendoorn PC, Taminiau AH, Bloem JL (1998) Malignant cartilage tumors. Radiologe 38(6): 502–508

    Article  PubMed  Google Scholar 

  13. Grimer RJ, Carter SR, Tillman RM et al. (2000) Chondrosarcoma of bone. J Bone Joint Surg Am 82-A(8): 1203–1204

    Google Scholar 

  14. Lee FY, Mankin HJ, Fondren G et al. (1999) Chondrosarcoma of bone: an assessment of outcome. J Bone Joint Surg Am 81(3): 326–338

    Article  PubMed  Google Scholar 

  15. Liu J, Hudkins PG, Swee RG, Unni KK (1987) Bone sarcomas associated with Ollier’s disease. Cancer 59(7): 1376–1385

    Article  PubMed  Google Scholar 

  16. Lodwick G (1971) Atlas of tumor radiology. The bones and joints. Year Book Med Publi, Chicago, pp 38–39

  17. Nakashima Y, Unni KK, Shives TC et al. (1986) Mesenchymal chondrosarcoma of bone and soft tissue. A review of 111 cases. Cancer 57(12): 2444–2453

    PubMed  Google Scholar 

  18. Noel G, Habrand JL, Mammar H et al. (2001) Combination of photon and proton radiation therapy for chordomas and chondrosarcomas of the skull base: the Centre de Protontherapie D’Orsay experience. Int J Radiat Oncol Biol Phys 51(2): 392–398

    Article  PubMed  Google Scholar 

  19. Patil S, de Silva MV, Reid R (2003) Chondrosarcoma of small bones of the hand. J Hand Surg [Br] 28(6): 602–608

    Google Scholar 

  20. Rizzo M, Ghert MA, Harrelson JM, Scully SP (2001) Chondrosarcoma of bone: analysis of 108 cases and evaluation for predictors of outcome. Clin Orthop Relat Res 391: 224–233

    Article  PubMed  Google Scholar 

  21. Schajowicz F (1994) Tumors and tumor like lesions of bone. Springer, Berlin Heidelberg New York Tokyo

  22. Schwartz HS, Zimmerman NB, Simon MA et al. (1987) The malignant potential of enchondromatosis. J Bone Joint Surg Am 69(2): 269–274

    PubMed  Google Scholar 

  23. Soderstrom M, Ekfors TO, Bohling TO et al. (2003) No improvement in the overall survival of 194 patients with chondrosarcoma in Finland in 1971–1990. Acta Orthop Scand 74(3): 344–350

    Article  PubMed  Google Scholar 

  24. Unni KK (2001) Cartilaginous lesions of bone. J Orthop Sci 6(5): 457–472

    Article  PubMed  Google Scholar 

  25. Unni KK, Dahlin DC, Beabout JW, Sim FH (1976) Chondrosarcoma: clear-cell variant. A report of sixteen cases. J Bone Joint Surg Am 58(5): 676–683

    PubMed  Google Scholar 

  26. Winkelmann W (2005) Tumoren und tumorähnliche Erkrankungen. Georg Thieme, Stuttgart

Download references

Interessenkonflikt

Es besteht kein Interessenkonflikt. Der korrespondierende Autor versichert, dass keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, bestehen. Die Präsentation des Themas ist unabhängig und die Darstellung der Inhalte produktneutral.

Author information

Authors and Affiliations

  1. Klinik und Poliklinik für allgemeine Orthopädie, Universitätsklinikum Münster, Albert-Schweitzer-Straße 33, 48149 , Münster

    A. Streitbuerger, J. Hardes, C. Gebert, H. Ahrens, W. Winkelmann & G. Gosheger

Authors
  1. A. Streitbuerger
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. Hardes
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C. Gebert
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. H. Ahrens
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. W. Winkelmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. G. Gosheger
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A. Streitbuerger.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Streitbuerger, A., Hardes, J., Gebert, C. et al. Knorpelbildende Knochentumore. Orthopäde 35, 871–882 (2006). https://doi.org/10.1007/s00132-006-0991-1

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00132-006-0991-1

Schlüsselwörter

Keywords

Search

Navigation