Skip to main content

Advertisement

Log in

The imaging of cartilaginous bone tumours. II. Chondrosarcoma

  • Review Article
  • Published:
Skeletal Radiology Aims and scope Submit manuscript

Abstract

Chondrosarcoma is the third most common primary malignant bone tumour. There are various histological subtypes of chondrosarcomas, of which conventional intramedullary chondrosarcoma is by far the most common. Rarer sub-types include clear cell chondrosarcoma, myxoid chondrosarcoma, mesenchymal chondrosarcoma and dedifferentiated chondrosarcoma. Chondrosarcoma is also classified into central, peripheral and periosteal, dependent upon the lesion site, and into primary chondrosarcoma if the lesion arises de novo and secondary chondrosarcoma if the tumour arises in a pre-existing lesion. The various subtypes of chondrosarcoma have characteristic imaging features that may aid diagnosis and may guide biopsy, therefore potentially preventing misdiagnosis. The aim of this article is to provide an overview of the pertinent clinical and imaging findings of the different forms of chondrosarcoma.

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

Access this article

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

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12
Fig. 13
Fig. 14
Fig. 15
Fig. 16
Fig. 17
Fig. 18
Fig. 19
Fig. 20
Fig. 21

Similar content being viewed by others

References

  1. Brien EW, Mirra JM, Kerr R. Benign and malignant cartilage tumors of bone and joint: their anatomic and theoretical basis with an emphasis on radiology, pathology and clinical biology. I. The intramedullary cartilage tumors. Skeletal Radiol. 1997;26:325–53.

    Article  PubMed  CAS  Google Scholar 

  2. Marco RA, Gitelis S, Brebach GT, Healey JH. Cartilage tumors: evaluation and treatment. J Am Acad Orthop Surg. 2000;8:292–304.

    PubMed  CAS  Google Scholar 

  3. Flemming DJ, Murphey MD. Enchondroma and chondrosarcoma. Semin Musculoskelet Radiol. 2000;4:59–71.

    Article  PubMed  CAS  Google Scholar 

  4. Aigner T. Towards a new understanding and classification of chondrogenic neoplasias of the skeleton—biochemistry and cell biology of chondrosarcoma and its variants. Virchows Arch. 2002;441:219–30.

    Article  PubMed  CAS  Google Scholar 

  5. Murphey MD, Walker EA, Wilson AJ, Kransdorf MJ, Temple HT, Gannon FH. From the archives of the AFIP: imaging of primary chondrosarcoma: radiologic–pathologic correlation. Radiographics. 2003;23:1245–78.

    Article  PubMed  Google Scholar 

  6. Ahmed AR, Tan TS, Unni KK, Collins MS, Wenger DE, Sim FH. Secondary chondrosarcoma in osteochondroma: report of 107 patients. Clin Orthop Relat Res. 2003;193–206.

  7. Altay M, Bayrakci K, Yildiz Y, Erekul S, Saglik Y. Secondary chondrosarcoma in cartilage bone tumors: report of 32 patients. J Orthop Sci. 2007;12:415–23.

    Article  PubMed  Google Scholar 

  8. Bovee JV, van Roggen JF, Cleton-Jansen AM, Taminiau AH, van der Woude HJ, Hogendoorn PC. Malignant progression in multiple enchondromatosis (Ollier’s disease): an autopsy-based molecular genetic study. Hum Pathol. 2000;31:1299–303.

    Article  PubMed  CAS  Google Scholar 

  9. Shah ZK, Peh WC, Wong Y, Shek TW, Davies AM. Sarcomatous transformation in diaphyseal aclasis. Australas Radiol. 2007;51:110–9.

    Article  PubMed  CAS  Google Scholar 

  10. Skeletal Lesions Interobserver Correlation among Expert Diagnosticians (SLICED) Study Group. Reliability of histopathologic and radiologic grading of cartilaginous neoplasms in long bones. J Bone Joint Surg Am. 2007;89:2113–23.

    Article  Google Scholar 

  11. Eefting D, Schrage YM, Geirnaerdt MJ, Le Cessie S, Taminiau AH, Bovee JV, et al. Assessment of interobserver variability and histologic parameters to improve reliability in classification and grading of central cartilaginous tumors. Am J Surg Pathol. 2009;33:50–7.

    Article  PubMed  Google Scholar 

  12. Reith JD, Horodyski MB, Scarborough MT. Grade 2 chondrosarcoma: stage I or stage II tumor? Clin Orthop Relat Res. 2003;45–51.

  13. O’Connor MI, Bancroft LW. Benign and malignant cartilage tumors of the hand. Hand Clin. 2004;20:317–23. vi.

    Article  PubMed  Google Scholar 

  14. Patil S, de Silva MV, Crossan J, Reid R. Chondrosarcoma of the bones of the feet. J Foot Ankle Surg. 2003;42:290–5.

    Article  PubMed  Google Scholar 

  15. Duarte MP, Maldjian C, Katta US, Kenan S. Conventional intramedullary chondrosarcoma with subarticular involvement. Clin Imaging. 2008;32:69–72.

    Article  PubMed  Google Scholar 

  16. Douis H, James SL, Grimer RJ, Davies MA. Is bone scintigraphy necessary in the initial surgical staging of chondrosarcoma of bone? Skeletal Radiol. 2012;41:429–36.

    Article  PubMed  Google Scholar 

  17. Leerapun T, Hugate RR, Inwards CY, Scully SP, Sim FH. Surgical management of conventional grade I chondrosarcoma of long bones. Clin Orthop Relat Res. 2007;463:166–72.

    PubMed  Google Scholar 

  18. Jones K, Pacella J, Kirby AD, Pervez N. Unusual behaviour of low-grade chondrosarcoma of bone. J Med Imaging Radiat Oncol. 2008;52:95–6.

    Article  PubMed  CAS  Google Scholar 

  19. Damron TA, Ward WG, Stewart A. Osteosarcoma, chondrosarcoma, and Ewing’s sarcoma: National Cancer Data Base report. Clin Orthop Relat Res. 2007;459:40–7.

    Article  PubMed  Google Scholar 

  20. Schwab JH, Wenger D, Unni K, Sim FH. Does local recurrence impact survival in low-grade chondrosarcoma of the long bones? Clin Orthop Relat Res. 2007;462:175–80.

    Article  PubMed  Google Scholar 

  21. Fong YC, Pairolero PC, Sim FH, Cha SS, Blanchard CL, Scully SP. Chondrosarcoma of the chest wall: a retrospective clinical analysis. Clin Orthop Relat Res. 2004;184–9.

  22. Pant R, Yasko AW, Lewis VO, Raymond K, Lin PP. Chondrosarcoma of the scapula: long-term oncologic outcome. Cancer. 2005;104:149–58.

    Article  PubMed  Google Scholar 

  23. Jawad MU, Haleem AA, Scully SP. Malignant sarcoma of the pelvic bones: treatment outcomes and prognostic factors vary by histopathology. Cancer. 2011;117:1529–41.

    Article  PubMed  Google Scholar 

  24. Pring ME, Weber KL, Unni KK, Sim FH. Chondrosarcoma of the pelvis. A review of sixty-four cases. J Bone Joint Surg Am. 2001;83-A:1630–42.

    PubMed  CAS  Google Scholar 

  25. Schneiderbauer MM, Blanchard C, Gullerud R, Harmsen WS, Rock MG, Shives TC, et al. Scapular chondrosarcomas have high rates of local recurrence and metastasis. Clin Orthop Relat Res. 2004;232–8.

  26. Giuffrida AY, Burgueno JE, Koniaris LG, Gutierrez JC, Duncan R, Scully SP. Chondrosarcoma in the United States (1973 to 2003): an analysis of 2890 cases from the SEER database. J Bone Joint Surg Am. 2009;91:1063–72.

    Article  PubMed  Google Scholar 

  27. Bramer JA, Abudu AA, Grimer RJ, Carter SR, Tillman RM. Do pathological fractures influence survival and local recurrence rate in bony sarcomas? Eur J Cancer. 2007;43:1944–51.

    Article  PubMed  CAS  Google Scholar 

  28. Ehara S, Nakayama T, Nishida J, Shiraishi H, Yoshioka H, Aoki J. Bone scintigraphic and CT evaluation of chondrosarcoma of the rib: correlation with histological grade in 6 cases. Ann Nucl Med. 2004;18:633–6.

    Article  PubMed  Google Scholar 

  29. Feldman F, Van Heertum R, Saxena C, Parisien M. 18FDG-PET applications for cartilage neoplasms. Skeletal Radiol. 2005;34:367–74.

    Article  PubMed  Google Scholar 

  30. Brenner W, Conrad EU, Eary JF. FDG PET imaging for grading and prediction of outcome in chondrosarcoma patients. Eur J Nucl Med Mol Imaging. 2004;31:189–95.

    Article  PubMed  Google Scholar 

  31. Yoo HJ, Hong SH, Choi JY, Moon KC, Kim HS, Choi JA, et al. Differentiating high-grade from low-grade chondrosarcoma with MR imaging. Eur Radiol. 2009;19:3008–14.

    Article  PubMed  Google Scholar 

  32. Collins MS, Koyama T, Swee RG, Inwards CY. Clear cell chondrosarcoma: radiographic, computed tomographic, and magnetic resonance findings in 34 patients with pathologic correlation. Skeletal Radiol. 2003;32:687–94.

    Article  PubMed  Google Scholar 

  33. Itala A, Leerapun T, Inwards C, Collins M, Scully SP. An institutional review of clear cell chondrosarcoma. Clin Orthop Relat Res. 2005;440:209–12.

    Article  PubMed  Google Scholar 

  34. Donati D, Yin JQ, Colangeli M, Colangeli S, Bella CD, Bacchini P, et al. Clear cell chondrosarcoma of bone: long time follow-up of 18 cases. Arch Orthop Trauma Surg. 2008;128:137–42.

    Article  PubMed  Google Scholar 

  35. Kaim AH, Hugli R, Bonel HM, Jundt G. Chondroblastoma and clear cell chondrosarcoma: radiological and MRI characteristics with histopathological correlation. Skeletal Radiol. 2002;31:88–95.

    Article  PubMed  Google Scholar 

  36. Memis A, Arkun R, Basdemir G, Sabah D, Ustun EE. Clear cell chondrosarcoma: unusual radiologic appearances with histologic correlation. Eur Radiol. 2002;12:427–30.

    Article  PubMed  Google Scholar 

  37. Corradi D, Bacchini P, Campanini N, Bertoni F. Aggressive clear cell chondrosarcomas: do distinctive characteristics exist?: a report of 4 cases. Arch Pathol Lab Med. 2006;130:1673–9.

    PubMed  Google Scholar 

  38. Kalil RK, Inwards CY, Unni KK, Bertoni F, Bacchini P, Wenger DE, et al. Dedifferentiated clear cell chondrosarcoma. Am J Surg Pathol. 2000;24:1079–86.

    Article  PubMed  CAS  Google Scholar 

  39. Cesari M, Bertoni F, Bacchini P, Mercuri M, Palmerini E, Ferrari S. Mesenchymal chondrosarcoma. An analysis of patients treated at a single institution. Tumori. 2007;93:423–7.

    PubMed  Google Scholar 

  40. Littrell LA, Wenger DE, Wold LE, Bertoni F, Unni KK, White LM, et al. Radiographic, CT, and MR imaging features of dedifferentiated chondrosarcomas: a retrospective review of 174 de novo cases. Radiographics. 2004;24:1397–409.

    Article  PubMed  Google Scholar 

  41. Staals EL, Bacchini P, Bertoni F. Dedifferentiated central chondrosarcoma. Cancer. 2006;106:2682–91.

    Article  PubMed  Google Scholar 

  42. Okada K, Hasegawa T, Tateishi U, Endo M, Itoi E. Dedifferentiated chondrosarcoma with telangiectatic osteosarcoma-like features. J Clin Pathol. 2006;59:1200–2.

    Article  PubMed  CAS  Google Scholar 

  43. Estrada EG, Ayala AG, Lewis V, Czerniak B. Dedifferentiated chondrosarcoma with a noncartilaginous component mimicking a conventional giant cell tumor of bone. Ann Diagn Pathol. 2002;6:159–63.

    Article  PubMed  Google Scholar 

  44. Grimer RJ, Gosheger G, Taminiau A, Biau D, Matejovsky Z, Kollender Y, et al. Dedifferentiated chondrosarcoma: prognostic factors and outcome from a European group. Eur J Cancer. 2007;43:2060–5.

    Article  PubMed  Google Scholar 

  45. Dickey ID, Rose PS, Fuchs B, Wold LE, Okuno SH, Sim FH, et al. Dedifferentiated chondrosarcoma: the role of chemotherapy with updated outcomes. J Bone Joint Surg Am. 2004;86-A:2412–8.

    PubMed  Google Scholar 

  46. Mitchell AD, Ayoub K, Mangham DC, Grimer RJ, Carter SR, Tillman RM. Experience in the treatment of dedifferentiated chondrosarcoma. J Bone Joint Surg Br. 2000;82:55–61.

    Article  PubMed  CAS  Google Scholar 

  47. MacSweeney F, Darby A, Saifuddin A. Dedifferentiated chondrosarcoma of the appendicular skeleton: MRI-pathological correlation. Skeletal Radiol. 2003;32:671–8.

    Article  PubMed  Google Scholar 

  48. Saifuddin A, Mann BS, Mahroof S, Pringle JA, Briggs TW, Cannon SR. Dedifferentiated chondrosarcoma: use of MRI to guide needle biopsy. Clin Radiol. 2004;59:268–72.

    Article  PubMed  CAS  Google Scholar 

  49. Brien EW, Mirra JM, Luck Jr JV. Benign and malignant cartilage tumors of bone and joint: their anatomic and theoretical basis with an emphasis on radiology, pathology and clinical biology. II. Juxtacortical cartilage tumors. Skeletal Radiol. 1999;28:1–20.

    Article  PubMed  CAS  Google Scholar 

  50. Robinson P, White LM, Sundaram M, Kandel R, Wunder J, McDonald DJ, et al. Periosteal chondroid tumors: radiologic evaluation with pathologic correlation. AJR Am J Roentgenol. 2001;177:1183–8.

    Article  PubMed  CAS  Google Scholar 

  51. Vanel D, De Paolis M, Monti C, Mercuri M, Picci P. Radiological features of 24 periosteal chondrosarcomas. Skeletal Radiol. 2001;30:208–12.

    Article  PubMed  CAS  Google Scholar 

  52. Papagelopoulos PJ, Galanis EC, Mavrogenis AF, Savvidou OD, Bond JR, Unni KK, et al. Survivorship analysis in patients with periosteal chondrosarcoma. Clin Orthop Relat Res. 2006;448:199–207.

    Article  PubMed  Google Scholar 

  53. Chaabane S, Bouaziz MC, Drissi C, Abid L, Ladeb MF. Periosteal chondrosarcoma. AJR Am J Roentgenol. 2009;192:W1–6.

    Article  PubMed  Google Scholar 

  54. Murphey MD, Choi JJ, Kransdorf MJ, Flemming DJ, Gannon FH. Imaging of osteochondroma: variants and complications with radiologic–pathologic correlation. Radiographics. 2000;20:1407–34.

    PubMed  CAS  Google Scholar 

  55. Staals EL, Bacchini P, Mercuri M, Bertoni F. Dedifferentiated chondrosarcomas arising in preexisting osteochondromas. J Bone Joint Surg Am. 2007;89:987–93.

    Article  PubMed  Google Scholar 

  56. Lee KC, Davies AM, Cassar-Pullicino VN. Imaging the complications of osteochondromas. Clin Radiol. 2002;57:18–28.

    Article  PubMed  CAS  Google Scholar 

  57. Woertler K, Lindner N, Gosheger G, Brinkschmidt C, Heindel W. Osteochondroma: MR imaging of tumor-related complications. Eur Radiol. 2000;10:832–40.

    Article  PubMed  CAS  Google Scholar 

  58. Feldman F, Vanheertum R, Saxena C. 18fluoro-deoxyglucose positron emission tomography evaluation of benign versus malignant osteochondromas: preliminary observations. J Comput Assist Tomogr. 2006;30:858–64.

    Article  PubMed  Google Scholar 

  59. Bernard SA, Murphey MD, Flemming DJ, Kransdorf MJ. Improved differentiation of benign osteochondromas from secondary chondrosarcomas with standardized measurement of cartilage cap at CT and MR imaging. Radiology. 2010;255:857–65.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to H. Douis.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Douis, H., Saifuddin, A. The imaging of cartilaginous bone tumours. II. Chondrosarcoma. Skeletal Radiol 42, 611–626 (2013). https://doi.org/10.1007/s00256-012-1521-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00256-012-1521-3

Keywords

Navigation