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MRI features of low-grade and high-grade chondrosarcoma in enchondromatosis

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Abstract

Objective

To identify magnetic resonance imaging (MRI) features which aid differentiation of low-grade chondral tumours (LGCT-enchondroma and grade 1 chondrosarcoma) from high-grade chondral tumours (HGCT) in patients with enchondromatosis.

Materials and method

Approval from our local Research and Innovation Centre of The Institute of Orthopaedics was gained. Patients with enchondromatosis who had biopsy and/or resection of chondral lesions over a 13-year period were identified. The pre-biopsy MRI study was assessed by two experienced musculoskeletal radiologists for tumour origin (intramedullary or surface), cortical expansion, cortical destruction, bone marrow oedema, periosteal reaction, soft tissue mass and soft tissue oedema. MRI features were compared with the final histopathological diagnosis.

Results

The study group comprised 25 males and 16 females, with a mean age of 34.9 years (range 6–81 years). Fifty-nine lesions were assessed (12 patients had > 1 tumour treated), including 43 LGCT and 16 HGCT. Significant MRI features suggesting malignant transformation to HGCT for both observers included bone oedema (p = < 0.001 and 0.002), periosteal reaction (p = 0.01) and soft tissue oedema (p = 0.001 and 0.05). Cortical destruction and soft tissue mass were predictors of HGCT in major long bones, but no significant differentiating features were identified in the hands and feet.

Conclusion

The presence of bone oedema, periosteal reaction and soft tissue oedema on MRI may indicate a high-grade malignant transformation of chondral tumours in patients with enchondromatosis.

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References

  1. Pansuriya TC, Kroon HM, Bovée JVMG. Enchondromatosis: insights on the different subtypes. Int J Clin Exp Pathol. 2010 Jun 26;3(6):557–69.

    PubMed  PubMed Central  Google Scholar 

  2. Herget GW, Strohm P, Rottenburger C, Kontny U, Krauß T, Bohm J, et al. Insights into Enchondroma, Enchondromatosis and the risk of secondary Chondrosarcoma. Review of the literature with an emphasis on the clinical behaviour, radiology, malignant transformation and the follow up. Neoplasma. 2014;61(4):365–78.

    Article  CAS  Google Scholar 

  3. Verdegaal SHM, Bovée JVMG, Pansuriya TC, Grimer RJ, Ozger H, Jutte PC, et al. Incidence, predictive factors, and prognosis of chondrosarcoma in patients with Ollier disease and Maffucci syndrome: an international multicenter study of 161 patients. The Oncologist. 2011 Dec;16(12):1771–9.

    Article  Google Scholar 

  4. Zwenneke Flach H, Ginai AZ, Wolter OJ. Best cases from the AFIP: Maffucci syndrome: radiologic and pathologic findings. RadioGraphics. 2001 Sep;21(5):1311–6.

    Article  CAS  Google Scholar 

  5. Douis H, Saifuddin A. The imaging of cartilaginous bone tumours. II. Chondrosarcoma. Skeletal Radiol. 2013 May;42(5):611–26.

    Article  CAS  Google Scholar 

  6. WHO, Classification of Tumours Editorial Board. Soft tissue and bone tumours. 2020.

  7. Choi B-B, Jee W-H, Sunwoo H-J, Cho J-H, Kim J-Y, Chun K-A, et al. MR differentiation of low-grade chondrosarcoma from enchondroma. Clin Imaging. 2013 May;37(3):542–7.

    Article  Google Scholar 

  8. Murphey MD, Flemming DJ, Boyea SR, Bojescul JA, Sweet DE, Temple HT. Enchondroma versus chondrosarcoma in the appendicular skeleton: differentiating features. RadioGraphics. 1998 Sep;18(5):1213–37.

    Article  CAS  Google Scholar 

  9. Geirnaerdt MJ, Hermans J, Bloem JL, Kroon HM, Pope TL, Taminiau AH, et al. Usefulness of radiography in differentiating enchondroma from central grade 1 chondrosarcoma. Am J Roentgenol. 1997 Oct;169(4):1097–104.

    Article  CAS  Google Scholar 

  10. Vanel D, Kreshak J, Larousserie F, Alberghini M, Mirra J, De Paolis M, et al. Enchondroma vs. chondrosarcoma: a simple, easy-to-use, new magnetic resonance sign. Eur J Radiol. 2013 Dec;82(12):2154–60.

    Article  Google Scholar 

  11. Fayad LM, Ahlawat S, Khan MS, McCarthy E. Chondrosarcomas of the hands and feet: a case series and systematic review of the literature. Eur J Radiol. 2015 Oct;84(10):2004–12.

    Article  Google Scholar 

  12. Crim J, Schmidt R, Layfield L, Hanrahan C, Manaster BJ. Can imaging criteria distinguish enchondroma from grade 1 chondrosarcoma? Eur J Radiol. 2015 Nov;84(11):2222–30.

    Article  Google Scholar 

  13. Douis H, Parry M, Vaiyapuri S, Davies AM. What are the differentiating clinical and MRI-features of enchondromas from low-grade chondrosarcomas? Eur Radiol. 2018 Jan;28(1):398–409.

    Article  Google Scholar 

  14. Ogose A, Unni KK, Swee RG, May GK, Rowland CM, Sim FH. Chondrosarcoma of small bones of the hands and feet. Cancer. 1997 Jul 1;80(1):50–9.

    Article  CAS  Google Scholar 

  15. De Coninck T, Jans L, Sys G, Huysse W, Verstraeten T, Forsyth R, et al. Dynamic contrast-enhanced MR imaging for differentiation between enchondroma and chondrosarcoma. Eur Radiol. 2013 Nov;23(11):3140–52.

    Article  Google Scholar 

  16. De Beuckeleer LHL, De Schepper AMA, Ramon F, Somville J. Magnetic resonance imaging of cartilaginous tumors: a retrospective study of 79 patients. Eur J Radiol. 1995 Nov;21(1):34–40.

    Article  Google Scholar 

  17. Yoo HJ, Hong SH, Choi J-Y, Moon KC, Kim H-S, Choi J-A, et al. Differentiating high-grade from low-grade chondrosarcoma with MR imaging. Eur Radiol. 2009 Dec;19(12):3008–14.

    Article  Google Scholar 

  18. Douis H, Singh L, Saifuddin A. MRI differentiation of low-grade from high-grade appendicular chondrosarcoma. Eur Radiol. 2014 Jan;24(1):232–40.

    Article  Google Scholar 

  19. Fritz B, Müller DA, Sutter R, Wurnig MC, Wagner MW, Pfirrmann CWA, et al. Magnetic resonance imaging–based grading of cartilaginous bone tumors: added value of quantitative texture analysis. Invest Radiol. 2018 Nov;53(11):663–672.

  20. Deckers C, Steyvers MJ, Hannink G, Schreuder HWB, de Rooy JWJ, Van Der Geest ICM. Can MRI differentiate between atypical cartilaginous tumors and high-grade chondrosarcoma? A systematic review. Acta Orthop. 2020 Jul 3;91(4):471–8.

    Article  Google Scholar 

  21. Vázquez-García B, Valverde M, San-Julián M. [Ollier disease: benign tumours with risk of malignant transformation. A review of 17 cases]. An Pediatr Barc Spain 2003. 2011 Mar;74(3):168–73.

  22. 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. Skeletal Radiol. 1997 Jun 9;26(6):325–53.

    Article  CAS  Google Scholar 

  23. Sun TC, Swee RG, Shives TC, Unni KK. Chondrosarcoma in Maffucci’s syndrome. J Bone Joint Surg Am. 1985 Oct;67(8):1214–9.

    Article  CAS  Google Scholar 

  24. Zhou J, Jiang Z-M, Zhang H-Z, Huang J. Clinicopathologic study of Ollier’s disease and its chondrosarcomatous transformation. Zhonghua Bing Li Xue Za Zhi. 2009 Oct;38(10):673–7.

    PubMed  Google Scholar 

  25. Oliveira I, Chavda A, Rajakulasingam R, Saifuddin A. Chondral tumours: discrepancy rate between needle biopsy and surgical histology. Skeletal Radiol [Internet]. 2020 Mar 9 [cited 2020 May 13]; Available from: http://link.springer.com/10.1007/s00256-020-03406-y

  26. Douis H, Jeys L, Grimer R, Vaiyapuri S, Davies AM. Is there a role for diffusion-weighted MRI (DWI) in the diagnosis of central cartilage tumors? Skeletal Radiol. 2015 Jul;44(7):963–9.

    Article  CAS  Google Scholar 

  27. Subhawong TK, Winn A, Shemesh SS, Pretell-Mazzini J. F-18 FDG PET differentiation of benign from malignant chondroid neoplasms: a systematic review of the literature. Skeletal Radiol. 2017 Sep;46(9):1233–9.

    Article  Google Scholar 

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Correspondence to Ban Sharif.

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Sharif, B., Rajakulasingam, R., Sharifi, S. et al. MRI features of low-grade and high-grade chondrosarcoma in enchondromatosis. Skeletal Radiol 50, 1637–1646 (2021). https://doi.org/10.1007/s00256-021-03718-7

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  • DOI: https://doi.org/10.1007/s00256-021-03718-7

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