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Peripheral and periosteal chondrosarcoma: MRI-pathological correlation in 58 cases

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Abstract

Objective

To determine whether MRI can distinguish atypical cartilaginous tumour/grade 1 peripheral/periosteal chondrosarcoma (ACT/Gd1 PP-CS) from high-grade peripheral/periosteal chondrosarcoma (HG-PP-CS) or dedifferentiated peripheral/periosteal chondrosarcoma (DD-PP-CS).

Materials and methods

Retrospective review of patients diagnosed between January 2007 and December 2020 who had undergone resection of PP-CS. Data collected included age, sex, and skeletal location. Histological tumour grades based on surgical resection were classified as ACT/grade 1 PP-CS, HG-PP-CS, or DD-PP-CS. A variety of MRI features were reviewed independently by 2 musculoskeletal radiologists blinded to final diagnosis and compared between the 3 groups. For statistical analysis, HG-PP-CS and DD-PP-CS were combined.

Results

Fifty-eight patients fulfilled the inclusion criteria, 31 (53%) males and 27 (47%) females with a mean age at diagnosis of 46.1 years (range 11–83 years), 14 (24%) of whom had an underlying diagnosis of diaphyseal aclasis. Forty-one (70.7%) cases were peripheral and 17 (29.3%) periosteal, 38 (66%) involving the flat bones, 15 (26%) the major long bones, 3 (5%) the spine, and 2 (3%) the bones of the hands and feet. Final histology revealed 33 (57%) ACT/Gd1-PP-CS, 18 (31%) HG-PP-CS, and 7 (12%) DD-PP-CS. Periosteal tumours were 16 times more likely to be HG/DD-CS compared to peripheral tumours (p < 0.001). Intra-medullary tumour extension was predictive of HG/DD-CS (p = 0.004) for both tumour types, while cap thickness (p = 0.04) and a diffuse cap type (p = 0.03) were differentiating features of low-grade and high-grade peripheral CS.

Discussion

A variety of features can help differentiate low-grade from high-grade peripheral/periosteal CS, the most significant being origin from the bone surface.

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Acknowledgements

The authors would like to acknowledge Mr Paul Bassett for statistical support.

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Authors and Affiliations

  1. Department of Radiology, The Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, HA7 4LP, UK

    William Tilden, Paul O’Donnell & Asif Saifuddin

  2. Department of Pathology, The Royal National Orthopaedic Hospital, Stanmore, UK

    Vanghelita Andrei

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  1. William Tilden
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  2. Vanghelita Andrei
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  4. Asif Saifuddin
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Correspondence to William Tilden.

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Tilden, W., Andrei, V., O’Donnell, P. et al. Peripheral and periosteal chondrosarcoma: MRI-pathological correlation in 58 cases. Skeletal Radiol 51, 1189–1199 (2022). https://doi.org/10.1007/s00256-021-03947-w

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  • DOI: https://doi.org/10.1007/s00256-021-03947-w

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