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Unusual soft tissue metastases in a patient with chondrosarcoma: a case report

  • Case Report - Pathology
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Abstract

Chondrosarcoma (CS) is the second most frequent primary malignant bone tumour, characterized by production of non‐osteoid cartilage matrix. Up to more than 30% of patients with CS present distant metastases, and the lungs represent the preferred site. Hence, CS soft tissue metastases and superficial cutaneous lesions are extremely rare. We report the case of a female who developed unusual multiple soft tissue CS metastases. This patient underwent left hindquarter amputation for recurrent grade 3 chondrosarcoma of the femoral neck with extension to the pelvis approximately 4 years after internal fixation with an intramedullary nail for pathological fracture of left proximal femur and subsequent total proximal femoral endoprosthetic replacement for grade 1–2 chondrosarcoma. In the following years, she underwent metastasectomy for several grade 2 pulmonary metastatic chondrosarcomas. More than 14 years after the amputation, she presented with multiple unusual superficial cutaneous lesions, and a whole-body magnetic resonance imaging demonstrated multiple soft tissue foci of metastatic disease. The histology of multiple soft tissue lesions excised confirmed metastatic chondrosarcoma. Then, she underwent marginal excision of further multifocal soft tissue metastatic high-grade chondrosarcoma. Unlike the poor survival from the onset of these metastases in the other cases reported in the literature, our patient is still alive 2 years after the first multiple soft tissue excision of metastatic chondrosarcoma, and approximately 20 years after the diagnosis of chondrosarcoma. Soft tissue CS metastases are a rare entity with few cases described in literature. This study aims to make the reader aware of this lesser-known CS manifestation.

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References

  1. Giuffrida AY, Burgueno JE, Koniaris LG et al (2009) Chondrosarcoma in the united states (1973 to 2003): an analysis of 2890 cases from the seer database. J Bone Jt Surg-Am. https://doi.org/10.2106/JBJS.H.00416

    Article  Google Scholar 

  2. Weinschenk RC, Wang W-L, Lewis VO (2021) Chondrosarcoma. J Am Acad Orthop Surg 29:553–562. https://doi.org/10.5435/JAAOS-D-20-01188

    Article  PubMed  Google Scholar 

  3. Brown JM, Rakoczy K, Hart J et al (2022) Presenting features and overall survival of chondrosarcoma of the pelvis. Cancer Treat Res Commun 30:100510. https://doi.org/10.1016/j.ctarc.2022.100510

    Article  PubMed  Google Scholar 

  4. Amer KM, Munn M, Congiusta D et al (2020) Survival and prognosis of chondrosarcoma subtypes: seer database analysis. J Orthop Res 38:311–319. https://doi.org/10.1002/jor.24463

    Article  PubMed  Google Scholar 

  5. Kim J-H, Lee SK (2023) Classification of chondrosarcoma: from characteristic to challenging imaging findings. Cancers 15:1703. https://doi.org/10.3390/cancers15061703

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Laitinen MK, Parry MC, Le Nail L-R et al (2019) Locally recurrent chondrosarcoma of the pelvis and limbs can only be controlled by wide local excision. Bone Jt J. https://doi.org/10.1302/0301-620X.101B3.BJJ-2018-0881.R1

    Article  Google Scholar 

  7. Angelini A, Guerra G, Mavrogenis AF et al (2012) Clinical outcome of central conventional chondrosarcoma: central conventional chondrosarcoma. J Surg Oncol 106:929–937. https://doi.org/10.1002/jso.23173

    Article  PubMed  Google Scholar 

  8. Li W, Dong S, Wang H et al (2021) Risk analysis of pulmonary metastasis of chondrosarcoma by establishing and validating a new clinical prediction model: a clinical study based on seer database. BMC Musculoskelet Disord 22:529. https://doi.org/10.1186/s12891-021-04414-2

    Article  PubMed  PubMed Central  Google Scholar 

  9. Nakamura T, Matsumine A, Yamada S et al (2016) Oncological outcome after lung metastasis in patients presenting with localized chondrosarcoma at extremities: tokai musculoskeletal oncology consortium study. OncoTargets Ther 9:4747–4751. https://doi.org/10.2147/OTT.S107638

    Article  Google Scholar 

  10. Gazendam A, Popovic S, Parasu N, Ghert M (2023) Chondrosarcoma: a clinical review. J Clin Med 12:2506. https://doi.org/10.3390/jcm12072506

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Zhang Y, Chen Y, Yang C et al (2021) TERT promoter mutation is an objective clinical marker for disease progression in chondrosarcoma. Mod Pathol 34:2020–2027. https://doi.org/10.1038/s41379-021-00848-0

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Limaiem F, Davis DD, Sticco KL (2023) Chondrosarcoma. StatPearls Publishing, Treasure Island (FL), StatPearls

    Google Scholar 

  13. Praag V, (Veroniek) VM, Rueten-Budde AJ, Ho V, et al (2018) Incidence, outcomes and prognostic factors during 25 years of treatment of chondrosarcomas. Surg Oncol 27:402–408. https://doi.org/10.1016/j.suronc.2018.05.009

    Article  Google Scholar 

  14. Leddy LR, Holmes RE (2014) Chondrosarcoma of Bone. In: Peabody TD, Attar S (eds) Orthopaedic Oncology. Springer International Publishing, Cham, pp 117–130

    Chapter  Google Scholar 

  15. Lee FY, Mankin HJ, Fondren G et al (1999) Chondrosarcoma of bone: an assessment of outcome. J Bone Jt Surg 81:326–338. https://doi.org/10.2106/00004623-199903000-00004

    Article  CAS  Google Scholar 

  16. Nazeri E, GouranSavadkoohi M, Majidzadeh-A K, Esmaeili R (2018) Chondrosarcoma: an overview of clinical behavior, molecular mechanisms mediated drug resistance and potential therapeutic targets. Crit Rev Oncol Hematol 131:102–109. https://doi.org/10.1016/j.critrevonc.2018.09.001

    Article  PubMed  Google Scholar 

  17. Arce FP, Pinto J, Portero I et al (2000) Cutaneous metastases as initial manifestation of dedifferentiated chondrosarcoma of bone. An autopsy case with review of the literature. J Cutan Pathol 27:262–267. https://doi.org/10.1034/j.1600-0560.2000.027005262.x

    Article  CAS  PubMed  Google Scholar 

  18. Lalam RK, Cassar-Pullicino VN, Kumar N et al (2015) Subcutaneous and lung metastases from chondrosarcoma of the thumb. BJRcase Rep 1:20150129. https://doi.org/10.1259/bjrcr.20150129

    Article  CAS  Google Scholar 

  19. Ramseier LE, Dumont CE, Ulrich Exner G (2007) Multiple subungual soft tissue metastases from a chondrosarcoma. Scand J Plast Reconstr Surg Hand Surg 41:332–333. https://doi.org/10.1080/02844310600723067

    Article  PubMed  Google Scholar 

  20. Sambri A, Rocca M, Tuzzato G et al (2020) Lung metastasectomy improves survival in patients affected by grade 2 and 3 chondrosarcoma. Oncol Res Treat 43:134–139. https://doi.org/10.1159/000504854

    Article  CAS  PubMed  Google Scholar 

  21. Jurik AG, Jørgensen PH, Mortensen MM (2020) Whole-body MRI in assessing malignant transformation in multiple hereditary exostoses and enchondromatosis: audit results and literature review. Skeletal Radiol 49:115–124. https://doi.org/10.1007/s00256-019-03268-z

    Article  PubMed  Google Scholar 

  22. Ollivier L, Vanel D, Leclère J (2003) Imaging of chondrosarcomas. Cancer Imaging 4:36–38. https://doi.org/10.1102/1470-7330.2003.0022

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Karabela-Bouropoulou V, Patra-Malli F, Agnantis N (1986) Chondrosarcoma of the thumb: an unusual case with lung and cutaneous metastases and death of the patient 6 years after treatment. J Cancer Res Clin Oncol 112:71–74. https://doi.org/10.1007/BF00394943

    Article  CAS  PubMed  Google Scholar 

  24. Leal-Khouri SM, Barnhill RL, Baden HP (1990) An unusual cutaneous metastasis of a chondrosarcoma. J Cutan Pathol 17:274–277. https://doi.org/10.1111/j.1600-0560.1990.tb00102.x

    Article  CAS  PubMed  Google Scholar 

  25. Sherr DL, Fountain KS, Kalb RE (1986) Cutaneous metastases from chondrosarcoma. J Dermatol Surg Oncol 12:146–149. https://doi.org/10.1111/j.1524-4725.1986.tb01445.x

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopedic Oncology, Royal Orthopedic Hospital, Birmingham, UK

    Giuseppe Francesco Papalia & Vineet Kurisunkal

  2. Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 00128, Rome, Italy

    Giuseppe Francesco Papalia

  3. Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham, UK

    Sisith Ariyaratne & Rajesh Botchu

  4. Department of Pathology, Royal Orthopedic Hospital, Birmingham, UK

    Sumathi Vaiyapuri

Authors
  1. Giuseppe Francesco Papalia
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  2. Sisith Ariyaratne
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  3. Sumathi Vaiyapuri
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  5. Vineet Kurisunkal
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Correspondence to Giuseppe Francesco Papalia.

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All procedures performed in the study were in accordance with the ethical. standards of the national research committee and with the 1964 Helsinki declaration.

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Papalia, G.F., Ariyaratne, S., Vaiyapuri, S. et al. Unusual soft tissue metastases in a patient with chondrosarcoma: a case report. Int Canc Conf J (2024). https://doi.org/10.1007/s13691-024-00684-4

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