Abstract
Chondrosarcoma is a cartilage forming neoplasm, which is the second most common primary malignancy of bone. Clinicians who treat chondrosarcoma patients must determine the grade of the tumor, and must ascertain the likelihood of metastasis. Acral lesions are unlikely to metastasize, regardless of grade, whereas axial, or more proximal lesions are much more likely to metastasize than tumors found in the distal extremities with equivalent histology. Chondrosarcoma is resistant to both chemotherapy and radiation, making wide local excision the only treatment. Local recurrence is frequently seen after intralesional excision, thus wide local excision is sometimes employed despite significant morbidity, even in low-grade lesions. Chondrosarcoma is difficult to treat. The surgeon must balance the risk of significant morbidity with the ability to minimize the chance of local recurrence and maximize the likelihood of long-term survival.
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References
Berend KR, Toth AP, Harrelson JM, Layfield LJ, Hey LA, Scully SP (1998) Association between ratio of matrix metalloproteinase-1 to tissue inhibitor of metalloproteinase-1 and local recurrence, metastasis, and survival in human chondrosarcoma. J Bone Joint Surg Am 80(1):11–17
Bjornsson J, McLeod RA, Unni KK, Ilstrup DM, Pritchard DJ (1998) Primary chondrosarcoma of long bones and limb girdles. Cancer 83(10):2105–2119
Bovee JV, Cleton-Jansen AM, Taminiau AH, Hogendoorn PC (2005) Emerging pathways in the development of chondrosarcoma of bone and implications for targeted treatment. Lancet Oncol 6(8):599–607. doi:10.1016/s1470-2045(05)70282-5
Brenner W, Conrad EU, Eary JF (2004) FDG PET imaging for grading and prediction of outcome in chondrosarcoma patients. Eur J Nucl Med Mol Imaging 31(2):189–195. doi:10.1007/s00259-003-1353-4
Brien EW, Mirra JM, Kerr R (1997) 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 26(6):325–353
Campanacci M (2001) Bone and soft tissue tumors: clinical features, imaging, pathology and treatment, 2nd edn. Springer, New York (Radiology 220(1):236)
Capanna R, Bertoni F, Bettelli G, Picci P, Bacchini P, Present D, Campanacci M (1988) Dedifferentiated chondrosarcoma. J Bone Joint Surg Am 70(1):60–69
Cawte TG, Steiner GC, Beltran J, Dorfman HD (1998) Chondrosarcoma of the short tubular bones of the hands and feet. Skeletal Radiol 27(11):625–632
Cesari M, Bertoni F, Bacchini P, Mercuri M, Palmerini E, Ferrari S (2007) Mesenchymal chondrosarcoma. An analysis of patients treated at a single institution. Tumori 93(5):423–427
Dickey ID, Rose PS, Fuchs B, Wold LE, Okuno SH, Sim FH., Scully SP (2004) Dedifferentiated chondrosarcoma: the role of chemotherapy with updated outcomes. J Bone Joint Surg Am 86-A(11):2412–2418
Donati D, El Ghoneimy A, Bertoni F, Di Bella C, Mercuri M (2005) Surgical treatment and outcome of conventional pelvic chondrosarcoma. J Bone Joint Surg Br 87(11):1527–1530. doi:10.1302/0301-620x.87b11.16621
Enneking WF (1986) A system of staging musculoskeletal neoplasms. Clin Orthop Relat Res 204:9–24
Evans HL, Ayala AG, Romsdahl MM (1977) Prognostic factors in chondrosarcoma of bone. A clinicopathologic analysis with emphasis on histologic grading. Cancer 40(2):818–831. doi:10.1002/1097-0142(197708)40:2<818:aid-cncr2820400234>3.0.co;2-b
Hisaoka M, Hashimoto H (2005) Extraskeletal myxoid chondrosarcoma: updated clinicopathological and molecular genetic characteristics. Pathol Int 55(8):453–463. doi:10.1111/j.1440-1827.2005.01853.x
Itala A, Leerapun T, Inwards C, Collins M, Scully SP (2005) An institutional review of clear cell chondrosarcoma. Clin Orthop Relat Res 440:209–212
Kawaguchi S, Wada T, Nagoya S, Ikeda T, Isu K, Yamashiro K, Hasegawa T (2003) Extraskeletal myxoid chondrosarcoma: a multi-institutional study of 42 cases in Japan. Cancer 97(5):1285–1292. doi:10.1002/cncr.11162
Kusuzaki K, Murata H, Takeshita H, Hirata M, Hashiguchi S, Tsuji Y, Hirasawa Y (1999) Usefulness of cytofluorometric DNA ploidy analysis in distinguishing benign cartilaginous tumors from chondrosarcomas. Mod Pathol 12(9):863–872
Lee FY, Mankin HJ, Fondren G, Gebhardt MC, Springfield DS, Rosenberg AE, Jennings LC (1999) Chondrosarcoma of bone: an assessment of outcome. J Bone Joint Surg Am 81(3):326–338
Lee FY, Yu J, Chang SS, Fawwaz R, Parisien MV (2004) Diagnostic value and limitations of fluorine-18 fluorodeoxyglucose positron emission tomography for cartilaginous tumors of bone. J Bone Joint Surg Am 86-A(12):2677–2685
Lin C, McGough R, Aswad B, Block JA, Terek R (2004) Hypoxia induces HIF-1alpha and VEGF expression in chondrosarcoma cells and chondrocytes. J Orthop Res 22(6):1175–1181. doi:10.1016/j.orthres.2004.03.002
Lin PP, Moussallem CD, Deavers MT (2010) Secondary chondrosarcoma. J Am Acad Orthop Surg 18(10):608–615
Littrell LA, Wenger DE, Wold LE, Bertoni F, Unni KK, White LM, Sundaram M (2004) Radiographic, CT, and MR imaging features of dedifferentiated chondrosarcomas: a retrospective review of 174 de novo cases. Radiographics 24(5):1397–1409. doi:10.1148/rg.245045009
Mandahl N, Gustafson P, Mertens F, Akerman M, Baldetorp B, Gisselsson D, Larsson O (2002) Cytogenetic aberrations and their prognostic impact in chondrosarcoma. Genes Chromosomes Cancer 33(2):188–200
Mankin HJ (1999) Chondrosarcomas of digits: are they really malignant? Cancer 86(9):1635–1637
Mankin HJ, Gebhardt MC, Jennings LC, Springfield DS, Tomford WW (1996) Long-term results of allograft replacement in the management of bone tumors. Clin Orthop Relat Res 324:86–97
Marco RA, Gitelis S, Brebach GT, Healey JH (2000) Cartilage tumors: evaluation and treatment. J Am Acad Orthop Surg 8(5):292–304
McGough RL, Aswad BI, Terek RM (2002) Pathologic neovascularization in cartilage tumors. Clin Orthop Relat Res 397:76–82
McGough RL, Lin C, Meitner P, Aswad BI, Terek RM (2002) Angiogenic cytokines in cartilage tumors. Clin Orthop Relat Res 397:62–69
Mitchell AD, Ayoub K, Mangham DC, Grimer RJ, Carter SR, Tillman RM (2000) Experience in the treatment of dedifferentiated chondrosarcoma. J Bone Joint Surg Br 82(1):55–61
Mittermayer F, Dominkus M, Krepler P, Schwameis E, Sluga M, Toma C, Kotz R (2004) Chondrosarcoma of the hand: is a wide surgical resection necessary? Clin Orthop Relat Res 424:211–215
Miyaji T, Nakase T, Onuma E, Sato K, Myoui A, Tomita T, Yoshikawa H (2003) Monoclonal antibody to parathyroid hormone-related protein induces differentiation and apoptosis of chondrosarcoma cells. Cancer Lett 199(2):147–155
Morris HG, Capanna R, Del Ben M, Campanacci D (1995) Prosthetic reconstruction of the proximal femur after resection for bone tumors. J Arthroplasty 10(3):293–299
Muller S, Soder S, Oliveira AM, Inwards CY, Aigner T (2005) Type II collagen as specific marker for mesenchymal chondrosarcomas compared to other small cell sarcomas of the skeleton. Mod Pathol 18(8):1088–1094. doi:10.1038/modpathol.3800391
Murphey MD, Walker EA, Wilson AJ, Kransdorf MJ, Temple HT, Gannon FH (2003) From the archives of the AFIP: imaging of primary chondrosarcoma: radiologic-pathologic correlation. Radiographics 23(5):1245–1278. doi:10.1148/rg.235035134
Nojima T, Unni KK, McLeod RA, Pritchard DJ (1985) Periosteal chondroma and periosteal chondrosarcoma. Am J Surg Pathol 9(9):666–677
Ogose A, Unni KK, Swee RG, May GK, Rowland CM, Sim FH (1997) Chondrosarcoma of small bones of the hands and feet. Cancer 80(1):50–59
Ozaki T, Lindner N, Hillmann A, Rodl R, Blasius S, Winkelmann W (1996) Influence of intralesional surgery on treatment outcome of chondrosarcoma. Cancer 77(7):1292–1297. doi:10.1002/(sici)1097-0142(19960401)77:7<1292:aid-cncr10>3.0.co;2-x
Pant R, Yasko AW, Lewis VO, Raymond K, Lin PP (2005) Chondrosarcoma of the scapula: long-term oncologic outcome. Cancer 104(1):149–158. doi:10.1002/cncr.21114
Patil S, de Silva MV, Crossan J, Reid R (2003) Chondrosarcoma of small bones of the hand. J Hand Surg Br 28(6):602–608
Pring ME, Weber KL, Unni KK, Sim FH (2001) Chondrosarcoma of the pelvis. A review of sixty-four cases. J Bone Joint Surg Am 83-A(11):1630–1642
Reith JD, Horodyski MB, Scarborough MT (2003) Grade 2 chondrosarcoma: stage I or stage II tumor? Clin Orthop Relat Res 415:45–51. doi:10.1097/01.blo.0000093895.12372.c1
Rosenthal DI, Schiller AL, Mankin HJ (1984) Chondrosarcoma: correlation of radiological and histological grade. Radiology 150(1):21–26
Sandberg AA, Bridge JA (2003) Updates on the cytogenetics and molecular genetics of bone and soft tissue tumors: chondrosarcoma and other cartilaginous neoplasms. Cancer Genet Cytogenet 143(1):1–31
Sawyer JR, Swanson CM, Lukacs JL, Nicholas RW, North PE, Thomas JR (1998) Evidence of an association between 6q13-21 chromosome aberrations and locally aggressive behavior in patients with cartilage tumors. Cancer 82(3):474–483
Shao L, Kasanov J, Hornicek FJ, Morii T, Fondren G, Weissbach L (2003) Ecteinascidin-743 drug resistance in sarcoma cells: transcriptional and cellular alterations. Biochem Pharmacol 66(12):2381–2395
Sheth DS, Yasko AW, Johnson ME, Ayala AG, Murray JA, Romsdahl MM (1996) Chondrosarcoma of the pelvis. Prognostic factors for 67 patients treated with definitive surgery. Cancer 78(4):745–750. doi:10.1002/(sici)1097-0142(19960815)78:4<745:aid-cncr9>3.0.co;2-d
Skeletal Lesions Interobserver Correlation among Expert Diagnosticians (SLICED) Study Group (2007) Reliability of histopathologic and radiologic grading of cartilaginous neoplasms in long bones. J Bone Jt Surg 89(10):2113–2123. doi:10.2106/jbjs.f.01530
Terek RM (2006) Recent advances in the basic science of chondrosarcoma. Orthop Clin North Am 37(1):9–14. doi:10.1016/j.ocl.2005.09.001
Terek RM, Schwartz GK, Devaney K, Glantz L, Mak S, Healey JH, Albino AP (1998) Chemotherapy and P-glycoprotein expression in chondrosarcoma. J Orthop Res 16(5):585–590. doi:10.1002/jor.1100160510
van Loon CJ, Veth RP, Pruszczynski M, Wobbes T, Lemmens JA, van Horn J (1994) Chondrosarcoma of bone: oncologic and functional results. J Surg Oncol 57(4):214–221
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Leddy, L.R., Holmes, R.E. (2014). Chondrosarcoma of Bone. In: Peabody, T., Attar, S. (eds) Orthopaedic Oncology. Cancer Treatment and Research, vol 162. Springer, Cham. https://doi.org/10.1007/978-3-319-07323-1_6
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