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MRI-histopathological correlation in paediatric conventional central chondrosarcoma: a report of 17 cases

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Abstract

Objective

To describe the MRI features of paediatric conventional central chondrosarcoma (CC-CS) and correlate with histological grade.

Materials and methods

A retrospective review of children/adolescents with histologically confirmed CC-CS. Data collected included age, sex, skeletal location, and histology from needle biopsy or resection, which was classified as atypical cartilaginous tumours/grade 1 CS (ACT/Gd 1 CS), high-grade chondrosarcoma (HGCS), and dedifferentiated chondrosarcoma (DD-CS). MRI studies were reviewed independently by 2 radiologists blinded to the histology grade, who graded the tumours as ACT/Gd 1 CS, HGCS, and DD-CS based on MRI features.

Results

The study included 7 males and 10 females with mean age 13.9 years (range 6–18 years). Tumours were located in the femur (n = 6), humerus (n = 3), tibia, ilium, scapula, and ulna (n = 1 each), and the small bones of the hands or feet (n = 4). Final histology grade was ACT/Gd 1 CS in 15 cases and HGCS in 2 (both grade 1 CS with focal transition to grade 2), 15 based on surgical specimens, 1 based on open biopsy, and 1 on needle biopsy alone. Predicted MRI grade for the 2 readers was ACT/Gd 1 CS in 11 cases each and HGCS in 6 cases each, indicating a mismatch between predicted MRI grade and histological grade in 8 (47%) cases (4 cases with one reader mismatch and 4 cases with both).

Conclusions

MRI findings in paediatric CC-CS may be misleading, showing features suggestive of HGCS 7 of 17 (41.2%) of cases. This should be taken into consideration when planning surgical treatment.

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Authors and Affiliations

  1. Department of Orthopaedic Oncology, Royal National Orthopaedic Hospital, Stanmore, UK

    Amir Ardakani & Panagiotis Gikas

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

    Michael Khoo, Paul O’Donnell & Asif Saifuddin

  3. Institute of Orthopaedics and Musculoskeletal Science, University College London, London, UK

    Paul O’Donnell

  4. Department of Histopathology, Royal National Orthopaedic Hospital, Stanmore, UK

    Roberto Tirabosco

Authors
  1. Amir Ardakani
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  2. Panagiotis Gikas
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  3. Michael Khoo
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  4. Paul O’Donnell
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  5. Roberto Tirabosco
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  6. Asif Saifuddin
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Corresponding author

Correspondence to Michael Khoo.

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The study was approved by the local Research and Innovation Centre of The Institute of Orthopaedics under the Integrated Research Application System number 262826, with no requirement for informed patient consent.

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The authors declare that they have no conflict of interest.

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Ardakani, A., Gikas, P., Khoo, M. et al. MRI-histopathological correlation in paediatric conventional central chondrosarcoma: a report of 17 cases. Skeletal Radiol 50, 711–721 (2021). https://doi.org/10.1007/s00256-020-03614-6

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  • DOI: https://doi.org/10.1007/s00256-020-03614-6

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