PRIMARY MALIGNANT BONE TUMORS

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PRIMARY MALIGNANT BONE TUMORS

• CHONDROSARCOMA

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CHONDROSARCOMA

• General Considerations
• Third m/c primary osseous malignancy
• Characterized by the formation of cartilage
• M/C tumor ? hand, sternum, and scapula
• Typically slow growing (depending upon grade and
  type) metastasizes late
• Primary or secondary central or peripheral
  juxtacortical
• Secondary malignant degeneration of
  enchondroma, osteochondroma, Pagets

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CHONDROSARCOMA

• Signs and Symptoms
• 40-60 years of age Males
• Most frequent complaint ? dull pain with an
  average duration of several years
• May be discovered incidentally
• Localized swelling without inflammation may occur

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CHONDROSARCOMA

• Location
• M/C site ? proximal femur
• Pelvis and proximal humerus
• Ribs, sternum and scapula
• Usually metaphyseal
• may be diaphyseal

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CHONDROSARCOMA

• Radiographic
• May present as a well-marginated, expansile
  osteolytic lesion
• Cortex may be thick or thin
• Matrix calcification ? 2/3 of cases
• Heavy or sparse
• Punctate, flocculent, circular, ring-like
• Occasionally ? periosteal response
• Endosteal scalloping may be a feature
• Common with cartilaginous and fibrous tumors

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CHONDROSARCOMA

• Radiographic
• Cortical destruction and soft tissue mass
  demonstrating calcification ? advance tumor
• High grade vs low grade differentiation based on
  tumor margins, cortical destruction, patterns of
  calcification, soft tissue involvement

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CHONDROSARCOMA

• Complications
• Slow growing with late metastasis hematogenously
  to the lungs
• Treatment and Prognosis
• Resection of the lesion is best
• Not radiosensitive
• 5 year survival approaches 90

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CHONDROSARCOMA

• Differential Diagnosis
• Early stages, may be impossible to distinguish
  from a proximal enchondroma
• If calcification is lacking, chondrosarcoma may
  mimick giant-cell tumor