eMedicine Specialties > Radiology > Musculoskeletal

Chondrosarcoma: Follow-up

Author: Geoff Hide, MBBS, MRCP, FRCR, Consultant Musculoskeletal Radiologist, Department of Radiology, Freeman Hospital; Honorary Clinical Lecturer, Faculty of Medical Sciences, University of Newcastle upon Tyne
Contributor Information and Disclosures

Updated: Nov 3, 2009

Intervention

Histologic confirmation of the nature of a lesion is required for optimal management. Although biopsy is often performed as an open surgical procedure, percutaneous biopsy with imaging guidance may be helpful in certain scenarios. Ultrasonography is useful for guiding needle biopsy of the soft tissue component of a tumor. CT-guided percutaneous biopsy of bone lesions may be helpful, but the pathologic differentiation between benign and low-grade malignant chondrosarcomas is difficult. Needle biopsy samples may be inadequate for making a precise pathologic diagnosis, and open surgical biopsy is often performed.

The mainstay of treatment is surgical resection because chondrosarcomas respond poorly to chemotherapy or radiation therapy.

Medicolegal Pitfalls

  • Although chondrosarcomas are malignant tumors, they often have features suggestive of a benign lesion.
  • Clinicians should be cautious not to mistake chondrosarcomas for benign lesions because of their well-circumscribed appearance and the lack of periosteal reaction.
 


More on Chondrosarcoma

Overview: Chondrosarcoma
Imaging: Chondrosarcoma
Follow-up: Chondrosarcoma
Multimedia: Chondrosarcoma
References
Further Reading
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References

  1. Flemming DJ, Murphey MD. Enchondroma and chondrosarcoma. Semin Musculoskelet Radiol. 2000;4(1):59-71. [Medline].

  2. Marco RA, Gitelis S, Brebach GT, Healey JH. Cartilage tumors: evaluation and treatment. J Am Acad Orthop Surg. Sep-Oct 2000;8(5):292-304. [Medline].

  3. Gelderblom H, Hogendoorn PC, Dijkstra SD, van Rijswijk CS, Krol AD, Taminiau AH, et al. The clinical approach towards chondrosarcoma. Oncologist. Mar 2008;13(3):320-9. [Medline].

  4. Giuffrida AY, Burgueno JE, Koniaris LG, Gutierrez JC, Duncan R, Scully SP. Chondrosarcoma in the United States (1973 to 2003): an analysis of 2890 cases from the SEER database. J Bone Joint Surg Am. May 2009;91(5):1063-72. [Medline].

  5. Murphey MD, Flemming DJ, Boyea SR, et al. Enchondroma versus chondrosarcoma in the appendicular skeleton: differentiating features. Radiographics. Sep-Oct 1998;18(5):1213-37; quiz 1244-5. [Medline].

  6. Resnik D, Kyriakos M, Greenaway GD. Tumors and tumor-like lesions of bone: imaging and pathology of specific lesions. In: Diagnosis of Bone and Joint Disorders. 4th ed. Philadelphia, Pa: WB Saunders Co;2002: 3897-919.

  7. Wang XL, De Beuckeleer LH, De Schepper AM, Van Marck E. Low-grade chondrosarcoma vs enchondroma: challenges in diagnosis and management. Eur Radiol. 2001;11(6):1054-7. [Medline].

  8. Saki N, Akhlagh SN, Mostofi NE, Ahmadi K. Chondrosarcoma of the hyoid bone: imaging, surgical, and histopathologic correlation. Laryngoscope. Jul 2008;118(7):1211-3. [Medline].

  9. Langheinrich AC, Stolle C, Kampschulte M, Lommel D, Rau WS, Bassaly B. Diagnostic Value of Ex-Vivo Three-Dimensional Micro-Computed Tomography Imaging of Primary Nonhematopoietic Human Bone Tumors: Osteosarcoma versus Chondrosarcoma. Acta Radiol. Jul 11 2008;1-8. [Medline].

  10. Murata H, Horie N, Matsui T, Akai T, Ueda H, Oshima Y, et al. Clinical usefulness of thallium-201 scintigraphy and magnetic resonance imaging in the diagnosis of chondromyxoid fibroma. Ann Nucl Med. Apr 2008;22(3):221-4. [Medline].

  11. Bauer HC, Brosjo O, Kreicbergs A, Lindholm J. Low risk of recurrence of enchondroma and low-grade chondrosarcoma in extremities. 80 patients followed for 2-25 years. Acta Orthop Scand. Jun 1995;66(3):283-8. [Medline].

  12. Walden MJ, Murphey MD, Vidal JA. Incidental enchondromas of the knee. AJR Am J Roentgenol. Jun 2008;190(6):1611-5. [Medline].

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Further Reading

Related eMedicine topics:
Chondrosarcoma (from Orthopedic Surgery)
Chondroma

Related Medscape topics:
Radiology CME and News
Specialty Site Radiology
Specialty Site Oncology

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Keywords

chondrosarcoma, bone tumors, primary bone tumor, bone malignancy, primary osseous neoplasms, sarcomas, chondroid, conventional chondrosarcomas, central chondrosarcoma, peripheral chondrosarcoma, enchondroma, osteochondroma, clear cell chondrosarcoma, myxoid chondrosarcoma, mesenchymal chondrosarcoma, dedifferentiated chondrosarcoma

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Contributor Information and Disclosures

Author

Geoff Hide, MBBS, MRCP, FRCR, Consultant Musculoskeletal Radiologist, Department of Radiology, Freeman Hospital; Honorary Clinical Lecturer, Faculty of Medical Sciences, University of Newcastle upon Tyne
Geoff Hide, MBBS, MRCP, FRCR is a member of the following medical societies: British Medical Association, Royal College of Physicians, and Royal College of Radiologists
Disclosure: Nothing to disclose.

Medical Editor

Michael A Bruno, MD, Associate Professor, Departments of Radiology and Medicine, Pennsylvania State University College of Medicine; Director, Radiology Quality Management Services, Milton S Hershey Medical Center, Pennsylvania State University College of Medicine
Michael A Bruno, MD is a member of the following medical societies: American College of Radiology, American Roentgen Ray Society, Association of University Radiologists, Radiological Society of North America, Society of Nuclear Medicine, and Society of Skeletal Radiology
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

Murali Sundaram, MBBS, FRCR, FACR, Consulting Staff, Department of Diagnostic Radiology, The Cleveland Clinic Foundation
Disclosure: Nothing to disclose.

CME Editor

Robert M Krasny, MD, Resolution Imaging Medical Corporation
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

Felix S Chew, MD, MBA, EdM, Professor, Department of Radiology, Vice Chairman for Radiology Informatics, Section Head of Musculoskeletal Radiology, University of Washington
Felix S Chew, MD, MBA, EdM is a member of the following medical societies: American Roentgen Ray Society, Association of University Radiologists, and Radiological Society of North America
Disclosure: Nothing to disclose.

 
 
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