Diagnostic Considerations

In addition to the conditions listed in the differential diagnosis, the following problems should be considered:

Fibrous histiocytoma
Metastatic carcinoma
Paget sarcoma ^{[20, 21]}

Differential Diagnoses

Workup

Limaiem F, Davis DD, Sticco KL. Chondrosarcoma. Treasure Island, FL: StatPearls; 2022. [Full Text].
Ryzewicz M, Manaster BJ, Naar E, Lindeque B. Low-grade cartilage tumors: diagnosis and treatment. Orthopedics. 2007 Jan. 30 (1):35-46; quiz 47-8. [QxMD MEDLINE Link].
Simon MA, Biermann JS. Biopsy of bone and soft-tissue lesions. J Bone Joint Surg Am. 1993 Apr. 75 (4):616-21. [QxMD MEDLINE Link].
Enneking WF, Spanier SS, Goodman MA. Current concepts review. The surgical staging of musculoskeletal sarcoma. J Bone Joint Surg Am. 1980 Sep. 62 (6):1027-30. [QxMD MEDLINE Link].
Healey JH, Lane JM. Chondrosarcoma. Clin Orthop Relat Res. 1986 Mar. 119-29. [QxMD MEDLINE Link].
Mankin HJ, Cantley KP, Schiller AL, Lippiello L. The biology of human chondrosarcoma. II. Variation in chemical composition among types and subtypes of benign and malignant cartilage tumors. J Bone Joint Surg Am. 1980 Mar. 62 (2):176-88. [QxMD MEDLINE Link].
Bovée JV, Cleton-Jansen AM, Kuipers-Dijkshoorn NJ, van den Broek LJ, Taminiau AH, Cornelisse CJ, et al. Loss of heterozygosity and DNA ploidy point to a diverging genetic mechanism in the origin of peripheral and central chondrosarcoma. Genes Chromosomes Cancer. 1999 Nov. 26 (3):237-46. [QxMD MEDLINE Link].
Bovée JV, Cleton-Jansen AM, Rosenberg C, Taminiau AH, Cornelisse CJ, Hogendoorn PC. Molecular genetic characterization of both components of a dedifferentiated chondrosarcoma, with implications for its histogenesis. J Pathol. 1999 Dec. 189 (4):454-62. [QxMD MEDLINE Link].
Castresana JS, Barrios C, Gómez L, Kreicbergs A. Amplification of the c-myc proto-oncogene in human chondrosarcoma. Diagn Mol Pathol. 1992 Dec. 1 (4):235-8. [QxMD MEDLINE Link].
Franchi A, Calzolari A, Zampi G. Immunohistochemical detection of c-fos and c-jun expression in osseous and cartilaginous tumours of the skeleton. Virchows Arch. 1998 Jun. 432 (6):515-9. [QxMD MEDLINE Link].
Brody RI, Ueda T, Hamelin A, Jhanwar SC, Bridge JA, Healey JH, et al. Molecular analysis of the fusion of EWS to an orphan nuclear receptor gene in extraskeletal myxoid chondrosarcoma. Am J Pathol. 1997 Mar. 150 (3):1049-58. [QxMD MEDLINE Link]. [Full Text].
Zhu GG, Nafa K, Agaram N, Zehir A, Benayed R, Sadowska J, et al. Genomic Profiling Identifies Association of IDH1/IDH2 Mutation with Longer Relapse-Free and Metastasis-Free Survival in High-Grade Chondrosarcoma. Clin Cancer Res. 2020 Jan 15. 26 (2):419-427. [QxMD MEDLINE Link].
Asioli S, Ruengwanichayakun P, Zoli M, Guaraldi F, Sollini G, Greco P, et al. Association of Clinicopathological Features With Outcome in Chondrosarcomas of the Head and Neck. Otolaryngol Head Neck Surg. 2021 Apr. 164 (4):807-814. [QxMD MEDLINE Link].
Czerniak B. Malignant cartilage tumors. Dorfman and Czerniak's Bone Tumors. 2nd ed. Philadelphia: Elsevier Saunders; 2016. 474-569.
Kaneuchi Y, Fujiwara T, Tsuda Y, Yoshida S, Stevenson JD, Abudu A. Chondrosarcoma of bone in children and adolescents. J Child Orthop. 2020 Aug 1. 14 (4):330-334. [QxMD MEDLINE Link]. [Full Text].
Larramendy ML, Mandahl N, Mertens F, Blomqvist C, Kivioja AH, Karaharju E, et al. Clinical significance of genetic imbalances revealed by comparative genomic hybridization in chondrosarcomas. Hum Pathol. 1999 Oct. 30 (10):1247-53. [QxMD MEDLINE Link].
Ellis MA, Gerry DR, Byrd JK. Head and neck chondrosarcomas: Analysis of the Surveillance, Epidemiology, and End Results database. Head Neck. 2016 Sep. 38 (9):1359-66. [QxMD MEDLINE Link].
Evans HL, Ayala AG, Romsdahl MM. Prognostic factors in chondrosarcoma of bone: a clinicopathologic analysis with emphasis on histologic grading. Cancer. 1977 Aug. 40 (2):818-31. [QxMD MEDLINE Link].
Gitelis S, Bertoni F, Picci P, Campanacci M. Chondrosarcoma of bone. The experience at the Istituto Ortopedico Rizzoli. J Bone Joint Surg Am. 1981 Oct. 63 (8):1248-57. [QxMD MEDLINE Link].
Ibáñez R, Gutierrez R, Fito C, del Val N, Loza E. Chondrosarcoma in Paget's disease of bone. Clin Exp Rheumatol. 2005 Mar-Apr. 23 (2):275. [QxMD MEDLINE Link].
Haibach H, Farrell C, Dittrich FJ. Neoplasms arising in Paget's disease of bone: a study of 82 cases. Am J Clin Pathol. 1985 May. 83 (5):594-600. [QxMD MEDLINE Link].
De Coninck T, Jans L, Sys G, Huysse W, Verstraeten T, Forsyth R, et al. Dynamic contrast-enhanced MR imaging for differentiation between enchondroma and chondrosarcoma. Eur Radiol. 2013 Nov. 23 (11):3140-52. [QxMD MEDLINE Link].
Jesus-Garcia R, Osawa A, Filippi RZ, Viola DC, Korukian M, de Carvalho Campos Neto G, et al. Is PET-CT an accurate method for the differential diagnosis between chondroma and chondrosarcoma?. Springerplus. 2016. 5:236. [QxMD MEDLINE Link]. [Full Text].
Roitman PD, Farfalli GL, Ayerza MA, Múscolo DL, Milano FE, Aponte-Tinao LA. Is Needle Biopsy Clinically Useful in Preoperative Grading of Central Chondrosarcoma of the Pelvis and Long Bones?. Clin Orthop Relat Res. 2017 Mar. 475 (3):808-814. [QxMD MEDLINE Link].
[Guideline] NCCN Clinical Practice Guidelines in Oncology. Bone cancer. Version 2.2023. National Comprehensive Cancer Network. Available at http://www.nccn.org/professionals/physician_gls/pdf/bone.pdf. September 28, 2022; Accessed: October 19, 2022.
[Guideline] Strauss SJ, Frezza AM, Abecassis N, Bajpai J, Bauer S, Biagini R, et al. Bone sarcomas: ESMO-EURACAN-GENTURIS-ERN PaedCan Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol. 2021 Dec. 32 (12):1520-1536. [QxMD MEDLINE Link]. [Full Text].
[Guideline] Blay JY, Palmerini E, Bollard J, Aguiar S, Angel M, Araya B, et al. SELNET clinical practice guidelines for bone sarcoma. Crit Rev Oncol Hematol. 2022 Jun. 174:103685. [QxMD MEDLINE Link]. [Full Text].
Grimer RJ, Gosheger G, Taminiau A, Biau D, Matejovsky Z, Kollender Y, et al. Dedifferentiated chondrosarcoma: prognostic factors and outcome from a European group. Eur J Cancer. 2007 Sep. 43 (14):2060-5. [QxMD MEDLINE Link].
Park K, Krumme J, Adebayo M, Adams BW, Henshaw RM. Can low-grade chondrosarcoma in flat bones be treated with intralesional curettage and cryotherapy?. J Surg Oncol. 2022 Oct 17. [QxMD MEDLINE Link].

Media Gallery

Plain radiograph shows low-grade chondrosarcoma in pelvis (B). Incidental finding is that proximal femur contains benign enchondroma (A).
T1-weighted MRI shows low-signal-intensity lesion in pelvis: chondrosarcoma.
T2-weighted MRI shows high-signal-intensity lesion in pubis: chondrosarcoma.
MRI of chondrosarcoma (B) shows contrast enhancement of lesion. Enchondroma (A) is also present.
Plain radiograph shows chondrosarcoma.

of 5

Author

Palaniappan Lakshmanan, MBBS, MS, AFRCS, FRCS(Tr&Orth) Consultant Spinal Surgeon, Department of Trauma and Orthopaedics, Sunderland Royal Hospital, UK

Palaniappan Lakshmanan, MBBS, MS, AFRCS, FRCS(Tr&Orth) is a member of the following medical societies: British Orthopaedic Association, AOSpine

Disclosure: Nothing to disclose.

Coauthor(s)

Ramasubramanian Dharmarajan, MBBS, FRCS(Tr&Orth) Consulting Staff, Department of Trauma and Orthopedic Surgery, Cumberland Infirmary, UK

Ramasubramanian Dharmarajan, MBBS, FRCS(Tr&Orth) is a member of the following medical societies: British Medical Association, British Orthopaedic Association, Royal College of Surgeons in Ireland

Disclosure: Nothing to disclose.

Peter G Jennings, MBChB, MRCP, FRCR Consultant in Musculoskeletal Radiology, Department of Radiology, Cumberland Infirmary, UK

Peter G Jennings, MBChB, MRCP, FRCR is a member of the following medical societies: Royal College of Radiologists

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Ian D Dickey, MD, FRCSC, LMCC Orthopedic Surgeon, Colorado Limb Consultants, Denver Clinic for Extremities at Risk; Medical Director, Denver Sarah Cannon Sarcoma Network; Staff Surgeon, Department of Orthopedics, Presbyterian/St Luke’s Hospital; Adjunct Professor, Department of Chemical and Biological Engineering, University of Maine

Ian D Dickey, MD, FRCSC, LMCC is a member of the following medical societies: Canadian Orthopaedic Association, Maine Society of Orthopaedic Surgeons, Mayo Clinic Alumni Association, Musculoskeletal Tumor Society, New England Orthopedic Society, Royal College of Surgeons of Canada

Disclosure: Received consulting fee from Stryker Orthopaedics for consulting; Received honoraria from Cadence for speaking and teaching; Received grant/research funds from Wright Medical for research; Received honoraria from Angiotech for speaking and teaching; Received honoraria from Ferring for speaking and teaching.

Chief Editor

Omohodion (Odion) Binitie, MD Medical Director, Assistant Member, Department of Sarcoma, Section Head, Orthopedics, Adolescent/Young Adult and Pediatric Orthopedic Oncology, Medical Director, Physical Therapy, Speech Therapy, and Rehabilitation Services, Assistant Fellowship Program Director, Musculoskeletal Oncology, Moffitt Cancer Center; Assistant Professor, Department of Oncologic Sciences, Department of Ortho and Sports Medicine, University of South Florida Morsani College of Medicine

Omohodion (Odion) Binitie, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, Children's Oncology Group, Florida Orthopaedic Society, Musculoskeletal Tumor Society

Disclosure: Nothing to disclose.

Acknowledgements

The authors and editors of Medscape Reference gratefully acknowledge the contributions of Mrs Jayanthi Palaniappanto the formatting of the source article.

Chondrosarcoma	Male-to-Female Ratio	Age of Peak Incidence
Conventional	Almost 1:1 (slight male predominance)	50-70 y (most common >50 y, gradual increase with age)
Dedifferentiated	Similar to the ratio above	>50 y
Clear cell	2.4:1	20-40 y (common 10-90 y)
Mesenchymal	1:1	20-30 y (common in teenagers and young adults)
Juxtacortical	1:1	20-40 y

Chondrosarcoma Differential Diagnoses

Diagnostic Considerations

Differential Diagnoses

References

Tables

Contributor Information and Disclosures

What would you like to print?