What Is a Chondrosarcoma?

Chondrosarcoma is one of the common malignant bone tumors. It occurs centrally in the medullary cavity and periosteum in the periosteum, and a few can occur in soft tissues. Tumors occur in the long bones and pelvis of the extremities, but also in the vertebrae, sacrum, clavicle, scapula and foot bone. The disease is divided into two types: primary and secondary. The latter can be caused by malignant changes of chondroma and osteochondroma, which is one of the reasons for the late onset of age. The disease is more common in adults, rare under 30 years of age, and the incidence gradually increases after 35 years of age. More men than women.

Basic Information

English name

chondrosarcoma

Visiting department

Oncology; Orthopedics

Multiple groups

Primary: Adolescent; Secondary: Male Adult

Common locations

Long bones and pelvis of limbs

Common symptoms

Blunt pain is predominant, with a local mass and no obvious tenderness. The surrounding skin is accompanied by red fever. Compression of the nerve can cause radiation pain and numbness.

Etiology of chondrosarcoma

The etiology of chondrosarcoma is unknown. The disease occurs from chondrocytes or mesoderm tissue and originates from the bones of any cartilage internalized in the body, which may be related to chromosomal abnormalities.

Chondrosarcoma clinical manifestations

The patient feels the discomfort of the affected area at an early stage. After a few days or weeks, swelling and mass appear, varicose veins may appear at a later stage, the local skin temperature rises and the blood becomes red. Patients will feel pain around the joints, which is intermittent pain at first, and gradually worsens, and then becomes persistent pain, which is more obvious at night, and painkillers are ineffective. Patients have limited joint movements, and some patients can develop joint effusions and even pathological fractures.

Primary chondrosarcoma is dominated by blunt pain, which gradually changes from intermittent to continuous. Those with adjacent joints can cause joint movement limitation. The lump can be palpated locally without obvious tenderness, and the surrounding skin is accompanied by red fever.

Secondary chondrosarcoma is more common in adult men over 30 years of age. Occurs in the pelvis, followed by the scapula, femur and humerus. Occasionally, a lump was found, the course was slow, the pain was not obvious, and the surrounding skin was not red and hot. When it was near the joint, it could cause joint swelling and limited movement. Compression of the nerve could cause radiation pain and numbness. It is difficult to find tumors in the thoracic cavity and pelvis, and the corresponding symptoms are not discovered until the internal organs are compressed.

Chondrosarcoma

1. Chondrosarcoma that occurs in the medullary cavity can show patchy, erosive, and cystic osteolytic destruction, and those that occur in the medullary cavity of the backbone can present a large cystic bone destruction area, which is absorbed by the inner edge of the bone cortex. When it is slow, it can make the cortex thin and swell. When the cortex is punctured, it can cause new bone under the periosteum, which is usually lighter, and occasionally there is needle-shaped bone next to the cortex.

2. Tumor cartilage calcification is the most basic and characteristic manifestation. When the tumor is confined to the medullary cavity, the tumor cartilage has less calcification. When it breaks through the cortex and grows into the soft tissue, a soft tissue mass appears quickly, and calcification of varying density can be seen. Secondary to osteochondroma, the tumor cartilage has more calcification, and the density varies. Tumor cartilage calcification was ring-shaped, semi-ring-shaped, crumb-like or even punctiform. Calcification is the deposition of calcium salts in the matrix of well-differentiated tumor chondrocytes. Calcified tumor cartilage can be destroyed by surrounding tumor cells that grow actively, thereby shrinking or disappearing. When osteochondroma malignant turns into chondrosarcoma, it is common to have a dense lobular calcification zone next to the bone, which is the calcification of the original osteochondroma; in the malignant mass, the calcification is less, scattered and blurred.

3. Secondary chondrosarcoma can appear like dentinoid tumor bone. Occurred in patients with chondroma and osteochondroma malignant transformation, tumor bone is located at the junction of the primary tumor and malignant chondrosarcoma.

4. When the primary chondrosarcoma breaks through the cortical bone, secondary to chondroma, and recurrence after chondrosarcoma resection, huge soft tissue masses can be formed. Among them, calcification of tumors of varying numbers and density can be seen.

Chondrosarcoma diagnosis

1. Primary chondrosarcoma is more common in adolescents and occurs in the long bones of the extremities and the bones of the trunk.

2. The local pain is not obvious, the mass grows rapidly, there is tenderness and joint dysfunction.

3. Secondary chondrosarcomas are mostly secondary to the original benign bone tumors, with a long course of disease and malignant changes, rapid growth and severe symptoms.

4. X-ray characteristics and pathological examination can confirm the diagnosis.

Differential diagnosis of chondrosarcoma

1. Chondroma often has scattered calcification points in the gravel, but it is smaller and smaller than chondrosarcoma, and the bone cortex is more intact, and there is no tumorous soft tissue mass.

2. Osteochondroma is a bony protrusion attached to the metaphysis, with various shapes. Cauliflower-like calcification shadows can also be seen at the end of the tumor if the cartilage cap is thick. For chondrosarcoma secondary to osteochondroma, the thickness of the cartilage cap is more pronounced, and a soft tissue mass is formed. A large number of irregular flocculent calcification points can be seen.

3. Osteosarcoma is easy to be confused with central chondrosarcoma, especially when there is no calcification in chondrosarcoma, which is quite similar to osteosarcoma, but if you see the characteristic tumor ossification of osteosarcoma, and those with significant periosteal reaction the difference.

Chondrosarcoma treatment

The most effective treatment for chondrosarcoma is surgical resection. After a clear diagnosis, consider local mass excision, segmental amputation or amputation according to the specific situation. Most chondrosarcomas undergo a surgical operation that requires a complete local excision, and amputation or joint dissection for relapsed or primary malignant and rapidly developing cases.

Chondrosarcoma prognosis

Chondrosarcoma grows slowly, and local recurrence and metastasis can occur 10 years after surgery, so the follow-up time of chondrosarcoma should be longer than other spinal primary tumors. The follow-up period must be at least 3 years. The 5-year survival rates for low, moderate, and severe malignant chondrosarcomas are 78%, 53%, and 22%, respectively.