Chondrosarcoma: Difference between revisions
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== Systemic Involvement == | == Systemic Involvement == | ||
Haversian system and bone marrow invasion | |||
Periosteal reaction | |||
Occasional sites of necrosis and hemorrhage | |||
== Medical Management (current best evidence) == | == Medical Management (current best evidence) == |
Revision as of 21:39, 10 April 2016
Original Editors - Students from Bellarmine University's Pathophysiology of Complex Patient Problems project.
Top Contributors - Dalton O'Brien, Corey Hardesty, Lucinda hampton, Nikhil Benhur Abburi, 127.0.0.1, Admin, Elaine Lonnemann, WikiSysop, Kim Jackson, Vidya Acharya and Rewan Elsayed Elkanafany
Definition/Description[edit | edit source]
Chondrosarcoma is a type of malignant bone tumor that most commonly effects the pelvis, sternum, scapula, or cartilage of long bones in the extremities. Typically, chondrosarcoma is a malignant cartilage tumor that is slow-growing and forms spontaneously or is due to malignant changes in a preexisting (secondary) bone tumor.
Prevalence[edit | edit source]
Chondrosarcoma is the most common malignant cartilage tumor and the third most common bone sarcoma (behind osteosarcoma and Ewing's sarcoma). This pathology is more common in adults over the age of 40, with peak occurrences in the fifth and seventh decades. It is possible to develop chondrosarcoma at younger age groups, which usually leads to higher malignancy and metastases rates.
Characteristics/Clinical Presentation[edit | edit source]
Clinical features seen in patients with chondrosasrcoma include age >25 years old, inflammatory pain (pain with palpation), axial skelton involvement.
Other characteristics of chondrosarcoma:
- Palpable mass
- Back, pelvis, or thigh pain
- Sciatica
- Bladder symptoms
- Unilateral edema
Associated Co-morbidities
[edit | edit source]
Sarcomas that involve soft tissue, such as chondrosarcoma, are more commonly found in individuals who have:
von Recklinghausen's disease Gardner's syndrome Werner's syndrome Tuberous sclerosis Basal cell nevus syndrome Li-Fraumeni syndrome AIDS (Kaposi's sarcoma) Radiation (following surgery), herbicides (phenoxyacetic acid), wood preservatives (chlorophenols), or vinyl chloride exposure
Medications[edit | edit source]
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Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]
Chondrosarcoma is initially assessed via radiographs. CT and MRI are used to view the amount of cortical loss seen. A biopsy is later performed to confirm the diagnosis.
Radiological features of Chondrosarcoma include:
- Intramedullary lesion
- Lesion >5cm
- Microfractures
- Endosteal scalloping (focal resorption of inner margin of cortical bone)
- Loss of calcification
- Soft tissue mass
Chondrosarcoma of the distal femur. This image shows the mineralization and endosteal scalloping commonly seen in chondrosarcoma.
Intramedullary lesion with calcification.
Causes[edit | edit source]
As a whole, the epidemiology of soft tissue sarcomas is not well understood. Although there is no proven genetic disposition, some studies indicate exposure to certain herbicides, wood preservatives, and radiation lead to an increased risk of development. Currently, chrondrosarcomas are thought to form spontaneously or from preexisting bone tumors that have become malignant. Benign bone tumors (osteochondromas, enchondromas, chondromas) that become malignant are referred to as secondary chondrosarcomas and are still composed of cartilaginous tissue entirely.
Systemic Involvement[edit | edit source]
Haversian system and bone marrow invasion
Periosteal reaction
Occasional sites of necrosis and hemorrhage
Medical Management (current best evidence)[edit | edit source]
Following a biopsy to confirm the diagnosis, surgery is the most common procedure to remove the tumor. Even for higher grade tumors, limb-sparing curettage (via cryotherapy) is more common, with amputation occurring in rare instances. Unlike most cancers, typical chondrosarcoma does not respond to chemotherapy and is resistant to radiation therapy. Different forms of chondrosarcoma including dedifferentiated and mesenchymal may be trial chemotherapy before or after surgery and follow a similar protocol to osteosarcoma and Ewing's sarcoma respectively. Depending on the grading of the sarcoma, proton-beam radiation has had some success, but does require very high doses and is considered less frequently than surgical approaches.
Physical Therapy Management (current best evidence)[edit | edit source]
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Alternative/Holistic Management (current best evidence)[edit | edit source]
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Differential Diagnosis[edit | edit source]
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Case Reports[edit | edit source]
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Resources
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Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
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