Chondrosarcoma

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Chondrosarcoma_table_infobox_0

ChondrosarcomaChondrosarcoma_header_cell_0_0_0
SpecialtyChondrosarcoma_header_cell_0_1_0 Oncology Q1076087?uselang=en#P1995Chondrosarcoma_cell_0_1_1

Chondrosarcoma is a bone sarcoma, a primary cancer composed of cells derived from transformed cells that produce cartilage. Chondrosarcoma_sentence_0

A chondrosarcoma is a member of a category of tumors of bone and soft tissue known as sarcomas. Chondrosarcoma_sentence_1

About 30% of bone sarcomas are chondrosarcomas. Chondrosarcoma_sentence_2

It is resistant to chemotherapy and radiotherapy. Chondrosarcoma_sentence_3

Unlike other primary bone sarcomas that mainly affect children and adolescents, a chondrosarcoma can present at any age. Chondrosarcoma_sentence_4

It more often affects the axial skeleton than the appendicular skeleton. Chondrosarcoma_sentence_5

Types Chondrosarcoma_section_0

Chondrosarcoma_table_general_1

Table 1: Types of ChondrosarcomaChondrosarcoma_table_caption_1
Chondrosarcoma_header_cell_1_0_0 SubtypeChondrosarcoma_header_cell_1_0_1 Percentage of cases %Chondrosarcoma_header_cell_1_0_2
ConventionalChondrosarcoma_cell_1_1_0 Primary CentralChondrosarcoma_cell_1_1_1 ~75%Chondrosarcoma_cell_1_1_2
Secondary PeripheralChondrosarcoma_cell_1_2_0 ~10%Chondrosarcoma_cell_1_2_1
Periosteal (aka juxtacortical)Chondrosarcoma_cell_1_3_0 <1%Chondrosarcoma_cell_1_3_1
RareChondrosarcoma_cell_1_4_0 DedifferentiatedChondrosarcoma_cell_1_4_1 ~10%Chondrosarcoma_cell_1_4_2
MesenchymalChondrosarcoma_cell_1_5_0 ~2%Chondrosarcoma_cell_1_5_1
Clear-cellChondrosarcoma_cell_1_6_0 ~2%Chondrosarcoma_cell_1_6_1

Symptoms and signs Chondrosarcoma_section_1

Chondrosarcoma_unordered_list_0

  • Back or thigh painChondrosarcoma_item_0_0
  • SciaticaChondrosarcoma_item_0_1
  • Bladder SymptomsChondrosarcoma_item_0_2
  • Unilateral edemaChondrosarcoma_item_0_3

Causes Chondrosarcoma_section_2

The cause is unknown. Chondrosarcoma_sentence_6

Patients may have a history of enchondroma or osteochondroma. Chondrosarcoma_sentence_7

A small minority of secondary chondrosarcomas occur in patients with Maffucci syndrome and Ollier disease. Chondrosarcoma_sentence_8

It has been associated with faulty isocitrate dehydrogenase 1 and 2 enzymes, which are also associated with gliomas and leukemias. Chondrosarcoma_sentence_9

Diagnosis Chondrosarcoma_section_3

Imaging studies - including radiographs ("x-rays"), computerized tomography (CT), and magnetic resonance imaging (MRI) - are often used to make a presumptive diagnosis of chondrosarcoma. Chondrosarcoma_sentence_10

However, a definitive diagnosis depends on the identification of malignant cancer cells producing cartilage in a biopsy specimen that has been examined by a pathologist. Chondrosarcoma_sentence_11

In a few cases, usually of highly anaplastic tumors, immunohistochemistry (IHC) is required. Chondrosarcoma_sentence_12

There are no blood tests currently available to enable an oncologist to render a diagnosis of chondrosarcoma. Chondrosarcoma_sentence_13

The most characteristic imaging findings are usually obtained with CT. Chondrosarcoma_sentence_14

Nearly all chondrosarcoma patients appear to be in good health. Chondrosarcoma_sentence_15

Often, patients are not aware of the growing tumor until there is a noticeable lump or pain. Chondrosarcoma_sentence_16

Earlier diagnosis is generally accidental, when a patient undergoes testing for another problem and physicians discover the cancer. Chondrosarcoma_sentence_17

Occasionally the first symptom will be a broken bone at the cancerous site. Chondrosarcoma_sentence_18

Any broken bone that occurs from mild trauma warrants further investigation, although there are many conditions that can lead to weak bones, and this form of cancer is not a common cause of such breaks. Chondrosarcoma_sentence_19

Treatment Chondrosarcoma_section_4

Treatment depends on the location of the disease and the aggressiveness of the tumors. Chondrosarcoma_sentence_20

Because chondrosarcomas are rare, they are treated at specialist hospitals with Sarcoma Centers. Chondrosarcoma_sentence_21

Surgery is the main form of treatment for chondrosarcoma. Chondrosarcoma_sentence_22

Musculoskeletal tumor specialists or orthopedic oncologists are usually chosen to treat chondrosarcoma, unless it is located in the skull, spine, or chest cavity, in which case, a neurosurgeon or thoracic surgeon experienced with sarcomas is chosen. Chondrosarcoma_sentence_23

Often, a limb-sparing operation can be performed, but in some cases amputation is unavoidable. Chondrosarcoma_sentence_24

Amputation of the arm, leg, jaw, or half of the pelvis (called a hemipelvectomy) may be necessary in some cases. Chondrosarcoma_sentence_25

There are two kinds of hemipelvectomy - internal and external. Chondrosarcoma_sentence_26

Chondrosarcoma_unordered_list_1

  • External hemipelvectomy - is removal of that half of the pelvis with the amputation of the leg. It is also called the hindquarter amputation.Chondrosarcoma_item_1_4
  • Internal hemipelvectomy - is removal of that half of the pelvis, but the leg is left intact.Chondrosarcoma_item_1_5

Amputation at the hip is called hip disarticulation and amputees who have had this amputation are also called hip disartics. Chondrosarcoma_sentence_27

Chemotherapy or traditional radiotherapy are not very effective for most chondrosarcomas, although proton therapy is showing promise with local tumor control at over 80%. Chondrosarcoma_sentence_28

Complete surgical ablation is the most effective treatment, but sometimes this is difficult. Chondrosarcoma_sentence_29

Proton therapy radiation can be useful in awkward locations to make surgery more effective. Chondrosarcoma_sentence_30

Recent studies have shown that induction of apoptosis in high-grade chondrosarcoma, both directly and by enhancement of response to chemotherapy and radiation, is a valid therapeutic strategy. Chondrosarcoma_sentence_31

Prognosis Chondrosarcoma_section_5

Prognosis depends on how early the cancer is discovered and treated. Chondrosarcoma_sentence_32

For the least aggressive grade, about 90% of patients survive more than five years after diagnosis. Chondrosarcoma_sentence_33

People usually have a good survival rate at the low grade volume of cancer. Chondrosarcoma_sentence_34

For the most aggressive grade, only 10% of patients will survive one year. Chondrosarcoma_sentence_35

Tumors may recur in the future. Chondrosarcoma_sentence_36

Follow up scans are extremely important for chondrosarcoma to make sure there has been no recurrence or metastasis, which usually occurs in the lungs. Chondrosarcoma_sentence_37

Chondrosarcoma_unordered_list_2


Credits to the contents of this page go to the authors of the corresponding Wikipedia page: en.wikipedia.org/wiki/Chondrosarcoma.