Chondrosarcoma Flashcards

1
Q

What are the types of Chondrosarcomas?

A

These are malignant chondrogenic lesions low, high or dedifferentiated Chondrosarcomas that are divided into primary or secondary.

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2
Q

What are the types of primary chondrosarcomas ?

A

Clear cell Chondrosarcomas and mesenchymal chondrosarcomas.

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3
Q

What are the types of secondary Chondrosarcomas ?

A
  • osteochondroma
  • multiple hereditary exostosis
  • Enchondroma
    *Ollier’s disease ( 25-40% malignant transformation risk)
    *maffucci’s disease (100% malignant transformation risk)
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4
Q

What is the epidemiology of Chondrosarcoma ?

A

It is typically seen in older male patients (40-75 years)than in woman.

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5
Q

what are the most common locations of Chondrosarcoma ?

A

Pelvis, Proximal femur and Scapula

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6
Q

what is the significance of tumor location in chondrosarcomas ?

A

It is important for diagnosis the histology of chondrosarcoma is considered benign in the hand and malignant if it is on long bones.

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7
Q

What is the grading of chondrosarcoma?

A

*85% are grade 01 or 02
* 15% are grade 03 they evolve from low grade chondroid lesions.

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8
Q

what is the prognosis of Chondrosarcoma ?

A

Axial and proximal bone lesions have an aggressive course.
The grade 01 has 90% survival rate, grade 02 has 60 to 70% survival rate, grade 03 has 30 to 50% survival rate
and de-differentiated chondrosarcoma has 10% survival rate.

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9
Q

what is the determinant of the recurrence of Chondrosarcoma ?

A

Increased telomerase activity.

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10
Q

What are clear cell chondrosarcomas ?

A

These are malignant cartilagenous tumors accounting for <2% of chondrosarcomas. They typically occur in the 4th to 5th decade as insidiously painful ephiphysal lesions that can be mistaken for low grade chondroblastomas. They are locally destructive with potential for mets.

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11
Q

What are Mesenchymal Chondrosarcoma ?

A

These are chondrosarcomas typically seen in young patients consist of small round blue cell components. They typically present in multiple sites simultaneously. They have to be treated with adjuvent chemotherapy followed by wider resection.

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12
Q

What is the presentation of Mesenchymal chondrosarcoma

A

Pain with slowly growing mass or symptoms of bladder or bowel obstruction due to mass effect. 50% case presents with pathologic fractures.

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13
Q

What is the radiological presentation of low grade Chondrosarcomas ?

A

They present with cortical thickening and endosteal erosions.

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14
Q

What is the radiological presentation of high grade Chondrosarcomas ?

A

They present with cortical destruction and soft tissue mass with intralesional popcorn mineralization.

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15
Q

What is the histology of Low grade Chondrosarcomas ?

A

They show few mitotic spindles with bland appearance and enlarged chondrocytes with plump-multinucelated lacunae.

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16
Q

What is the histology of high grade Chondrosarcomas ?

A

Hypercellular stroma consist of blueball appearing cartilagenous lesions with disruption of trabeculae.

17
Q

What is the Tx of Chondrosarcomas ?

A

Low grade (01): Intra lesional Curretage.
Wide resection + multi-agent chemo for Grade 02 and 03.