Conventional chondrosarcoma

Changed by Rohit Sharma, 9 Jun 2018

Updates to Article Attributes

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Conventional chondrosarcoma also known as central chondrosarcoma is the most common subtype of chondrosarcoma and may be low, intermediate or high grade (see chondrosarcoma grading).

Epidemiology

They typically occur in the 4th and 5th decades with a slight male predominance 1.5-2.0:1.

PresentationClinical presentation

At diagnosis it is typically a large mass, usually over 4 cm in diameter. When arising in long bones (most common location, see below) it typically involves more than 50% of the length of the shaft.

Typically chondrosarcomas present with:

  • pain: present in 95% of cases, often long standing and worse at night
  • palpable mass: present in 28-82% of cases
  • pathological fracture: present in 3-17% of cases

Pathology

Histologically, the tumour grows as multiple hyaline cartilage nodules with central high water content and peripheral endochondral ossification. This accounts for not only the high T2 MRI signal but also for rings and arcs calcification and popcorn calcificationon on CT and plain film.

Location

Imaging findingsRadiographic features

For imaging findings please refer to the article on chondrosarcoma

Location

  • long bones (45%)
    • femur (20-35%)
    • tibia (5%)
    • upper limb, especially proximal humerus (10-20%)
  • pelvis (25%)
  • ribs (8%)
  • spine (7%)
  • scapula (5%)
  • sternum (2%)
  • skull (uncommon)

Differential diagnosis

  • enchondroma
    • Low gradelow-grade conventional chondrosarcomas can be difficult to distinguish from an enchondroma, as both grow in a nodular pattern and result in scalloping of the inner surface of the cortex. Scalloping
    • scalloping of greater than 2/3two-thirds of the cortical thickness, cortical breach and soft tissue mass beyond the confines of the bone are useful distinguishing features
    • see article: enchondroma vs. chondrosarcoma
  • -<p><strong>Conventional chondrosarcoma</strong> also known as central chondrosarcoma is the most common subtype of <a href="/articles/chondrosarcoma">chondrosarcoma </a>and may be low, intermediate or high grade (see <a href="/articles/chondrosarcoma-grading">chondrosarcoma grading</a>). They typically occur in the 4<sup>th</sup> and 5<sup>th </sup>decades with a slight male predominance 1.5-2.0:1.</p><h4>Presentation</h4><p>At diagnosis it is typically a large mass, usually over 4 cm in diameter. When arising in long bones (most common location, see below) it typically involves more than 50% of the length of the shaft.</p><p>Typically chondrosarcomas present with:</p><ul>
  • +<p><strong>Conventional chondrosarcoma</strong> also known as central chondrosarcoma is the most common subtype of <a href="/articles/chondrosarcoma">chondrosarcoma </a>and may be low, intermediate or high grade (see <a href="/articles/chondrosarcoma-grading">chondrosarcoma grading</a>).</p><h4>Epidemiology</h4><p>They typically occur in the 4<sup>th</sup> and 5<sup>th </sup>decades with a slight male predominance 1.5-2:1.</p><h4>Clinical presentation</h4><p>At diagnosis it is typically a large mass, usually over 4 cm in diameter. When arising in long bones (most common location) it typically involves more than 50% of the length of the shaft.</p><p>Typically chondrosarcomas present with:</p><ul>
  • -<li>palpable mass: 28-82% cases</li>
  • -<li>pathological fracture: 3-17%</li>
  • -</ul><h4>Pathology</h4><p>Histologically, the tumour grows as multiple hyaline cartilage nodules with central high water content and peripheral <a href="/articles/endochondral-ossification">endochondral ossification</a>. This accounts for not only the high T2 MRI signal but also for <a href="/articles/rings-and-arcs-calcification">rings and arcs calcification</a> and <a href="/articles/popcorn-calcification">popcorn calcification </a>on CT and plain film. </p><h4>Imaging findings</h4><p>For imaging findings please refer to the article on <a href="/articles/chondrosarcoma">chondrosarcoma</a>. </p><h4>Location</h4><ul>
  • +<li>palpable mass: present in 28-82% of cases</li>
  • +<li>pathological fracture: present in 3-17% of cases</li>
  • +</ul><h4>Pathology</h4><p>Histologically, the tumour grows as multiple hyaline cartilage nodules with central high water content and peripheral <a href="/articles/endochondral-ossification">endochondral ossification</a>. This accounts for not only the high T2 MRI signal but also for <a href="/articles/rings-and-arcs-calcification">rings and arcs calcification</a> and <a href="/articles/popcorn-calcification">popcorn calcification</a> on CT and plain film.</p><h5>Location</h5><ul>
  • -<li>femur (20-35%)</li>
  • -<li>tibia (5%)</li>
  • -<li>upper limb, especially proximal humerus (10-20%)</li>
  • +<li>
  • +<a href="/articles/femur">femur</a> (20-35%)</li>
  • +<li>
  • +<a href="/articles/tibia">tibia</a> (5%)</li>
  • +<li>upper limb, especially proximal <a href="/articles/humerus">humerus</a> (10-20%)</li>
  • -<li>pelvis (25%)</li>
  • -<li>ribs (8%)</li>
  • -<li>spine (7%)</li>
  • -<li>scapula (5%)</li>
  • -<li>sternum (2%)</li>
  • +<li>
  • +<a href="/articles/pelvis-1">pelvis</a> (25%)</li>
  • +<li>
  • +<a href="/articles/ribs">ribs</a> (8%)</li>
  • +<li>
  • +<a href="/articles/spinal-anatomy-1">spine</a> (7%)</li>
  • +<li>
  • +<a href="/articles/scapula">scapula</a> (5%)</li>
  • +<li>
  • +<a href="/articles/sternum">sternum</a> (2%)</li>
  • -</ul><h4>Differential diagnosis</h4><ul><li>
  • -<a href="/articles/enchondroma-vs-low-grade-chondrosarcoma-3">Enchondroma vs. chondrosarcoma</a><ul><li>Low grade conventional chondrosarcomas can be difficult to distinguish from an <a href="/articles/enchondroma">enchondroma</a>, as both grow in a nodular pattern and result in scalloping of the inner surface of the cortex. Scalloping of greater than 2/3 of the cortical thickness, cortical breach and soft tissue mass beyond the confines of the bone are useful distinguishing features</li></ul>
  • +</ul><h4>Radiographic features</h4><p>For imaging findings please refer to the article on <a href="/articles/chondrosarcoma">chondrosarcoma</a>. </p><h4>Differential diagnosis</h4><ul><li>
  • +<a href="/articles/enchondroma">enchondroma</a><ul>
  • +<li>low-grade conventional chondrosarcomas can be difficult to distinguish from an <a href="/articles/enchondroma">enchondroma</a>, as both grow in a nodular pattern and result in scalloping of the inner surface of the cortex</li>
  • +<li>scalloping of greater than two-thirds of the cortical thickness, cortical breach and soft tissue mass beyond the confines of the bone are useful distinguishing features</li>
  • +<li>see article: <a href="/articles/enchondroma-vs-low-grade-chondrosarcoma-3">enchondroma vs. chondrosarcoma</a>
  • +</li>
  • +</ul>
Images Changes:

Image ( update )

Caption was changed:
Case 2: T1 GadC+ (Gd)

Image 1 Pathology (H&E) ( update )

Caption was added:
Figure 1: histology

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