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Chondrosarcoma

Etiology: • The etiology of chondrosarcoma is unknown.

Pathogenesis: • Not understood.

Epidemiology: • Usually a tumor of older age groups. • Approximately twice as common in men as in women. • No racial preferences have been noted.

General Gross Description: • Tumors exhibit features of cartilage, including abundant ground substance and chondrocytes. • Areas of calcification, necrosis an hemorrhage are seen in rapidly growing tumors. • Myxoid variants exhibit a viscous and gelatinous consistency. • Cellular atypia increases with poorly differentiated tumors.

General Microscopic Description: • Histologically, chondrosarcomas can be divided into three grades - grade 1 (most differentiated) to grade 3 (most anaplastic) • Grade 1 tumors resemble normal cartilage closely, with little deviation from normal histology. • Grade 3 tumors can show considerable cellular atypia. • Most common grade of chondrosarcoma is grade 1. • More aggressive grades show areas of necrosis, hemorrhage. • The myxoid variant exhibits areas of myxomatous matrix.

Clinical Correlations: • Most chondrosarcomas are slow growing, indolent tumors. • Five year survival rates for the three grades of chondrosarcoma are 90%, 81% and 43%. • Larger tumors behave more aggressively than smaller tumors. • As with all sarcomas, spread is preferentially through the vascular tree. • Tumors are rare in the distal extremities. • Common in central portions of the skeleton including the pelvis, shoulders and ribs. • Presenting symptoms are usually of a painful enlarging mass.

References: •Reference: Pathological basis of disease, by Cotran, Kumar and Robbins, Fifth Edition, page 1240.