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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: • Lobulated, translucent, somewhat gelatinous tumors. • The more rapidly growing tumors tend to have areas of dystrophic calcification, necrosis and hemorrhage. • Often large, bulky tumors.

General Microscopic 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 show areas of myxoid differentiation. • Cellular atypia increases with poorly differentiated tumors. Thus grade 1 tumors (most differentiated) resemble cartilage histologically; the least differentiated tumors (grade 3) show cellular atypica and reduction in the amounts of ground substance.

Clinical Correlations: • Most chondrosarcomas are slow growing, indolent tumors. • Based on level of differentiation, chondrosarcomas can be classified into grade 1 (most differentiated) to grade 3 (least differentiated). • 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. • Most tumors arise from central skeleton including 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.