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    CHONDROSARCOMA

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    Akash Balakrishnan
    This document discusses chondrosarcoma, a malignant bone tumor. It is the second most common primary bone malignancy that typically affects adults aged 30-70 years. Chondrosarcoma most commonly affects the pelvis and long bones. It is diagnosed through imaging like CT or MRI followed by biopsy and histopathological examination. Treatment involves wide surgical resection of the tumor with reconstruction. Chondrosarcoma has a poor prognosis due to resistance to chemotherapy and radiation. Close long-term follow up is needed due to risk of recurrence.

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    CHONDROSARCOMA

    Uploaded by

    Akash Balakrishnan
    77 views21 pages
    This document discusses chondrosarcoma, a malignant bone tumor. It is the second most common primary bone malignancy that typically affects adults aged 30-70 years. Chondrosarcoma most commonly affects the pelvis and long bones. It is diagnosed through imaging like CT or MRI followed by biopsy and histopathological examination. Treatment involves wide surgical resection of the tumor with reconstruction. Chondrosarcoma has a poor prognosis due to resistance to chemotherapy and radiation. Close long-term follow up is needed due to risk of recurrence.

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    This document discusses chondrosarcoma, a malignant bone tumor. It is the second most common primary bone malignancy that typically affects adults aged 30-70 years. Chondrosarcoma most commonly affects the pelvis and long bones. It is diagnosed through imaging like CT or MRI followed by biopsy and histopathological examination. Treatment involves wide surgical resection of the tumor with reconstruction. Chondrosarcoma has a poor prognosis due to resistance to chemotherapy and radiation. Close long-term follow up is needed due to risk of recurrence.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    77 views21 pages

    CHONDROSARCOMA

    Uploaded by

    Akash Balakrishnan
    This document discusses chondrosarcoma, a malignant bone tumor. It is the second most common primary bone malignancy that typically affects adults aged 30-70 years. Chondrosarcoma most commonly affects the pelvis and long bones. It is diagnosed through imaging like CT or MRI followed by biopsy and histopathological examination. Treatment involves wide surgical resection of the tumor with reconstruction. Chondrosarcoma has a poor prognosis due to resistance to chemotherapy and radiation. Close long-term follow up is needed due to risk of recurrence.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 21

    CHONDROSARCOMA

    ABHIJEET CVSS
    CHONDROSARCOMA

     Malignant counterpart of Enchondroma.


     Second most common Primary bone malignancy.
     Age- 30-70 years
     M/F ratio- 5:4
     Commonly affecting Pelvis.
     Others- Ribs, Neck of femur, Distal femur
    CHONDROSARCOMA

    Benign(ENCHODROMA) Malignant (Chondrosarcoma)


    Hypocellular Cellular
    Composed of hyaline hylaine
    Mineralised, matrix Myxoid matrix
    Permeative growth pattern Permeative growth pattern
    NO nuclear atypia Nuclear atypia
    NO mitosis Mitosis
    SYMPTOMS

     Patients usually present with pain

     pathological fracture,

     a palpable lump or local mass


    CLASSIFICATION

     GRADE 1(Atypical cartilaginous tumor)- [Thorough Currettage]


    Nuclei small, high cromatin density, high cartilage content matrix

     GRADE 2-[Complete resection]


    Nuclei medium sized, loose chromatin structure

     GRADE 3-[Complete resection and Reconstruction]


    Polymorphic nuclei, Binucleas forms, mucomyxoid matrix
    RADIOGRAPHY

     CT- for matrix calcifications and permeative destruction of tumor

     MRI- for tumor extent and active parts of tumor showing further
    differentiation
    - Differentiate High grade from low grade tumors- essential
    before surgery
    RADIOGRAPHY

    X-RAY
     Large, Intraosseous, Osteolytic

     Honeycomb/Popcorn-Irregular granular calcifications within matrix

     Endosteal scalloping of cortex with cortical destruction later.

     Faint periosteal reaction


    TYPES

     CONVENTIONAL CHONDROSARCOMA- CENTRAL/PERIPHERAL

     JUXTACORTICAL CHONDROSARCOMA

     CLEAR-CELL CHONDROSARCOMA

     MESENCHYMAL CHONDROSARCOMA
    CENTRAL CHONDROSARCOMA

     Develops in the medullary cavity of tubular/flat bones.

     Commonly- proximal end of femur/ innominate bone of pelvis

    X-RAY
     -expanded, radiolucent area, flecks of increased density
    within the tumour

     Aggressive lesions- Globular appearance with destruction of cortex


    PERIPHERAL CHONDROSARCOMA

     Arises from cartilage cap of an exostosis present from childhood


     Commonly- pelvis and scapula
     Xray shows- bony exostosis
    Cloudy exostosis otherwise normal cartilage cap
     MRI best for size and internal features of cartilage cap
    JUXTACORTICAL
    (PERIOSTEAL)CHONDROSARCOMA
     Appears as a excrescence on the surface of tubular bones- femur

     Arises from outermost layer of cortex

     XRAY -Outgrowth from bone surface,


    flecks of calcification, Sunray streaks and new bone
    formation

     Dominant cell type-Chondroblastic


    CLEAR CELL CHONDROSARCOMA

     Resembles aggressive chondroblastoma

     Very slow growing but eventually metastasize


    MESENCHYMAL CHONDROSARCOMA

     Occurs in younger individuals.

     Tumor lies in soft tissue outside adjacent bone.

     Xray similar to the other types

     Histology shows mesenchymal cells with chondroid tissue

     More aggressive
    INVESTIGATIONS

     For full staging-


     XRAY
     MRI
     Chest XRAY
     Finally to confirm diagnosis- Biopsy
     Histopathology- Macroscopic lobular white hyaline cartilage
     cystic changes, erosion of cortex, soft tissue
     expansion
     Microscopically- high cellularity, hyperchromatosis, atypia, mitosis
    TREATMENT

     Poor prognosis (5-year survival 7-24%)

     Improved by wide surgical resection

     Worsened by- Pathological fracture, advancing age, metastasis


    TREATMENT

    Because of their extracellular matrix, low percentage of dividing cells,


    and poor vascularity, they are relatively chemo- and radiotherapy
    resistant.

     Ideal for wise excision and prosthetic replacement

     If loss of function- amputation

     Tendency for recurrence later, follow up for 10 years or longer


    THANKYOU

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