J Korean Bone Joint Tumor Soc.  2010 Jun;16(1):21-26. 10.5292/jkbjts.2010.16.1.21.

Secondary Chondrosarcoma Arising from Osteochondroma(tosis)

• Cho HM
• Rhee SK
• Kang YK
• Chung YG
• Lee AH
• Park JM
• Bahk WJ

• KMID: 2006338
• DOI: http://doi.org/10.5292/jkbjts.2010.16.1.21

Abstract

PURPOSE
To analyze clinical, radiological and pathological features as well as clinical outcome after surgical treatment of patients with secondary chondrosarcoma arising from osteochondroma(tosis).
MATERIALS AND METHODS
We retrospectively reviewed clinical records, radiographs, pathologic slides of 14 patients. Nine patients were male and five were female. The mean age was 34 years. The mean follow-up period was 54 months.
RESULTS
All patients had a history of previous mass since childhood or puberty. Preexisted osteochondroma was single in 3 patients and multiple in 10. Remaining 1 patient had multiple osteochondromatosis with enchondromatosis. MRI clearly provided thickness of cartilage cap, which was over 2 cm except in 2 cases. Chondrosarcoma was grade 1 in all except 1 case, which was grade 2. Wide excision was performed in 10 patients, marginal excision in 3 and amputation in 1. Twelve patients were doing very well without evidence of disease. Among 3 patients with marginal excision, 1 patient had local recurrence and 1 patient died of disease.
CONCLUSION
Comprehensive understanding of clinical, radiological and pathological features of secondary chondrosarcoma is warranted for accurate diagnosis. The best result can be expected with early recognition of malignant change of osteohcondroma(tosis) and wide excision.

Keyword

osteochondroma(tosis); secondary chondrosarcoma; wide excision

MeSH Terms

Amputation
Cartilage
Chondrosarcoma
Enchondromatosis
Female
Follow-Up Studies
Humans
Male
Osteochondroma
Osteochondromatosis
Puberty
Recurrence
Retrospective Studies

Figure

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  Figure 1. Plain radiograph shows irregularity of the surface and radiolucency with punctuated calcification in right inferior ramus.

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  Figure 2. CT scan reveals well-defined bony mass with indistinctive sclerotic margin and punctuated calcification within the mass.

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  Figure 3. Gross finding shows cartilage cap with maximum 2.8 cm of thickness.

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  Figure 4. Plain radiograph demonstrates a huge soft tissue mass with indistinctive margin and scattered punctuated calcification within the mass in left pelvic area.

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  Figure 5. MRI shows a large inhomogeneous, irregularly marginated mass with maximum 4 cm-thick cartilage cap of decreased T1 and increased T2 signal intensities.

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  Figure 6. (A) Low-power microscopic examination shows high cellularity (H&E, ×40). (B) High-power examination reveals atypism with hyperchromatic neclei and a few binucelated chondrocytes (H&E, ×200).

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