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{{Chondrosarcoma}}
{{Chondrosarcoma}}
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{{CMG}}; {{AE}} {{Rohan}}
==Overview==
Chondrosarcoma may be classified based on histological findings and location.
==Classification==
==Classification==
===Classification===
*Chondrosarcoma be classified based on [[Histology|histological findings]] and location.
Chondrosarcoma is classified into six "subtypes" based on:
(a) The topographical location of the tumor.
(b) The histological characteristics of the cancerous cartilage cells.
(c) The makeup of the surrounding matrix material associated with the tumor.


*Chondrosarcoma NOS ("Not Otherwise Specified")
===Histological Classification===
*Juxtacortical chondrosarcoma
*Chondrosarcoma may be classified based on [[Histological|histological findings]] into following groups:<ref name="pmid8378694">{{cite journal| author=Raymond E, L'Her P, Jeanbourquin D, Schill H, Jancovici R, Daly JP et al.| title=[Chondrosarcoma of the thoracic wall. Review of the literature apropos of 4 cases]. | journal=Rev Pneumol Clin | year= 1993 | volume= 49 | issue= 1 | pages= 19-25 | pmid=8378694 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8378694  }} </ref><ref name="pmid30559960">{{cite journal| author=Lex JR, Evans S, Stevenson JD, Parry M, Jeys LM, Grimer RJ| title=Dedifferentiated chondrosarcoma of the pelvis: clinical outcomes and current treatment. | journal=Clin Sarcoma Res | year= 2018 | volume= 8 | issue=  | pages= 23 | pmid=30559960 | doi=10.1186/s13569-018-0110-1 | pmc=6293503 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30559960  }} </ref>
*Myxoid chondrosarcoma
*Mesenchymal chondrosarcoma
*Clear cell chondrosarcoma
*Dedifferentiated chondrosarcoma


'''Primary Chondrosarcoma'''
*Chondrosarcoma that arises denovo and comprises of following subtypes:
**Conventional chondrosarcoma - Low-grade, high-grade, and dedifferentiated chondrosarcoma (90% of all chondrosarcomas)
**Clear cell chondrosarcoma (1% of all chondrosarcomas)
**Mesenchymal chondrosarcoma (2% of all chondrosarcomas)


===Grading===
'''Secondary Chondrosarcoma'''
Physicians grade chondrosarcoma using several criteria, but particularly on how abnormal the cancerous cells appear under the microscope and the growth rate of the tumors themselves, both of which are directly linked to the propensity of the cancer to invade locally, and to spread widely to distant organs and sites in the body (called [[metastasis]]).
*Chondrosarcoma that arises from [[benign]] [[cartilage]] lesions includes (7% of all chondrosarcomas):
**[[Osteochondroma]] (<1% risk of [[malignant]] transfomation)
**Multiple hereditary exostosis (1-10% risk of [[malignant]] transformation)
**[[Enchondroma|Enchondromas]] (1% risk of [[malignant]] transformation)
**[[Enchondroma|Ollier's disease]] (25-40% risk of [[malignant]] transformation)
**[[Maffucci's disease]](100% risk of [[malignant]] transformation)


====Grade 1====
===Based on Location===
*Chondrosarcoma grows relatively slowly, has cells whose [[histological]] appearance is quite similar to cells of normal cartilage.
*Chondrosarcoma may be classified based on location into following groups:<ref name="pmid19411454">{{cite journal| author=Giuffrida AY, Burgueno JE, Koniaris LG, Gutierrez JC, Duncan R, Scully SP| title=Chondrosarcoma in the United States (1973 to 2003): an analysis of 2890 cases from the SEER database. | journal=J Bone Joint Surg Am | year= 2009 | volume= 91 | issue= 5 | pages= 1063-72 | pmid=19411454 | doi=10.2106/JBJS.H.00416 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19411454  }} </ref><ref name="pmid17908885">{{cite journal| author=Skeletal Lesions Interobserver Correlation among Expert Diagnosticians (SLICED) Study Group| title=Reliability of histopathologic and radiologic grading of cartilaginous neoplasms in long bones. | journal=J Bone Joint Surg Am | year= 2007 | volume= 89 | issue= 10 | pages= 2113-23 | pmid=17908885 | doi=10.2106/JBJS.F.01530 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17908885  }} </ref>
*Mostly chondroid matrix, little if any myxoid.
**Centrally located within the [[medullary cavity]]. (central chondrosarcoma) (70% of all chondrosarcomas)
*Mild-to-moderate increase of cellularity +/- binucleated cells.
**Peripherally located on the surface of bone as a result of [[malignant]] transformation within the [[cartilaginous]] cap. (Peripheral chondrosarcoma) (15% of all chondrosarcomas)
*Have much less aggressive invasive and metastatic properties.
{| align
|-valign="top"
| [[Image:800px-Bone Chondrosarcoma Grade1 HP2 PA.JPG|thumb|350px|Grade 1 - Somewhat cellular cartilage with binucleation]]
|}


====Grade 2====
==References==
*Intermediate grade chondrosarcoma.
{{Reflist|2}}
*Little chondroid matrix, Necrosis and more common prominent myxoid.
{{WH}}
{| align
{{WS}}
|-valign="top"
| [[Image:800px-Bone Chondrosarcoma Grade2 HP PA.jpg|thumb|350px|Grade 2 - Very cellular cartilage with obvious hyperchromasia and nuclear atypia]]
|}
====Grades 3====
*Grade 3 chondrosarcoma is increasingly faster-growing cancer, with more varied and abnormal-looking cells.
*Characterized by myxoid stroma, nuclear [[pleomorphism]] and [[mitoses]].
*Absent chondroid matrix.
*These are much more likely to infiltrate surrounding tissues, [[lymph nodes]], and organs.
{| align
|-valign="top"
| [[Image:800px-Bone Chondrosarcoma Grade3 HP PA.JPG|thumb|350px|Grade 3 - Even more cellular neoplastic cartilage with high grade nuclear atypia]]
|}
 
====Grade 4====
*Some, but not all, authorities and medical facilities assign a "Grade 4" to the most [[anaplastic]], undifferentiated cartilage-derived tumors.


==References==
[[Category:Up-To-Date]]
{{reflist|2}}
[[Category:Disease]]
[[Category:Orthopedics]]
[[Category:Orthopedics]]
[[Category:Types of cancer]]
[[Category:Oncology]]
[[Category:Skeletal disorders]]
[[Category:Medicine]]
 
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Latest revision as of 15:52, 24 January 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rohan A. Bhimani, M.B.B.S., D.N.B., M.Ch.[2]

Overview

Chondrosarcoma may be classified based on histological findings and location.

Classification

Histological Classification

Primary Chondrosarcoma

  • Chondrosarcoma that arises denovo and comprises of following subtypes:
    • Conventional chondrosarcoma - Low-grade, high-grade, and dedifferentiated chondrosarcoma (90% of all chondrosarcomas)
    • Clear cell chondrosarcoma (1% of all chondrosarcomas)
    • Mesenchymal chondrosarcoma (2% of all chondrosarcomas)

Secondary Chondrosarcoma

Based on Location

  • Chondrosarcoma may be classified based on location into following groups:[3][4]
    • Centrally located within the medullary cavity. (central chondrosarcoma) (70% of all chondrosarcomas)
    • Peripherally located on the surface of bone as a result of malignant transformation within the cartilaginous cap. (Peripheral chondrosarcoma) (15% of all chondrosarcomas)

References

  1. ↑ Raymond E, L'Her P, Jeanbourquin D, Schill H, Jancovici R, Daly JP; et al. (1993). "[Chondrosarcoma of the thoracic wall. Review of the literature apropos of 4 cases]". Rev Pneumol Clin. 49 (1): 19–25. PMID 8378694.
  2. ↑ Lex JR, Evans S, Stevenson JD, Parry M, Jeys LM, Grimer RJ (2018). "Dedifferentiated chondrosarcoma of the pelvis: clinical outcomes and current treatment". Clin Sarcoma Res. 8: 23. doi:10.1186/s13569-018-0110-1. PMC 6293503. PMID 30559960.
  3. ↑ Giuffrida AY, Burgueno JE, Koniaris LG, Gutierrez JC, Duncan R, Scully SP (2009). "Chondrosarcoma in the United States (1973 to 2003): an analysis of 2890 cases from the SEER database". J Bone Joint Surg Am. 91 (5): 1063–72. doi:10.2106/JBJS.H.00416. PMID 19411454.
  4. ↑ Skeletal Lesions Interobserver Correlation among Expert Diagnosticians (SLICED) Study Group (2007). "Reliability of histopathologic and radiologic grading of cartilaginous neoplasms in long bones". J Bone Joint Surg Am. 89 (10): 2113–23. doi:10.2106/JBJS.F.01530. PMID 17908885.

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