Chondrosarcoma classification

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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

There is no established system for the classification of [disease name].

OR

[Disease name] may be classified according to [classification method] into [number] subtypes/groups: [group1], [group2], [group3], and [group4].

OR

[Disease name] may be classified into [large number > 6] subtypes based on [classification method 1], [classification method 2], and [classification method 3]. [Disease name] may be classified into several subtypes based on [classification method 1], [classification method 2], and [classification method 3].

OR

Based on the duration of symptoms, [disease name] may be classified as either acute or chronic.

OR

If the staging system involves specific and characteristic findings and features: According to the [staging system + reference], there are [number] stages of [malignancy name] based on the [finding1], [finding2], and [finding3]. Each stage is assigned a [letter/number1] and a [letter/number2] that designate the [feature1] and [feature2].

OR

The staging of [malignancy name] is based on the [staging system].

OR

There is no established system for the staging of [malignancy name].

Classification

  • Chondrosarcoma be classified based on histological findings, location and imaging findings.

Histological Classification

  • Chondrosarcoma may be classified based on histological findings into following groups:[1][2]

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

  • 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)
    • Enchondromas (1% risk of malignant transformation)
    • Ollier's disease (25-40% risk of malignant transformation)
    • Maffucci's disease(100% risk of malignant transformation)

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)

Enneking (MSTS) Staging System

  • The Enneking surgical staging system (also known as the MSTS system) for malignant musculoskeletal tumors based on radiographic characteristics of the tumor host margin.[5]
  • It is widely accepted and routinely used classification.
Stages Grade Site Metastasis
IA G1: Low grade T1: Intracompartmental M0: No metastasis
IB G1: Low grade T2: Extracompartmental M0: No metastasis
IIA G2: High grade T1: Intracompartmental M0: No metastasis
IIB G2: High grade T2: Extracompartmental M0: No metastasis
III G1 or G2 T1 or T2 M1: Regional or distant metastasis

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.
  5. Jawad MU, Scully SP (2010). "In brief: classifications in brief: enneking classification: benign and malignant tumors of the musculoskeletal system". Clin Orthop Relat Res. 468 (7): 2000–2. doi:10.1007/s11999-010-1315-7. PMC 2882012. PMID 20333492.

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