Chondrosarcoma

What is chondrosarcoma?

Chondrosarcoma is a type of cancer that develops in cartilage cells. Cartilage is the specialized, gristly connective tissue that is present in adults and the tissue from which most bones develop. Cartilage plays an important role in the growth process. There are many different types of cartilage that are present throughout the body. Chondrosarcoma is a malignant type of bone cancer that primarily affects the cartilage cells of the femur (thighbone), arm, pelvis, knee, and spine. Although less frequent, other areas (such as the ribs) may be affected.

Chondrosarcoma is the second most common type of primary bone cancer. A primary bone cancer is one that originates from bone, as opposed to starting in another organ and then spreading to the bone. This type of cancer rarely affects individuals under age 20 and continues to rise until age 75. The incidence between males and females is equal.

What causes chondrosarcoma?

The exact cause of chondrosarcoma is not known. There may be a genetic or chromosomal component that predisposes certain individuals to this type of malignancy. Chondrosarcomas have been observed as a late consequence of radiation therapy for other cancers. 

What are the risk factors for chondrosarcoma?

Most often, chondrosarcoma occurs from normal cartilage cells, but it may also stem from a preexisting benign (non-cancerous) bone or cartilage tumor. The following is a list of some benign conditions that may be present when chondrosarcoma occurs:

• Enchondromas--A type of benign bone tumor that originates from cartilage and usually affects the hands (can also affect other areas).

• Osteochondromas--An overgrowth of cartilage and bone near the end of the bone near the growth plate.

• Multiple exostoses--The presence of multiple osteochondromas (an overgrowth of cartilage and bone near the end of the growth plate).

• Ollier's disease--A cluster of enchondromas (benign cartilage tumors that usually affect the hands).

• Maffucci's syndrome--A combination of multiple enchondroma (benign cartilage tumors that usually affect the hands) tumors and angiomas (benign tumors made up of blood vessels).

What are the symptoms of chondrosarcoma?

Symptoms of chondrosarcoma may vary depending on the location of the tumor. The following are the most common symptoms of chondrosarcoma. However, each individual may experience symptoms differently. Symptoms may include:

• Large mass on the affected bone

• Feeling of pressure around the mass

• Pain that is usually worse at night and may be relieved by taking anti-inflammatory medications such as ibuprofen

• Pain that is not usually relieved through rest

• Pain that may be present for years but increases gradually over time

How is chondrosarcoma diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for chondrosarcoma may include the following:

• Biopsy--A procedure in which tissue samples are removed (with a needle or during surgery) from the body for examination under a microscope; this is done to determine if cancer or other abnormal cells are present.

• X-ray--A diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.

• Computed tomography scan (also called a CT or CAT scan)--A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.

• Magnetic resonance imaging (MRI)--A diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.

Treatment for chondrosarcoma:

Specific treatment for chondrosarcoma will be determined by your physician based on:

• Your age, overall health, and medical history

• Extent of the disease

• Your tolerance for specific medications, procedures, and therapies

• Expectation for the course of the disease

• Your opinion or preference

The goal for treatment of chondrosarcoma is to remove the mass and reduce the likelihood that it will return. Close follow-up with your physician may be necessary. Treatment may include:

• Surgery to remove the tumor

• Physical therapy to regain strength and use of the affected area after surgery

• Chemotherapy, although not the primary treatment, may be required if the cancer has spread to other areas of the body.