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radiation followed by surgical excision followed by chemotherapy
10%
362/3552
chemotherapy followed by surgical excision followed by chemotherapy
15%
536/3552
neoadjuvant radiation followed by chemotherapy
3%
98/3552
wide surgical excision alone
68%
2425/3552
radical resection and brachytherapy followed by reconstruction
103/3552
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Chondrosarcoma of the pelvis is treated with wide surgical excision alone. There are different grades and types of chondrosarcoma, all of which are treated with wide surgical excision. Cartilage in general is very slow growing and therefore not very chemo or radiation sensitive. That being said however, adjuvant chemotherapy is added for mesenchymal chondrosarcoma with some controversy surrounding chemotherapy for de-differentiated chondrosarcoma. Donati et al. reviewed the treatment of 124 patients with conventional chondrosarcoma of the pelvis treated over a 20 year time period. The cases were stratified based on tumor location/type (central or peripheral), operation performed, grade, and local recurrence and or metastases. High grade tumors were found to have the worst outcomes and required aggressive surgical treatment with wide margins, especially those involving the SI joint. Figure A, B, and C show a lytic lestion. Figure D shows a low power view demonstrating the lobulated architecture with abundant cartilaginous matrix that is characteristic of chondrosarcoma. Figure E shows a high power view of tumor cells in lacunar spaces with small pyknotic nuclei and surrounded by an abundant cartilaginous matrix Incorrect Answers: Answer 1,2,3,5: All considered incorrect because as stated chondrosarcoma is not radiation or chemo sensitive
4.5
(17)
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