Review Question - QID 4669

This patient has a conventional intramedullary chondrosarcoma. The treatment is wide resection alone.

Conventional chondrosarcomas are usually found in older patients (40-75 yrs) with a slight male preponderance. Common locations include the pelvis, proximal femur, scapula. Axial and proximal extremity lesions are more aggressive. Treatment involves only surgery as these tumors are neither chemo- nor radiosensitive.

Seo et al. reviewed chondrosarcoma. They define chondrosarcomas as cartilage-forming malignant cells without evidence of osteoid formation. Histologic grade is the single most important factor for predicting local recurrence and metastases.

Figure A is a radiograph showing a lesion of the proximal femur with popcorn calcification. Figure B is a T2-weighted MRI image confirming an intramedullary chondroid lesion with surrounding marrow edema. Figures C and D are low and high power biopsy images showing hypercellular stroma with enlarged chondrocytes with nuclear atypia characteristic of conventional chondrosarcoma.

Incorrect Answers:
Answers 2, 3, 4, 5: There is no significant role for radiation or chemotherapy in conventional intramedullary chondrosarcoma.