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Repeat CT scan in 3 months
3%
55/2169
Neoadjuvant radiation followed by marginal surgical resection followed by adjuvant chemotherapy
6%
126/2169
Marginal surgical resection
17%
358/2169
Wide surgical resection
67%
1447/2169
Neoadjuvant chemotherapy followed by marginal surgical resection followed by adjuvant chemotherapy
8%
164/2169
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The history, imaging, and biopsy is consistent with chondrosarcoma and is appropriately treated with wide surgical resection. Chondrosarcoma is a malignant tumor of cartilaginous origin. It can be a primary lesion but may also develop from a preexisting cartilaginous lesion (e.g., osteochondroma, enchondroma). On plain radiographs, chondrosarcoma is typically visualized as a destructive, lytic lesion. Extension into surrounding soft tissues is frequently seen and delineated well on MRI. The characteristic chondroid matrix (rings and arcs) can be seen on radiographs (70%), and better visualized by CT. The histology generally demonstrates enlarged, pleomorphic chondrocytes with multinucleated lacunae. Level 4 evidence by Lee et al reviewed 227 patients with chondrosarcoma with an average follow-up of 6 years. They found that “patients who had had a resection with wide margins (margins extending outside the reactive zone) had a longer duration of survival than did those who had had a so-called marginal resection (margins extending outside the tumor but within the reactive zone) or an intralesional resection (margins within the lesion) (p < 0.04)."
4.2
(27)
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