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Neoadjuvant radiation followed by surgical resection
6%
224/3673
Neoadjuvant chemotherapy followed by surgery followed by adjuvant chemotherapy
13%
468/3673
Wide surgical resection
74%
2732/3673
Chemotherapy followed by radiation therapy
4%
144/3673
Radiation therapy
2%
89/3673
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The history, radiographs, and biopsy specimen are consistent with the diagnosis of a chondrosarcoma. The oblique pelvis view shows a periacetabular lytic lesion with cortical destruction and reactive thickening of the surrounding cortex. The biopsy specimen shows enlarged chondrocytes with plump multinucleated lacunae and hyperchromic nuclear pleomorphism. Chondrosarcoma is primarily treated with wide surgical resection. There is a very limited role for chemotherapy or radiation. Donati et al reviewed 124 patients with pelvic chondrosarcoma and found that the most significant prognostic factor for distant metastases was the histologic grade of the tumor. They report that limb-sparing resection or hemipelvectomy are acceptable techniques of resection and that central, high-grade tumors need aggressive surgical treatment in order to achieve adequate surgical margins.
4.4
(22)
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