Conventional chondrosarcoma
Updates to Article Attributes
Conventional chondrosarcoma (also known as central chondrosarcoma) is the most comon subtype of chondrosarcoma and may be low, intermediate or high grade (see chondrosarcoma grading). They typically occur in the 4th and 5th decades with a slight male predominance 1.5-2.0:1.
Presentation
At diagnosis it is typically a large mass, usually over 4 cm in diameter. When arising in long bones (most common location, see below) it typically involves more than 50% of the length of the shaft.
Typically chondrosarcomas present with:
- pain: present in 95% of cases, often long standing and worse at night
- palpable mass: 28-82% cases
- pathological fracture: 3-17%
Pathology
Histologically, the tumour grows as multiple hyaline cartilage nodules with central high water content and peripheral enchondralendochondral ossification. This accounts for not only the high T2 MRI signal but also forrings and arcs calcification andpopcorn calcificationon CT and plain film.
Imaging findings
For imaging findings please refer to the article on chondrosarcoma.
Location
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long bones (45%)
- femur (20-35%)
- tibia (5%)
- upper limb, especially proximal humerus (10-20%)
- pelvis (25%)
- ribs (8%)
- spine (7%)
- scapula (5%)
- sternum (2%)
- skull (uncommon)
Differential diagnosis
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Enchondroma vs. chondrosarcoma
- Low grade conventional chondrosarcomas can be difficult to distinguish from an enchondroma, as both grow in a nodular pattern and result in scalloping of the inner surface of the cortex. Scalloping of greater than 2/3 of the cortical thickness, cortical breach and soft tissue mass beyond the confines of the bone are useful distinguishing features.
(seeEnchondroma vs. chondrosarcoma)Imaging findingsFor imaging findings please refer to the article onchondrosarcoma.Location-
long bones (45%)femur (20-35%)tibia (5%)upper limb, especially proximal humerus (10-20%)
pelvis (25%)ribs (8%)spine (7%)scapula (5%)sternum (2%)skull (uncommon)
-
- Low grade conventional chondrosarcomas can be difficult to distinguish from an enchondroma, as both grow in a nodular pattern and result in scalloping of the inner surface of the cortex. Scalloping of greater than 2/3 of the cortical thickness, cortical breach and soft tissue mass beyond the confines of the bone are useful distinguishing features.
-</ul><h4>Pathology</h4><p>Histologically, the tumour grows as multiple hyaline cartilage nodules with central high water content and peripheral enchondral ossification. This accounts for not only the high T2 MRI signal but also for <a href="/articles/rings-and-arcs-calcification">rings and arcs calcification</a> and <a href="/articles/popcorn-calcification">popcorn calcification </a>on CT and plain film. </p><p>Low grade conventional chondrosarcomas can be difficult to distinguish from an <a href="/articles/enchondroma">enchondroma</a>, as both grow in a nodular pattern and result in scalloping of the inner surface of the cortex. Scalloping of greater than 2/3 of the cortical thickness, cortical breach and soft tissue mass beyond the confines of the bone are useful distinguishing features. (see <a href="/articles/enchondroma-vs-low-grade-chondrosarcoma-2">Enchondroma vs. chondrosarcoma</a>) </p><h4>Imaging findings</h4><p>For imaging findings please refer to the article on <a href="/articles/chondrosarcoma">chondrosarcoma</a>. </p><h4>Location</h4><ul>- +</ul><h4>Pathology</h4><p>Histologically, the tumour grows as multiple hyaline cartilage nodules with central high water content and peripheral <a href="/articles/endochondral-ossification">endochondral ossification</a>. This accounts for not only the high T2 MRI signal but also for <a href="/articles/rings-and-arcs-calcification">rings and arcs calcification</a> and <a href="/articles/popcorn-calcification">popcorn calcification </a>on CT and plain film. </p><h4>Imaging findings</h4><p>For imaging findings please refer to the article on <a href="/articles/chondrosarcoma">chondrosarcoma</a>. </p><h4>Location</h4><ul>
-</ul>- +</ul><h4>Differential diagnosis</h4><ul><li>
- +<a style="line-height: 20.8px;" href="/articles/enchondroma-vs-low-grade-chondrosarcoma-1">Enchondroma vs. chondrosarcoma</a><ul><li>Low grade conventional chondrosarcomas can be difficult to distinguish from an <a href="/articles/enchondroma">enchondroma</a>, as both grow in a nodular pattern and result in scalloping of the inner surface of the cortex. Scalloping of greater than 2/3 of the cortical thickness, cortical breach and soft tissue mass beyond the confines of the bone are useful distinguishing features.</li></ul>
- +</li></ul>
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