Conventional chondrosarcoma - sacrum

Case contributed by A.Prof Frank Gaillard
Modality: MRI

Destructive sacral mass with large extra osseous component

Modality: CT

see below

Case Discussion

Chondrosarcoma in a 30 year old male

Final Diagnosis:

Complex resection of right hemisacrum, sacroiliac joint, medial
ilium, proximal sciatic nerve, and associated soft tissues:
1. Conventional chondrosarcoma
2. Low grade, grade 2/3
3. Maximum size 9.0 cm
4. Tumor is based in the sacroiliac joint but invades the adjacent portions of sacrum and ilium, as well as skeletal muscle and soft tissues anterior and posterior to the SI joint
5. All resection margins negative
6. Closest soft tissue margin (medial) = 0.5 cm
7. Closest osteotomy margin (sacrum in region of spinal canal) = 0.4 cm
8. Negative for vascular invasion
9. Biopsy tract with scar (negative for displaced tumor)

Histology

Preoperative core biopsy

The lesion appears well-sampled and is comprised of disorganized cartilage, with some areas of myxoid change. Chondrocyte necrosis is present, dissociated from calcification. This core biopsy demonstrates permeative growth of atypical cartilage around preexisting bony trabeculae (a feature rarely captured in core biopsies), allowing an outright histologic diagnosis of malignancy.

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Case Information

rID: 6173
Case created: 1st May 2009
Last edited: 15th Nov 2015
Inclusion in quiz mode: Included

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