Dedifferentiated chondrosarcoma with pathological fracture - femur

Case contributed by A.Prof Frank Gaillard

see below

see below

Case Discussion

55 year old male with dedifferentiated chondrosarcoma and pathological fracture.

Final Diagnosis:

Left proximal femur and soft tissues, en bloc excision:

  1. Dedifferentiated chondrosarcoma
  2. High grade, grade 3/3
  3. Maximum size 14.6 cm
  4. Tumor is based in the proximal metadiaphysis of the femur but involves metaphysis and diaphysis, with cortical and periosteal breach and soft tissue extension
  5. Positive for vascular invasion
  6. Pathological fracture with tracking hemorrhage (most prominent medially), containing fragmented tumor

Final Diagnosis Comment:

Sections show a well-differentiated cartilaginous neoplasm based in the medulla, immediately adjacent to a cellular, high grade, poorly differentiated sarcomatous component. The latter dominates the soft tissue extension and grows mainly in an infiltrative, sheet-like pattern. However, some areas form filigree osteoid, raising a differential diagnosis of chondroblastic osteosarcoma. Dedifferentiated chondrosarcoma is nevertheless favoured due to the minimal cytologic atypia in the chondroid component, the abrupt transition, and the predominance of the poorly differentiated portion in the soft tissue extension; some degree of osteosarcomatous differentiation can often be found in association with dedifferentiated chondrosarcoma.

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Case information

rID: 6174
Case created: 2nd May 2009
Last edited: 15th Nov 2015
Inclusion in quiz mode: Included

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