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Chondrosarcoma
	Classification and external resources
	; Histopathogic image of chodrosarcoma of the chest wall. Surgical resection of recurrent mass. H & E stain.
ICD-9	170.9
ICD-O:	M9220/3-9240/3
MeSH	D002813

A chondrosarcoma is a type of cancer^[1] of the cartilage. Chondrosarcoma is a cartilage-based tumor and is in a category of cancers called sarcomas. About 25% of primary bone cancers (meaning those which start in the bone) are chondrosarcomas. This disease can affect people or animals of any age, although it is more common among older people than among children.^[2]

[edit] Classification

Physicians grade chondrosarcomas based chiefly on how fast they grow and the likelihood of metastasis. Grade 1 is the slowest growing form. Grades 2 and 3 are faster-growing cancers, and some medical facilities also assign grade 4 to the fastest growing and usually metastasized occurrences.

The most common sites for chondrosarcoma to grow are the pelvic and shoulder bones along with the superior metaphysial and diaphysial regions of the arms and legs.^[3] But chondrosarcoma may occur in any bone, even the base of the skull.

ICD-O codes are used for more precise classification:

[edit] Diagnosis

Like all other bone tumors and disease processes, diagnosis is made primarily by imaging. There are no blood tests to determine a diagnosis of chondrosarcoma. The most characteristic imaging findings are on CT, where detection of a chondroid matrix is present.

Nearly all chondrosarcoma patients appear to be in good health. This form of cancer generally doesn't affect the whole body. Often, patients are not aware of the growing tumor until there is a noticeable lump or pain. Earlier diagnosis is generally accidental, when a patient undergoes testing for another problem and physicians discover the cancer. Occasionally the first symptom will be a broken bone at the cancerous site. Any broken bone that occurs from mild trauma warrants further investigation, although there are many conditions that can lead to weak bones, and this form of cancer is not a common cause of such breaks.^[4]

[edit] Causes

The cause is unknown. Patients may have a history of enchondroma or osteochondroma.

[edit] Treatment

Treatment depends on the location of the disease and the aggressiveness of the tumors.^[3] Because chondrosarcomas are rare, they are treated at specialist hospitals with Sarcoma Centers.

Surgery is the main form of treatment for chondrosarcoma. Musculoskeletal tumor specialists or orthopedic oncologists are usually chosen to treat chondrosarcoma, unless it is located in the skull, spine, or chest cavity, in which case, a neurosurgeon or thoracic surgeon experienced with sarcomas is chosen. Often, a limb-sparing operation can be performed, however in some cases amputation is unavoidable. Amputation of the arm, leg, jaw, or half of the pelvis (called a hemipelvectomy) may be necessary in some cases.

Chemotherapy or traditional radiotherapy are not very effective for most chondrosarcomas, although proton therapy is showing promise with local tumor control at over 80%.^[5]

Complete surgical ablation is the most effective treatment, but sometimes this is difficult. Proton therapy Radiation can be useful in awkward locations to make surgery more effective.

[edit] Prognosis

Prognosis depends on how early the cancer is discovered and treated. For the least aggressive grade, about 90% of patients survive more than five years after diagnosis. People usually have a good survival rate at the low grade volume of cancer.^[2] For the most aggressive grade, more than a quarter of patients live more than five years.

Tumors may recur in the future. Follow up scans are extremely important for chondrosarcoma to make sure there has been no recurrence or metastasis, which usually occurs in the lungs.