Secondary Chondrosarcoma Arising from Osteochondroma(tosis)

Hyun-min Cho; Seung-Koo Rhee; Yong-Koo Kang; Yang-Guk Chung; An-Hi Lee; Jung-Mi Park; Won-Jong Bahk

doi:10.5292/jkbjts.2010.16.1.21

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Cho, Rhee, Kang, Chung, Lee, Park, and Bahk: Secondary Chondrosarcoma Arising from Osteochondroma(tosis)

Original Article

J Korean Bone Joint Tumor Soc 2010;16(1):21-26.

Published online: 17 December 2010

DOI: https://doi.org/10.5292/jkbjts.2010.16.1.21

Secondary Chondrosarcoma Arising from Osteochondroma(tosis)

Hyun-min Cho, M.D., Seung-Koo Rhee, M.D., Yong-Koo Kang, M.D., Yang-Guk Chung, M.D., An-Hi Lee, M.D., Jung-Mi Park, M.D., Won-Jong Bahk, M.D.

Department of The Musculoskeletal Oncology Group, School of Medicine, Catholic University, Uijeongbu, Korea

Correspondence to: Won-Jong Bahk, M.D. Department of Orthopedic Surgery, School of Medicine, Catholic University, 65-1, Geumo-dong, Uijeongbu 480-130, Korea TEL: +82-31-820-3066 FAX: +82-31-847-3671 E-mail: wjbahk@catholic.ac.kr

Received 10 April 20108 May 2010 Accepted 9 June 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To analyze clinical, radiological and pathological features as well as clinical outcome after surgical treatment of patients with secondary chondrosarcoma arising from osteochondroma(tosis).

Materials and Methods

We retrospectively reviewed clinical records, radiographs, pathologic slides of 14 patients. Nine patients were male and five were female. The mean age was 34 years. The mean followup period was 54 months.

Results

All patients had a history of previous mass since childhood or puberty. Preexisted osteochondroma was single in 3 patients and multiple in 10. Remaining 1 patient had multiple osteochondromatosis with enchondromatosis. MRI clearly provided thickness of cartilage cap, which was over 2 cm except in 2 cases. Chondrosarcoma was grade 1 in all except 1 case, which was grade 2. Wide excision was performed in 10 patients, marginal excision in 3 and amputation in 1. Twelve patients were doing very well without evidence of disease. Among 3 patients with marginal excision, 1 patient had local recurrence and 1 patient died of disease.

Conclusion

Comprehensive understanding of clinical, radiological and pathological features of secondary chondrosarcoma is warranted for accurate diagnosis. The best result can be expected with early recognition of malignant change of osteohcondroma(tosis) and wide excision.

Keywords: osteochondroma(tosis), secondary chondrosarcoma, wide excision

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Figure 1.

Plain radiograph shows irregularity of the surface and radiolucency with punctuated calcification in right inferior ramus.

Figure 2.

CT scan reveals well-defined bony mass with indistinctive sclerotic margin and punctuated calcification within the mass.

Figure 3.

Gross finding shows cartilage cap with maximum 2.8 cm of thickness.

Figure 4.

Plain radiograph demonstrates a huge soft tissue mass with indistinctive margin and scattered punctuated calcification within the mass in left pelvic area.

Figure 5.

MRI shows a large inhomogeneous, irregularly marginated mass with maximum 4 cm-thick cartilage cap of decreased T1 and increased T2 signal intensities.

Figure 6.

(A) Low-power microscopic examination shows high cellularity (H&E, ×40). (B) High-power examination reveals atypism with hyperchromatic neclei and a few binucelated chondrocytes (H&E, ×200).

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