Chondrosarcoma

Chondrosarcoma is a type of bone cancer that develops in cartilage cells — the gristly connective tissue from which most bones develop. It primarily affects the cartilage cells of the thigh bone, arm, pelvis or knee, although it can also appear in your ribs. Chondrosarcomas often develop in bones but also may grow in the nearby soft tissue called cartilage. They can occur in the bones of the skull base. These tumors usually grow slowly.  It’s a rare type of bone tumor and affects 1 person per 200,000 per year in the US.  

Types & Stages 

Most often, chondrosarcoma develops from normal cartilage cells, but may also stem from a preexisting benign (noncancerous) bone or cartilage tumor.  

• Conventional chondrosarcoma. The most common type, which usually grows very slowly. There are rare subtypes of chondrosarcoma. These include dedifferentiated chondrosarcoma, myxoid chondrosarcoma, clear cell chondrosarcoma and mesenchymal chondrosarcoma. They may grow more quickly and may spread to other parts of the body.  
   
• Benign conditions. These may present when chondrosarcoma occurs:
   
  • Enchondromas. A type of benign bone tumor that begins from cartilage and usually affects the hands.
     
  • Multiple exostoses (osteochondromas). The presence of multiple osteochondromas (an overgrowth of cartilage and bone near the end of the growth plate).
     
  • Ollier disease. A cluster of enchondromas.
     
  • Maffucci syndrome. A combination of multiple enchondromas and angiomas (benign tumors made up of blood vessels).

Signs & Symptoms 

Signs and symptoms of chondrosarcoma may include:

• Increasing pain
• A growing lump or area of swelling
• Weakness or bowel and bladder control problems if the cancer presses on the spinal cord

Diagnosis 

Tests and procedures used to diagnose chondrosarcoma include:

• Imaging tests. These may include:  
   
  • X-ray. Black and white images of your bones and joints.  
     
  • Bone scans. A whole-body bone scan is a nuclear medicine test to check your bones for issues or changes. You receive an injection of a substance called a radiotracer. The radiotracer collects in areas of irregular activity and highlights these areas on an imaging scan.  
     
  • Computerized tomography scan (CT or CAT scan). A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. CT scans are good at showing bone changes, such as holes or weak spots. On a CT scan, chordomas usually look like light or dark spots with damaged bone around them.
     
  • Magnetic resonance imaging (MRI). MRI scans are better at showing tumors and the blood vessels around them. MRI scans can show if the tumor has different sections and how it's affecting the tissues around the spine. Chordomas usually appear as bright spots with darker areas inside them.
     
• Biopsy. A procedure to remove some cells for testing. The sample might be removed with a needle put through the skin. Or the sample might be taken during surgery to remove the cancer. The type of biopsy depends on the cancer's location.

Treatment 

Treatment of chondrosarcoma can include:

• Surgery. The goal of surgery for chondrosarcoma is to remove the cancer and a margin of healthy tissue around it. The type of surgery you undergo will depend on the location of your chondrosarcoma. Options might include:
   
  • Scraping the cancer away from the bone. Small and slow-growing chondrosarcomas in the arms and legs are sometimes treated with a procedure to scrape the cancer cells from the bone. The surgeon might apply cold gas or a chemical to kill any cancer cells that remain. The bone can be repaired with a bone graft or bone cement, if needed.
     
  • Cutting away the cancer and some healthy tissue around it. Most chondrosarcomas require a procedure to cut away more of the bone in order to remove all of the cancer. For chondrosarcoma in an arm or a leg, it might be necessary to remove the entire limb. When possible, surgeons remove the cancer in a way that preserves the limb. For example, the surgeon might remove the affected bone and replace it or reconstruct it (limb salvage surgery).
     
• Radiation therapy. Radiation might be recommended for chondrosarcomas located in places that make surgery tricky or if the cancer can't be removed completely during surgery. Radiation may also be used to control cancer that spreads to other areas of the body.
   
• Chemotherapy. It's not often used for chondrosarcoma because this type of cancer often doesn't respond to chemotherapy. But some fast-growing types of chondrosarcoma may respond to this treatment.

Causes & Risk Factors 

Factors that can increase the risk of chondrosarcoma include:

• Age. Chondrosarcoma occurs most often in middle-aged and older adults, though it can occur at any age.
   
• Other bone diseases. Ollier's disease and Maffucci's syndrome are conditions that cause noncancerous bone growths (enchondromas) in the body. These growths sometimes transform into chondrosarcoma.

Screening 

There is no routine screening for chondrosarcoma.