Chondrosarcoma

What is chondrosarcoma?

Chondrosarcoma is a type of bone cancer that develops in cartilage cells. Cartilage is the specialized, gristly connective tissue that is present in adults and the tissue from which most bones develop. Cartilage plays an important role in the growth process. There are many different types of cartilage that are present throughout the body. Chondrosarcoma primarily affects the cartilage cells of the femur (thighbone), arm, pelvis, or knee. Although less often, other areas (such as the ribs) may be affected.

Chondrosarcoma is the second most common type of primary bone cancer. A primary bone cancer is one that starts from bone. This is opposed to starting in another organ and then spreading to the bone. This type of cancer rarely affects individuals under age 20. The risk continues to rise until age 75. The incidence between males and females is equal.

What causes chondrosarcoma?

The exact cause of chondrosarcoma is not known. There may be a genetic or chromosomal component that makes certain individuals more open to this type of malignancy. Chondrosarcomas have been observed as a late consequence of radiation therapy for other cancers. 

What are the risk factors for chondrosarcoma?

Most often, chondrosarcoma happens from normal cartilage cells. It may also stem from a preexisting benign (noncancerous) bone or cartilage tumor. The following is a list of some benign conditions that may be present when chondrosarcoma happens:

• Enchondromas. A type of benign bone tumor that begins from cartilage and usually affects the hands (can also affect other areas).

• 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 (benign cartilage tumors that usually affect the hands).

• Maffucci syndrome. A combination of multiple enchondromas (benign cartilage tumors that usually affect the hands) angiomas (benign tumors made up of blood vessels).

What are the symptoms of chondrosarcoma?

Symptoms of chondrosarcoma may vary depending on the location of the tumor. The following are the most common symptoms of chondrosarcoma. However, each individual may experience symptoms differently. Symptoms may include:

• Large mass on the affected bone

• Feeling of pressure around the mass

• Pain that increases gradually over time. It is usually worse at night and may be relieved by taking anti-inflammatory medicines, such as ibuprofen. It is not usually relieved through rest. 

• Pain that is usually worse at night and may be relieved by taking anti-inflammatory medicines, such as ibuprofen

• Local swelling

How is chondrosarcoma diagnosed?

In addition to a complete medical history and physical exam, diagnostic procedures for chondrosarcoma may include the following:

• Biopsy. A procedure in which tissue samples are removed (with a needle or during surgery) from the body for exam under a microscope. This is done to determine if cancer or other abnormal cells are present.

• X-ray. A diagnostic test that uses invisible electromagnetic energy beams to make images of internal tissues, bones, and organs onto film.

• Computed tomography scan (also called a CT or CAT scan). This is an imaging test that uses X-rays and a computer to make detailed images of the body. A CT scan shows details of the bones, muscles, fat, and organs.

• Magnetic resonance imaging (MRI). A diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to make detailed images of organs and structures within the body.

• Positron emission tomography (PET) scan. An imaging test in which radioactive-tagged glucose (sugar) is injected into the bloodstream. Tissues that use the glucose more than normal tissues (such as tumors) can be detected by a scanning machine. 

Treatment for chondrosarcoma

Specific treatment for chondrosarcoma will be determined by your healthcare provider based on:

• Your age, overall health, and medical history

• Type, stage (extent), and location of the cancer 

• Your tolerance for specific medicines, procedures, and therapies

• Expectation for the course of the disease

• Your opinion or preference

The goal for treatment of chondrosarcoma is to remove the mass and reduce the likelihood that it will return. Close follow-up with your healthcare provider may be necessary. Treatment may include:

• Surgery. Removal of the tumor. If the tumor is on an arm or leg, the surgeon will try to save the limb. In some cases, amputation might be needed. 

• Physical therapy. This treatment helps to regain strength and use of the affected area after surgery.

• Radiation therapy. Radiation might be given at high doses.  

• Chemotherapy. Although not the primary treatment, it may be needed if the cancer has spread to other areas of the body.