chondrosarcoma

Generality

Chondrosarcoma is a malignant tumor that affects the cartilage.

The cartilages most prone to chondrosarcoma are those of: pelvis, femur (leg bone), humerus (arm bone), scapula and ribs.

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At the origin of a chondrosarcoma, there are mutations of those genes that control the growth, differentiation and death of the cartilaginous tissues' constituent cells.

Typical symptoms of chondrosarcoma include: bone pain, bone fragility followed by a marked tendency to fracture, fever, lameness, nocturnal iodination and the presence of swelling.

For a correct diagnosis of chondrosarcoma, imaging tests and tumor biopsy are essential.

The possible treatments of a chondrosarcoma are: surgical removal of the tumor, radiotherapy and chemotherapy.

Short review of what a tumor is

In medicine, the terms tumor and neoplasia identify a mass of very active cells, able to divide and grow uncontrollably.

We speak of a benign tumor when the growth of cell mass is not infiltrative (that is, it does not invade the surrounding tissues) and even metastasizing.
There is talk of a malignant tumor when the abnormal cell mass has the ability to grow very quickly and to spread to the surrounding tissues and the rest of the body.
The terms malignant tumor, cancer and malignant neoplasia are to be considered synonymous.

What is chondrosarcoma?

Chondrosarcoma is a malignant bone tumor that originates from a cartilaginous tissue cell in the human skeleton. In simpler words, it is a malignant cartilage tumor .

Chondrosarcoma is a malignant neoplasm belonging to the great category of sarcomas . A sarcoma is any malignant tumor originating from a soft tissue cell (soft tissue sarcoma) or osteo-cartilaginous tissue (bone sarcoma).

Based on the above definition, chondrosarcoma is a type of bone sarcoma .

Other bone sarcomas are: osteosarcoma, Ewing's sarcoma and secondary bone sarcomas (ie bone sarcomas resulting from the spread of metastases of other malignant tumors).

MOST INTERESTED ANATOMICAL SEATS

The cartilage tissues most prone to chondrosarcoma are those of: pelvis, femur (leg bone), humerus (arm bone), scapula and ribs.

Epidemiology

Chondrosarcoma is a rare malignant tumor, but data on its exact incidence on the general population are lacking.

According to some statistical studies, chondrosarcoma episodes represent 30% of all primary bone tumors. All neoplasms that arise directly from bone or cartilage tissue are to be considered primary bone tumors (and NOT derived from metastases spread by other primary tumors located elsewhere).

Chondrosarcoma can affect people of any age; however, it seems to have a marked preference for people in their 40s.

Causes

Most tumors - including chondrosarcoma - arise due to genetic DNA mutations that alter cellular processes of growth, division and death. The tumor cells, in fact, grow and divide in an anomalous way, with a rhythm higher than normal, so that, for these reasons, the experts tend to define them with the terminology of " mad cells ".

WHAT FACTORS FAVOR THE DNA MUTATIONS?

Despite the large number of experimental researches, pathologists have not yet accurately identified the precise factors that induce DNA genetic mutations at the origin of chondrosarcoma.

The discovery of what favors the mutational events at the base of chondrosarcoma represents an important step, for any discourse concerning the prevention of the malignant tumor in question.

CONDROSARCOMA, CANCER THE BONES BENIGNI AND OTHER ASSOCIATIONS

Clinical investigations have shown that those suffering from chondroma or osteochondroma - ie two benign-type bone tumors - have an increased risk of developing chondrosarcoma. It is as if there is a certain relationship between the two aforementioned benign neoplasms and chondrosarcoma.

Furthermore, other studies have shown that there is a predisposition to chondrosarcoma, from those who suffer from two particular medical conditions: Ollier syndrome and Maffucci syndrome .

Symptoms and Complications

The typical symptom of chondrosarcoma is pain at the level of the anatomical area where the affected bone resides. Generally, it is a deaf painful sensation, occasional at the beginning, severe and constant at an advanced stage.

It is quite common for patients to experience a worsening of the aforementioned painful sensation, when they become tired with some activity or when they wake up from sleep at night.

Among the less common symptoms compared to bone pain, they deserve a mention:

The fragility of the bones affected by the neoplasm: these, in fact, become extremely susceptible to fractures (pathological fractures);
The presence of swelling at the bone or bones affected by the tumor;
The fever;
Episodes of night sweats;
Lameness, if the bone tumor involves one of the two lower limbs.

WHAT DOES SYMPTOMOLOGY DEPEND ON?

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In the case of chondrosarcoma, the presence of a certain symptomatology depends on the site and the size of the neoplasm. Think, for example, of lameness, which is present only when the tumor affects one of the two lower limbs.

Location and dimensions of chondrosarcoma also affect the severity of the symptomatology.

COMPLICATIONS

An advanced phase chondrosarcoma is a malignant tumor capable of spreading its cancer cells to organs and tissues distant from the place of origin (lungs and liver are the most common sites).

The cells that a tumor disperses in other anatomical districts of the body are called metastases .

Diagnosis

For a correct diagnosis of chondrosarcoma, the fundamental tests are: physical examination, medical history, diagnostic imaging tests (eg X-rays, nuclear magnetic resonance, CT, bone scintigraphy, etc.) and tumor biopsy.

TUMOR BIOPSY

A tumor biopsy consists of the collection and histological analysis, in the laboratory, of a sample of cells from the tumor mass.

It is the most suitable test to define the main characteristics of a chondrosarcoma, from the histology to the cells of origin, passing through the degree of malignancy, staging, etc.

Performed under local or general anesthesia, the removal of cells from a bone tumor can take place in at least two different ways: by means of a needle (needle biopsy) or by means of a scalpel ("open" biopsy).

To learn more about this topic, readers can consult the article here.

What are staging and the degree of a malignant tumor?

The staging of a malignant tumor includes all that information, collected during biopsy, which concerns the size of the tumor mass, its infiltrating power and its metastasizing capacities. There are 4 levels of staging (or stages): stage 1 is the least severe, stage 4 is the most severe.

The degree of a malignant tumor, on the other hand, includes all those data that emerged during the biopsy, which concern the extent of transformation of malignant tumor cells, compared to their healthy counterparts. There are 4 degrees of increasing gravity: therefore, grade 1 is the least serious, while grade 4 is the most serious.

Treatment

The choice of the best therapy to treat a chondrosarcoma depends on several factors, including: staging and degree of the tumor (presence of metastases, progression of the disease, etc.), the patient's general health status, the age of the patient and the districts of the affected body.

Currently, the possible treatments to which a chondrosarcoma sufferer may be subjected are: surgery to remove the tumor mass, radiotherapy and chemotherapy.

Depending on the circumstances, doctors could opt to combine the aforementioned treatments in order to get a better result.

SURGERY

Surgical removal of the tumor mass involves the removal of a portion of healthy bone. The removal of a portion of healthy bone makes the application of a prosthesis or the grafting of a bone graft indispensable, to replace the aforementioned bone portion eliminated for the good of the patient.

If the surgery involves a joint, doctors must arrange for a joint replacement, instead of the original one, affected by the tumor.

In the past, surgical treatment of chondrosarcoma was much more invasive than at the present time: for example, due to chondrosarcomas located on the upper or lower limbs, amputation was expected.

RADIOTHERAPY

Radiation therapy involves exposing the tumor mass to a certain dose of high-energy ionizing radiation (X-rays), which are intended to destroy neoplastic cells.

The use of radiotherapy, for the treatment of chondrosarcoma, is rare.

CHEMOTHERAPY

Chemotherapy consists of the administration of drugs capable of killing rapidly growing cells, including cancer ones.

In the case of chondrosarcoma, the use of chemotherapy is very rare.

Prognosis

The prognosis in the case of chondrosarcoma depends on how early the diagnosis and treatment of the neoplasm takes place. This means that a person with an identified and cured chondrosarcoma at an early stage is more likely to heal than a person with an identified and cured chondrosarcoma at an advanced stage.

In support of what has just been stated, there are several statistical searches, some of which have shown that: