Chondrosarcoma

Chondrosarcoma is a type of bone cancer that occurs in cartilage cells. Cartilage is the specialized, gristly connective tissue that is present in adults. Most bones develop from this tissue. Cartilage plays an important role in the growth process. There are many different types of cartilage all over the body. Chondrosarcoma mainly affects the cartilage cells of the thighbone (femur), arm, pelvis, or knee. In some cases, 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 different than a cancer that starts in another organ and then spreads to the bone. Chondrosarcoma rarely affects people younger than age 20. The risk keeps rising until age 75. It affects men and women equally.

The exact cause of chondrosarcoma is not known. There may be a genetic or chromosomal role. So certain people may be more open to this type of cancer. Chondrosarcomas have been seen as a late consequence of radiation therapy for other cancers. 

In most cases, chondrosarcoma happens from normal cartilage cells. It may also stem from a preexisting noncancer (benign) bone or cartilage tumor. Here are some benign conditions that may be present when chondrosarcoma happens:

• Enchondromas. This is a type of noncancer bone tumor that begins from cartilage and often affects the hands. But it can also affect other areas.

• Multiple exostoses (osteochondromas). The presence of multiple osteochondromas. These are an overgrowth of cartilage and bone near the end of the growth plate.

• Ollier disease. This is a cluster of benign cartilage tumors that often affects the hands (enchondromas).

• Maffucci syndrome. This is a combination of multiple enchondromas and benign tumors made up of blood vessels (angiomas).

Symptoms of chondrosarcoma may vary depending on the location of the tumor. Symptoms may include:

• Large mass on the affected bone

• Feeling of pressure around the mass

• Pain that increases slowly over time. It is often worse at night. It may be relieved by taking anti-inflammatory medicines such as ibuprofen. It is not often relieved by rest. 

• Pain that is often worse at night. This may be relieved by taking anti-inflammatory medicines such as ibuprofen.

• Local swelling

Your healthcare provider will take a full health history and give you a physical exam. You may also need some diagnostic tests for chondrosarcoma. These may include:

• Biopsy. Tissue samples are removed from the body (with a needle or during surgery). Then they are checked under a microscope. This is done to see 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.

• CT scan. This imaging test 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.

• MRI. An imaging test that uses a combination of large magnets, radio waves, 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 sugar (glucose) is injected into the blood. Tissues that use the glucose more than normal tissues (such as tumors) can be found by a scanning machine. 

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.

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 needed. Treatment may include:

• Surgery. The tumor is removed. 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. This is not the main treatment. But it may be needed if the cancer has spread to other parts of the body.