Chondrosarcoma is a rare type of bone cancer that develops in cartilage cells. It most often affects the pelvis, femur, knee, arm, shoulder blade, sternum, or ribs.
This type of cancer is more common in men over 50. It can cause symptoms such as bone pain, swelling, and a lump in the affected area.
Treatment for chondrosarcoma is usually managed by an orthopedic oncologic surgeon. The doctor may recommend surgery, radiation therapy, and/or chemotherapy.
Main symptoms
The main symptoms of chondrosarcoma are:
-
Bone pain in the affected area, which may come and go and worsen at night
-
A lump in the bone
-
Swelling in the affected area
In addition, as the cancer progresses, other symptoms may appear, such as unexplained weight loss and fatigue.
The bones most often affected by chondrosarcoma are the pelvis, femur, knee, arm, shoulder blade, sternum, and ribs.
Confirming a diagnosis
Chondrosarcoma is diagnosed by an orthopedic surgeon based on the person’s symptoms, physical exam, and health history.
To confirm the diagnosis, the doctor may order imaging tests, such as an X-ray, CT scan, bone scan, MRI, or PET scan. However, the doctor will often also request a biopsy, as this is the only way to definitively diagnose cancer when other tests show changes.
According to the NCCN Guidelines for Bone Cancer, biopsy is part of the diagnostic workup for suspected primary bone cancer and should be planned carefully by specialists involved in treatment.
Possible causes
Most chondrosarcomas are caused by the malignant transformation of osteochondromas and enchondromas, which are benign bone tumors that form from cartilage tissue.
Similarly, people with Ollier disease or Maffucci syndrome have a higher risk of developing this type of cancer.
Tumor grade
The grades of chondrosarcoma are:
-
Low-grade chondrosarcoma (grade I): Also called an atypical cartilaginous tumor, it tends to grow more slowly and has a low chance of spreading
-
Intermediate-grade chondrosarcoma (grade II): Slightly more likely to spread than low-grade chondrosarcoma
-
High-grade chondrosarcoma (grade III): Has the highest chance of spreading and causing metastases
-
Grade IV or dedifferentiated chondrosarcoma: A rare and highly aggressive form of chondrosarcoma that generally has an unfavorable prognosis because it grows and spreads quickly
The grade of a tumor measures how quickly it can grow and spread.
Treatment options
Treatment should be managed by an orthopedic oncologic surgeon, based on the person’s age, medical history, type of chondrosarcoma, and stage of the disease.
The main goal of treatment is to remove the tumor through surgery. In cases of late diagnosis or fast-growing tumors, amputation of the affected limb may also be necessary to prevent any remaining tumor cells from growing again and causing cancer to return.
Based on the ESMO clinical guidelines, surgery is the main treatment for localized chondrosarcoma, while radiation therapy or systemic treatments may be considered in selected cases, such as unresectable, recurrent, or metastatic disease.
Although chondrosarcoma does not usually respond well to chemotherapy or radiation therapy, these treatments may still help control cancer spread and prevent disease progression in advanced cases.
Life expectancy
Life expectancy for a person with chondrosarcoma depends on several factors, such as the type of chondrosarcoma, grade of malignancy, tumor location, and whether metastasis has occurred.
Most chondrosarcomas grow slowly and do not metastasize. However, rarer types may be more aggressive and spread to the lungs or other parts of the body.
In general, life expectancy is good for low-grade chondrosarcoma or tumors that can be completely removed. However, high-grade chondrosarcomas or tumors that cannot be completely removed have a more guarded prognosis.