oncology
Chondrosarcoma
advanced
6 min
28 marks
6 questions
Clinical Scenario
A 52-year-old man presents with a 12-month history of progressive right hip pain. The pain is deep, aching, and worse at night. He has noticed increasing difficulty walking. He has no prior history of bone lesions. On examination, there is tenderness over the proximal femur with reduced hip range of motion. X-ray shows an expansile lesion with calcification in the proximal femur extending into the soft tissues.
AP pelvis radiograph demonstrating a Grade 2 chondrosarcoma of the right proximal femur. There is an expansile lytic lesion with endosteal scalloping, cortical thickening, and characteristic rings and arcs (popcorn) calcification within the matrix. The lesion shows aggressive features with cortical destruction and soft tissue extension. MRI is required to assess marrow extent and soft tissue component.
Source: Dedifferentiated chondrosarcoma: Radiological features, prognostic factors and survival statistics • PMC5354284 • CC-BY
Questions
Question 1 (4 marks)
Describe the clinical and radiographic features of chondrosarcoma.
Question 2 (5 marks)
How do you differentiate chondrosarcoma from enchondroma?
Question 3 (6 marks)
Describe the grading system and its treatment implications.
Question 4 (5 marks)
What are the surgical principles for chondrosarcoma?
Question 5 (4 marks)
Discuss secondary chondrosarcoma and predisposing conditions.
Question 6 (4 marks)
What are the subtypes and prognosis of chondrosarcoma?
Exam Day Cheat Sheet
Must Mention
- •Most common primary bone sarcoma in adults
- •Rings and arcs calcification on X-ray
- •Endosteal scalloping >2/3 = concerning for malignancy
- •Chemotherapy-resistant
- •Wide surgical resection only curative treatment
- •Grade determines prognosis
Common Pitfalls
- •Using chemotherapy
- •Wrong grade criteria
- •Missing syndromes
- •Wrong enchondroma distinction
- •Missing dedifferentiated
- •Wrong survival rates