Cancer and Chondrosarcoma

A chondrosarcoma is a rare cancer that begins in the cartilage cells of bones. These cells can become cancerous because of genetic mutations and divide uncontrollably to form a tumor. Some risk factors for chondrosarcoma have been identified, and these include age, exposure to radiation, and a family history of bone tumors.

Yes, a chondrosarcoma is a malignant bone cancer. The suffix -sarcoma usually refers to a malignant type of tumor. Thus, by definition, tumors such as chondrosarcoma and osteosarcoma are malignant. However, chondrosarcomas can behave differently with some being slower growing than others. They tend to occur in the bones of the hips, legs and arms. They can also occur at the base of the skull, in the tailbone, and in the spine. Although they are generally slow growing, they cause significant damage to nearby tissues and bones. They are also known to recur, making their treatment challenging.

Although rare, chondrosarcomas have been known to metastasize. Metastasis is the spread of cancer from the original (primary) site to other parts of the body. The cancer cells can spread through the body’s circulation system, including blood and lymphatics, and form new tumors in other organs or tissues. Chondrosarcoma metastases commonly occur in the lungs and bone.

It is important to remember that not all chondrosarcomas metastasize. The risk of metastasis depends on the size, location, grade, and subtype of the tumor. Early detection and treatment are important to improve the chances of controlling the spread of the tumor. Treatment of metastatic chondrosarcomas involves a combination of surgery, radiation therapy, and chemotherapy. The goal of treatment is to relieve symptoms and limit the progression of the tumor.

Grading of a tumor is a way to determine how aggressive it is. It helps decide suitable treatment options and predict the outcome.

If your doctor suspects a chondrosarcoma, they will perform a biopsy, in which a small sample of the tumor is collected and examined under a microscope. The biopsy results will also include the grading of the tumor.

The World Health Organization (WHO) grading system is a commonly used system for classifying chondrosarcomas into 3 grades:

• Grade I: This is the least aggressive type of chondrosarcoma and has the best prognosis. A grade I tumor typically grows slowly and is confined to the site of origin.
• Grade II: This type of chondrosarcoma is moderately aggressive and has a more unpredictable behavior. A grade II tumor may recur locally or spread to the surrounding tissues.
• Grade III: This is the most aggressive type of chondrosarcoma and has the least favorable prognosis. A grade III tumor tends to grow quickly and spread to other parts of the body, making it more difficult to treat.

Although important, the WHO grading system is not the only prognostic indicator. Other factors, such as the location of the tumor and the patient’s overall health, also affect the prognosis.

The staging of chondrosarcoma is determined by the grade of the tumor, how invasive it is, and whether it has spread to other parts of the body. The most commonly used staging system is the Enneking staging system, which categorizes chondrosarcomas as follows:

• Stage 1A: Low-grade tumor, located only within the vertebra, with no spread to other distant parts of the body.
• Stage 1B: Low-grade tumor, invaded surrounding tissue, with no spread to other distant parts of the body.
• Stage 2A: High-grade tumor, located only within the vertebra, with no spread to other distant parts of the body.
• Stage 2B: High-grade tumor, invaded surrounding tissue, with no spread to other distant parts of the body.
• Stage 3: Tumor has spread to other distant parts of the body.

The higher the stage, the more severe and aggressive the tumor is.

To determine the level of invasion of surrounding tissues, computed tomography (CT) and magnetic resonance imaging (MRI) scans of the chondrosarcoma are needed, whereas to discover spread to distant parts of the body, CT scans of the chest and abdomen prove useful. Positron emission tomography (PET) scans are essential to look for signs of metastases.

• Chondrosarcomas develop from cartilage cells in the bone that divide uncontrollably to form a tumor.
• Chondrosarcomas are rare bone cancers that are locally aggressive but rarely spread to distant organs and tissues.
• The grade of the chondrosarcoma is determined by a biopsy and examination of the tumor sample under a microscope.
• The stage of the chondrosarcoma is determined by the grade of the tumor, its invasion into surrounding bone and tissues, and its spread to distant parts of the body. The higher the stage, the more severe the tumor.

• Sarcoma Foundation of America
• The Liddy Shriver Sarcoma Initiative
• Chondrosarcoma Foundation
• National Brain Tumor Society
• American Brain Tumor Association