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Shahnazari R, Montazer F, Shirzadi S, Karaji S. Extraskeletal mesenchymal chondrosarcoma arising from soft tissues: A rare case report. Cancer Rep (Hoboken) 2023; 6:e1883. [PMID: 37559178 PMCID: PMC10598256 DOI: 10.1002/cnr2.1883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/25/2023] [Accepted: 07/28/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Chondrosarcomas are an exceedingly rare form of cancer, impacting only a few individuals per million. Among chondrosarcomas, a small fraction belongs to the mesenchymal sub-type. Furthermore, only one-third of mesenchymal chondrosarcomas manifest in extraskeletal locations. CASE A 38-year-old woman was referred by a midwife after experiencing pain in the right upper quadrant of her right breast for 2 months. The mass had been palpable for 1 week before the initial assessment. According to radiological evaluations, the tumor is outside breast tissue and not connected to the bones. Hence, a biopsy of the mass is done. The biphasic morphology of the tumor during pathological evaluation, in addition to immunohistochemistry testing, confirms the diagnosis of extraskeletal mesenchymal chondrosarcoma (EMCS). Finally, the mass was surgically removed, and 6 months of chemotherapy were administered to the patient. CONCLUSION Given the tumor's rarity and the lack of established guidelines, diagnosing EMCS can be challenging and prone to errors. As such, meticulous sampling, along with precise pathological and imaging investigations, is imperative to accurately establish the diagnosis of these tumors.
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Affiliation(s)
- Razieh Shahnazari
- Radiology Department of Iran University of Medical Sciences (IUMS)TehranIran
| | - Fatemeh Montazer
- Firoozabadi Clinical Research Development Unit (FACRDU)Iran University of Medical Sciences (IUMS)TehranIran
| | - Shahriar Shirzadi
- Radiology Department of Hamedan University of Medical SciencesHamedan University of Medical SciencesHamedanIran
| | - Sina Karaji
- Radiology Department of Iran University of Medical Sciences (IUMS)TehranIran
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2
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Esfahani MM, Mirazimi SMA, Azadbakht J, Dashti F. Retroperitoneal mesenchymal chondrosarcoma with metastasis to iliac vein: A rare case report and review of the literature. Clin Case Rep 2022; 10:e6633. [DOI: 10.1002/ccr3.6633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 11/02/2022] [Accepted: 11/08/2022] [Indexed: 11/25/2022] Open
Affiliation(s)
- Mahsa Masjedi Esfahani
- Department of Diagnostic Radiology, Kashan School of Medicine Kashan University of Medical Sciences Kashan Iran
| | - Seyed Mohammad Ali Mirazimi
- Department of Diagnostic Radiology, Kashan School of Medicine Kashan University of Medical Sciences Kashan Iran
| | - Javid Azadbakht
- Department of Diagnostic Radiology, Kashan School of Medicine Kashan University of Medical Sciences Kashan Iran
| | - Fatemeh Dashti
- Department of Diagnostic Radiology, Kashan School of Medicine Kashan University of Medical Sciences Kashan Iran
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3
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Extraskeletal Mesenchymal Chondrosarcoma of the Uterus. Diagnostics (Basel) 2022; 12:diagnostics12030643. [PMID: 35328196 PMCID: PMC8946862 DOI: 10.3390/diagnostics12030643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/28/2022] [Accepted: 03/04/2022] [Indexed: 11/17/2022] Open
Abstract
Mesenchymal chondrosarcoma is an uncommon malignant mesenchymal tumor with an aggressive behavior. Diagnoses of mesenchymal chondrosarcoma are established based on histomorphological, immunohistochemical, and molecular findings. Only one case of extraskeletal mesenchymal chondrosarcoma (EMC) of the uterus has been reported. This article presents the second case of primary uterine EMC, occurring in a 33-year-old woman. We describe the histological and immunophenotypical features of EMC. Our observations will help pathologists and clinicians perform accurate histological diagnoses of uterine EMC and plan appropriate treatment strategies for this rare tumor.
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4
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Hameed M. Malignant Cartilage-Forming Tumors. Surg Pathol Clin 2021; 14:605-617. [PMID: 34742483 DOI: 10.1016/j.path.2021.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Chondrosarcomas are heterogeneous matrix-producing cartilaginous neoplasms with variable clinical behavior. Subtypes include conventional (75%), dedifferentiated (10%), clear cell (2%), mesenchymal (2%), and periosteal chondrosarcoma (<1%). Tumor location and primary vs secondary also play a role. In conventional chondrosarcoma, histologic grading (I, II, and III) remains the gold standard for predicting recurrence and metastases. Due to the locally aggressive but overall nonmetastatic behavior, grade I chondrosarcomas (primary and secondary) of long and short tubular bones have been reclassified as atypical cartilaginous tumor. In this review, the pathologic features of malignant cartilage tumors are discussed with updates on recent genetic findings.
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Affiliation(s)
- Meera Hameed
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
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5
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Mesenchymal chondrosarcoma: imaging features and clinical findings. Skeletal Radiol 2021; 50:333-341. [PMID: 32734374 PMCID: PMC8491146 DOI: 10.1007/s00256-020-03558-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/14/2020] [Accepted: 07/20/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To describe imaging and clinical features of primary mesenchymal chondrosarcoma (MCS) and evaluate for presence of a distinct biphasic pattern on imaging. MATERIAL AND METHODS Patients with a pathologic diagnosis of MCS were identified along with imaging of their primary tumor. Size, location, appearance (lytic, sclerotic, or mixed), presence, extent and distribution of calcifications, cortical destruction, soft tissue extension, periosteal reaction, contrast enhancement, and radiotracer uptake were recorded. The presence of T2-hyperintense tumor lobules on MRI and a biphasic morphology (distinct calcified and non-calcified components) on CT were assessed. Presence and location of metastases were documented. RESULTS Twenty-three patients (mean age 28.0 ± 13.8 years) were reviewed (13 skeletal, 10 extraskeletal). Overall mean tumor size was 10.2 ± 7.2 cm, 7.1 ± 7.3 cm in non-metastatic and 13.2 ± 5.9 cm (p = 0.004) in metastatic cases. Locations were extremities (n = 11), head/neck (n = 4), chest wall (n = 4), pelvis (n = 3), and retroperitoneum (n = 1). Skeletal MCS were aggressive mixed lytic and sclerotic (n = 8), purely lytic (n = 4), or juxtacortical (n = 1) lesions with cortical destruction and soft tissue extension. Chondroid calcifications were common (80%). On MRI, the presence of T2-hyperintense lobules was seen in 35%. A biphasic morphology on imaging was seen in 30%. Metastases were common (52%) with the most common site being the lungs (75%). All tumors were hypermetabolic with a mean SUVmax of 14.3 (5.6-34) on PET/CT. CONCLUSION Skeletal MCS commonly present as aggressive lytic bone lesions with chondroid calcifications. A biphasic morphology was seen in one-third of cases. Metastases were common at initial presentation and more commonly seen with larger tumors.
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Biagini R, Orsini U, Demitri S, Ruggieri P, Ferrari S, Bertoni F. Mesenchymal Chondrosarcoma of the Sacrum: A Case Report and Review of the Literature. TUMORI JOURNAL 2018; 86:75-8. [PMID: 10778771 DOI: 10.1177/030089160008600114] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The authors present a case of mesenchymal chondrosarcoma located in the sacrum of a 23-year-old patient treated with radiotherapy and chemotherapy. A review of the literature on the topic is also reported.
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Affiliation(s)
- R Biagini
- First Orthopedic Clinic, Istituti Ortopedici Rizzoli, Bologna, Italy
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7
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Cesari M, Bertoni F, Bacchini P, Mercuri M, Palmerini E, Ferrari S. Mesenchymal Chondrosarcoma. An Analysis of Patients Treated at a Single Institution. TUMORI JOURNAL 2018; 93:423-7. [DOI: 10.1177/030089160709300503] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background We analyzed clinical and treatment-related factors influencing the outcome of patients with mesenchymal chondrosarcoma (MC). Twenty-six patients (median age, 31 years) were identified using the Tumor Center and Chemotherapy Department database of the study institute. Methods Patients received surgery (24 patients) and/or radiotherapy (5 patients), and chemotherapy (12 patients). Results After a median follow-up of 48 months (7-237 months) 10 patients were alive. The 10-year overall survival (OS) was 27% in those who achieved complete surgical remission and 0% in those who did not (P = 0.0007). A worse 10-year probability of OS was observed in patients who were metastatic at presentation (metastatic 0%, localized 31%, P = 0.02), in patients with soft tissue MC (soft tissue MC 0%, bone MC 29%, P = 0.06) and in hemangiopericytoma-like MC (hemangiopericytoma-like MC 0%, Ewing's-like MC 33.5%, P = 0.9). In those patients who achieved complete surgical remission, the 10-year DFS was 76% for those who received chemotherapy and 17% for those who did not (P = 0.008). Conclusions Our experience confirmed the importance of complete surgical remission in MC treatment and suggests that the addition of chemotherapy should offer a benefit in terms of DFS. Due to the rarity of MC, multicentrer studies are needed to identify the most active chemotherapy regimen.
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Affiliation(s)
- Marilena Cesari
- Chemotherapy, Department of Musculoskeletal Oncology, Istituti Ortopedici Rizzoli, Bologna, Italy
| | - Franco Bertoni
- Pathology, Department of Musculoskeletal Oncology, Istituti Ortopedici Rizzoli, Bologna, Italy
| | - Patrizia Bacchini
- Pathology, Department of Musculoskeletal Oncology, Istituti Ortopedici Rizzoli, Bologna, Italy
| | - Mario Mercuri
- 5th Division of Orthopedic Surgery, Department of Musculoskeletal Oncology, Istituti Ortopedici Rizzoli, Bologna, Italy
| | - Emanuela Palmerini
- Chemotherapy, Department of Musculoskeletal Oncology, Istituti Ortopedici Rizzoli, Bologna, Italy
| | - Stefano Ferrari
- Chemotherapy, Department of Musculoskeletal Oncology, Istituti Ortopedici Rizzoli, Bologna, Italy
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8
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Alkatan HM, Eberhart CG, Alshomar KM, Elkhamary SM, Maktabi AM. Primary mesenchymal chondrosarcoma of the orbit: Histopathological report of 3 pediatric cases. Saudi J Ophthalmol 2018; 32:69-74. [PMID: 29755276 PMCID: PMC5943970 DOI: 10.1016/j.sjopt.2018.02.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 02/17/2018] [Accepted: 02/26/2018] [Indexed: 11/23/2022] Open
Abstract
Mesenchymal chondrosarcoma (MCS) is an unusual tumor mainly found in the skeleton. Around third of the cases occur in extra-skeletal sites with the orbit being the third most common site in these cases. In previous reviews of the orbital cases, it has been concluded that orbital MCS tends to occur in women in the second or third decades of life. However, 8 cases of orbital MCS have been reported so far in the pediatric age group (age less than 18 years-old) one of which has been considered congenital MCS in a 5-days old newborn girl. We describe 3 additional pediatric cases with primary orbital MCS and they were all males. Our cases presented with proptosis and calcific orbital masses on imaging studies. Histopathological examination of the excised masses shared the typical presence of undifferentiated mesenchymal cells and immature areas of cartilage. The diagnosis of MCS was further confirmed by immunohistochemical staining. Brief review of the literature in relation to this diagnosis in the orbit is also presented.
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Affiliation(s)
- Hind M. Alkatan
- Ophthalmology Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pathology Department, King Saud University-Medical City, Riyadh, Saudi Arabia
| | - Charles G. Eberhart
- Departments of Pathology, Ophthalmology, and Oncology, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| | | | - Sahar M. Elkhamary
- Diagnostic Imaging Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
- Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Egypt
| | - Azza M.Y. Maktabi
- Pathology and Laboratory Medicine Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
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9
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Tsuda Y, Ogura K, Hakozaki M, Kikuta K, Ae K, Tsuchiya H, Iwata S, Ueda T, Kawano H, Kawai A. Mesenchymal chondrosarcoma: A Japanese Musculoskeletal Oncology Group (JMOG) study on 57 patients. J Surg Oncol 2017; 115:760-767. [DOI: 10.1002/jso.24567] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 01/09/2017] [Indexed: 12/17/2022]
Affiliation(s)
- Yusuke Tsuda
- Department of Orthopedic Surgery, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Koichi Ogura
- Department of Orthopedic Surgery, Graduate School of MedicineThe University of TokyoTokyoJapan
- Department of Musculoskeletal OncologyNational Cancer Center HospitalTokyoJapan
| | - Michiyuki Hakozaki
- Department of Orthopedic SurgeryFukushima Medical University School of MedicineFukushimaJapan
| | - Kazutaka Kikuta
- Department of Orthopedic SurgeryKeio University School of MedicineTokyoJapan
| | - Keisuke Ae
- Department of Orthopedic SurgeryCancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
| | - Hiroyuki Tsuchiya
- Department of Orthopedic Surgery, Graduate School of Medical SciencesKanazawa UniversityIshikawaJapan
| | - Shintaro Iwata
- Division of Orthopedic SurgeryChiba Cancer CenterChibaJapan
| | - Takafumi Ueda
- Department of Orthopedic SurgeryOsaka National HospitalOsakaJapan
| | - Hirotaka Kawano
- Department of Orthopedic Surgery, Graduate School of MedicineThe University of TokyoTokyoJapan
- Department of Orthopedic SurgeryTeikyo University School of MedicineTokyoJapan
| | - Akira Kawai
- Department of Musculoskeletal OncologyNational Cancer Center HospitalTokyoJapan
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10
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Kumar R, Duran C, Amini B, Araujo DM, Wang WL. Periosteal mesenchymal chondrosarcoma of the tibia with multifocal bone metastases: a case report. Skeletal Radiol 2017; 46:995-1000. [PMID: 28352960 DOI: 10.1007/s00256-017-2626-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 03/01/2017] [Accepted: 03/05/2017] [Indexed: 02/02/2023]
Abstract
Mesenchymal chondrosarcoma of bone is a rare high-grade variant of chondrosarcoma, which typically has central intramedullary location. The tumor is characterized by admixture of highly anaplastic small round malignant cells and islands of mineralized low-grade hyaline cartilage. It is most unusual for this tumor to arise on the surface of a long bone. We describe a patient with periosteal mesenchymal chondrosarcoma that arose at the surface of the right tibia with multifocal bone metastases. Radiographic, CT, MRI, and PET-CT features of this unusual tumor are presented.
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Affiliation(s)
- Rajendra Kumar
- Department of Diagnostic Imaging, The University of Texas M.D. Anderson Cancer Center, Unit 1475, 1515 Holcombe Blvd, Unit 1475, Houston, Texas, 77030, USA.
| | - Cihan Duran
- Department of Diagnostic Imaging, The University of Texas M.D. Anderson Cancer Center, Unit 1475, 1515 Holcombe Blvd, Unit 1475, Houston, Texas, 77030, USA
| | - Behrang Amini
- Department of Diagnostic Imaging, The University of Texas M.D. Anderson Cancer Center, Unit 1475, 1515 Holcombe Blvd, Unit 1475, Houston, Texas, 77030, USA
| | - Dejka M Araujo
- Department of Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Unit 1475, 1515 Holcombe Blvd, Unit 1475, Houston, Texas, 77030, USA
| | - Wei-Lien Wang
- Department of Pathology, The University of Texas M.D. Anderson Cancer Center, Unit 1475, 1515 Holcombe Blvd, Unit 1475, Houston, Texas, 77030, USA
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11
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Schneiderman BA, Kliethermes SA, Nystrom LM. Survival in Mesenchymal Chondrosarcoma Varies Based on Age and Tumor Location: A Survival Analysis of the SEER Database. Clin Orthop Relat Res 2017; 475:799-805. [PMID: 26975384 PMCID: PMC5289165 DOI: 10.1007/s11999-016-4779-2] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Studies suggest that mesenchymal chondrosarcoma is associated with a poorer prognosis and a higher proportion of extraskeletal tumors than conventional chondrosarcoma. However, these investigations have been small heterogeneous cohorts, limiting analysis of prognostic factors. QUESTIONS/PURPOSES (1) What is the 5- and 10-year survival rate of patients diagnosed with mesenchymal chondrosarcoma? (2) What is the effect of demographic and tumor characteristics on survival in patients with mesenchymal chondrosarcoma? METHODS The Surveillance, Epidemiology, and End Results (SEER) database was used to identify all patients diagnosed with mesenchymal chondrosarcoma from 1973 to 2011. SEER reports survival data on over 8.2 million patients with cancer and has attained 98% completeness in reporting. Using variables within the database, this study designated each patient's tumor as skeletal or extraskeletal and cranial, axial, or appendicular, respectively. Overall survival (OS) was determined for the entire series as well as each group. Median survival was calculated using Kaplan-Meier methods. Cox proportional hazards regression was used to determine whether demographic and tumor variables affected survival. Two hundred five patients with mesenchymal chondrosarcoma were identified, including 82 (40%) skeletal and 123 (60%) extraskeletal. RESULTS OS for the entire series was 51% (95% confidence interval [CI], 43%-58%) and 43% (95% CI, 35%-51%) at 5 and 10 years, respectively. No difference in OS was detected between extraskeletal and skeletal tumors. Kaplan-Meier analyses showed OS was worse for tumors in axial locations compared with appendicular and cranial locations. Appendicular tumors demonstrated an OS of 50% (95% CI, 36%-63%) at 5 years and 39% (95% CI, 26%-52%) at 10 years. OS for axial tumors was 37% (95% CI, 25%-49%) and 31% (95% CI, 20%-43%), whereas it was 74% (95% CI, 59%-84%) and 67% (95% CI, 50%-79%) for cranial tumors at 5 and 10 years, respectively. When controlling for age, sex, tumor origin, and tumor location, the presence of metastasis (hazard ratio [HR], 12.38; 95% CI, 5.75-26.65; p < 0.001) and 1-cm size increase (HR, 1.16; 95% CI, 1.09-1.23; p < 0.001) were both independently associated with an increased risk of death. Tumor location showed different behaviors depending on patient age. In comparison to cranial tumors at age 20 years, the HR was 5.56 (95% CI, 1.47-21.05; p = 0.01) for axial tumors and 6.26 (95% CI, 1.54-25.42; p = 0.01) for appendicular tumors. At age 60 years, those ratios were 0.10 (95% CI, 0.02-0.55; p = 0.01) and 0.14 (95% CI, 0.04-0.58; p = 0.01), respectively. CONCLUSIONS Our data suggest that extraskeletal tumors are more common than previously reported; however, this factor does not have clear prognostic value. Presence of metastatic disease and increased tumor size are the main predictors of poor survival outcome. Cranial tumors appear to have a different clinical behavior with our data suggesting better overall survival in young patients (compared with axial and appendicular locations) and a worse survival outcome in older patients. LEVEL OF EVIDENCE Level IV, prognostic study.
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Affiliation(s)
- Brian A. Schneiderman
- Harbor-UCLA Medical Center, Los Angeles, CA USA ,Stritch School of Medicine, Loyola University Chicago, 2160 South First Avenue, Maywood, IL 60153 USA
| | - Stephanie A. Kliethermes
- Stritch School of Medicine, Loyola University Chicago, 2160 South First Avenue, Maywood, IL 60153 USA
| | - Lukas M. Nystrom
- Stritch School of Medicine, Loyola University Chicago, 2160 South First Avenue, Maywood, IL 60153 USA
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Mendenhall WM, Reith JD, Scarborough MT, Stechmiller BK, Mendenhall NP. Mesenchymal Chondrosarcoma. Int J Part Ther 2016; 3:300-304. [PMID: 31772981 DOI: 10.14338/ijpt-16-00019.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 10/12/2016] [Indexed: 11/21/2022] Open
Abstract
Purpose To review the treatment and outcomes of patients with mesenchymal chondrosarcomas (MC). Materials and Methods Review of the pertinent literature. Results MC is a rare aggressive small round blue cell malignancy that may arise in either bone or soft tissue. It usually presents in the 2nd or 3rd decade of life and exhibits an approximately equal gender predilection. Patients usually present with pain and swelling. The majority of MCs arise in either the trunk or extremities. Distant metastases are present at diagnosis in about 15% of patients. The most common sites for distant metastases are lung and bone. The optimal treatment is surgery. Although the role of adjuvant chemotherapy is unclear, an anthracycline-based chemotherapy regimen combined with ifosfamide or cisplatin, may be considered. Adjuvant radiation therapy (RT) is employed for patients with close (<5 mm) or positive margins as well as those with incompletely resectable tumors. The most common mechanism of recurrence is hematogenous dissemination. Although most recurrences are observed within 5 years of treatment, late recurrences are not unusual. The likelihood of successful salvage in the event of a recurrence is modest. The overall survival rates for all patients are approximately 50% at 5 years and 40% at 10 years. The overall survival rates for the subset of patients with localized disease that is resected are approximately 70% to 80% at 5 years and 60% at 10 years. Conclusion Patients with MCs are optimally treated with surgery. The role of adjuvant chemotherapy is uncertain. However, given the relatively high risk of recurrence, adjuvant chemotherapy should be considered in medically fit patients. Radiation therapy should be considered for those with incompletely resectable tumors and those with inadequate margins.
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Affiliation(s)
- William M Mendenhall
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL, USA.,University of Florida Health Proton Therapy Institute, Jacksonville, FL, USA
| | - John D Reith
- Department of Pathology, University of Florida College of Medicine, Gainesville, FL, USA
| | - Mark T Scarborough
- Department of Orthopaedic Surgery, University of Florida College of Medicine, Gainesville, FL, USA
| | - Bruce K Stechmiller
- Department of Medicine, University of Florida College of Medicine, Gainesville, FL, USA
| | - Nancy P Mendenhall
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL, USA.,University of Florida Health Proton Therapy Institute, Jacksonville, FL, USA
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13
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De Amorim Bernstein K, Liebsch N, Chen YL, Niemierko A, Schwab JH, Raskin K, Lozano-Calderon SA, Cote G, Harmon DC, Choy E, Haynes A, Mullen J, Hornicek FJ, DeLaney TF. Clinical outcomes for patients after surgery and radiation therapy for mesenchymal chondrosarcomas. J Surg Oncol 2016; 114:982-986. [PMID: 27790706 DOI: 10.1002/jso.24435] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 08/18/2016] [Indexed: 12/18/2022]
Abstract
INTRODUCTION We report the outcome of 23 patients with mesenchymal chondrosarcomas treated with surgery and radiation therapy +/- chemotherapy. The intent of the project was to review the impact of patient and treatment variables on treatment outcome, in particular with regard to extent of surgery and radiation dose. PATIENTS AND METHODS Twenty-three patients with mesenchymal chondrosarcomas were treated with surgery and radiation therapy (min. dose 44 Gy; max. dose 78 Gy; median dose 60 Gy; mean dose 61 Gy). RESULTS The median survival for the entire cohort of patients was 21.65 years (95% confidence interval ± 4.25). The 5- and 10-year OS was 78.6%. Median disease-free survival for the 23 patients was 7.2 years. Disease-free survival (DFS) at 3 and 5 years was 70.7% and 57.8%, respectively. The local control rate at 5 and 10 years was 89.5% (95%CI 64.1-97.3%). Only three patients experienced local failure, three patients had regional failure, and eight developed distant metastases. CONCLUSIONS In this cohort of patients local tumor control was high when using a combination of surgery and radiation. There was not a clear relationship between radiation dose and local tumor control. J. Surg. Oncol. 2016;114:982-986. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Karen De Amorim Bernstein
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Norbert Liebsch
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Yen-Lin Chen
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Andrzej Niemierko
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Joseph H Schwab
- Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Kevin Raskin
- Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Santiago A Lozano-Calderon
- Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Gregory Cote
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - David C Harmon
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Edwin Choy
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Alex Haynes
- Department of General Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - John Mullen
- Department of General Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Francis J Hornicek
- Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Thomas F DeLaney
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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14
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Abstract
Mesenchymal chondrosarcomas (MC) are rare and aggressive forms of chondrosarcoma. They are distinct tumors arising in unicentric or multicentric locations from both skeletal and extraskeletal tissues. The most affected region is the facial skeleton, especially the jaws. In this report, we present a case of MC primarily involving the mandible in a 60-year-old female patient.
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Affiliation(s)
- Sumit Majumdar
- Department of Oral Pathology, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Rajyalakshmi Boddepalli
- Department of Oral Pathology, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Divya Uppala
- Department of Oral Pathology, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - A Kameswara Rao
- Department of Oral Pathology, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
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15
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Uppaluri SAS, Yin LH, Goh GH. Maxillary mesenchymal chondrosarcoma presenting with epistaxis in a child. J Radiol Case Rep 2015; 9:33-8. [PMID: 26629302 DOI: 10.3941/jrcr.v9i8.2419] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Mesenchymal chondrosarcomas are a rare variant of primary chondrosarcomas and can pose a diagnostic dilemma, especially when the features on conventional imaging are equivocal for an aggressive lesion. There is very little PET-CT experience in mesenchymal chondrosarcomas as per the literature and to the best of our knowledge, we are the first to describe a maxillary mesenchymal chondrosarcoma on PET-CT imaging. We report a case where PET-CT not only complemented conventional imaging in suspecting a malignant osseous lesion, but also was indicative of the grade of the tumor.
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Affiliation(s)
| | - Loi Hoi Yin
- Department of Diagnostic Radiology, National University Hospital, Singapore
| | - Giap Hean Goh
- Department of Pathology, National University Hospital, Singapore
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16
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Mesenchymal Chondrosarcoma in Children and Young Adults: A Single Institution Retrospective Review. Sarcoma 2015; 2015:608279. [PMID: 26146478 PMCID: PMC4469840 DOI: 10.1155/2015/608279] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 05/04/2015] [Accepted: 05/21/2015] [Indexed: 01/09/2023] Open
Abstract
Background. Mesenchymal chondrosarcoma is an aggressive, uncommon histologic entity arising in bone and soft tissues. We reviewed our institutional experience with this rare diagnosis. Methods. We conducted a retrospective chart review on patients with mesenchymal chondrosarcoma over a 24-year period. Clinicopathologic and radiographic features were reviewed. Results. Twelve patients were identified. Nine were females; median age was 14.5 years (1.2–19.7 years). The most common site was the head/neck (7/12). Disease was localized in 11/12 patients (one with lung nodules). Six with available tissue demonstrated NCOA2 rearrangement by FISH. Six underwent upfront surgical resection, and six received neoadjuvant therapy (2 chemotherapy alone and 4 chemotherapy and radiation). All patients received adjuvant chemotherapy (most commonly ifosfamide/doxorubicin) and/or radiation (median dose 59.4 Gy). At a median follow-up of 4.8 years, 5-year disease-free survival and overall survival were 68.2% (95% CI 39.8%, 96.6%) and 88.9% (95% CI 66.9%, 100%). Two patients had distant recurrences at 15 and 42 months, respectively. Conclusion. Aggressive surgical resection of mesenchymal chondrosarcoma with chemoradiotherapy yields excellent local control and may reduce likelihood of late recurrence. Characterization of downstream targets of the HEY1-NCOA2 fusion protein, xenograft models, and drug screening are needed to identify novel therapeutic strategies.
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17
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Gherman V, Tomuleasa C, Bungardean C, Crisan N, Ona VD, Feciche B, Irimie A, Coman I. Management of renal extraskeletal mesenchymal chondrosarcoma. BMC Surg 2014; 14:107. [PMID: 25511186 PMCID: PMC4289544 DOI: 10.1186/1471-2482-14-107] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 11/27/2014] [Indexed: 11/11/2022] Open
Abstract
Background Primary mesenchymal chondrosarcoma of the kidney is an extremely rare malignant tumor. To our best knowledge, only 9 such cases have been reported so far. Case presentation In the current paper, we present the case of a 67 year-old patient with recurrent left lumbar pain, increased fatigability and intermittent macroscopic hematuria. He underwent a surgical resection of the left kidney and left hemicolon. The pathological diagnosis was primary extraskeletal renal mesenchymal chondrosarcoma. Overall survival was 9 months, with pulmonary metastasis and local recurrence at 6 months. The management of the patient is described, from the initial differential diagnosis, after the first clinical examination to the surgical resection, with a special emphasis on the surgical procedures that were carried out. Conclusion Extraskeletal chondrosarcoma of primary origin in the kidney are extremely rare tumors with a highly malignant potential and very poor prognosis. Because the role of chemotherapy or radiation therapy has not been evaluated properly yet, we underline the importance of surgery in the management of such cases as the main and best approach to achieve clinical remission and long-term survival, provided the patient is referred to a surgical consult in time.
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Affiliation(s)
| | - Ciprian Tomuleasa
- Research Center for Functional Genomics and Translational Medicine at the Iuliu Hatieganu, University of Medicine and Pharmacy, Cluj Napoca, Romania.
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18
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Suzuki Y, Todo Y, Okamoto K, Kato H, Yamashiro K, Hasegawa T. Mesenchymal chondrosarcoma of the uterus. Pathol Int 2014; 64:45-7. [PMID: 24471970 DOI: 10.1111/pin.12130] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Yoshihiro Suzuki
- Department of Obstetrics and Gynecology, Abashiri Kosei hospital, Abashiri, Japan
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19
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Yu L, Li M, Lin R, Mu Y, Zhao J. Mesenchymal chondrosarcoma of the right buccal region: A case report and review of the literature. Oncol Lett 2014; 8:2557-2560. [PMID: 25364427 PMCID: PMC4214473 DOI: 10.3892/ol.2014.2595] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 08/22/2014] [Indexed: 11/23/2022] Open
Abstract
Extraskeletal mesenchymal chondrosarcoma (EMCS) is a rare malignant cartilaginous tumor arising from the soft tissues. The most common areas of extraskeletal origin are the lower extremities, the orbits and the central nervous system, among others. In this study, the case of primary EMCS arising from the right buccal region in a 26-year old female is presented. Histological and immunohistochemical analysis confirmed the diagnosis of EMCS. Subseqently, the patient was treated with radical surgery, but declined chemotherapy or radiotherapy, which was recommended. One year after surgery, no recurrence had been identified in the patient. To the best of our knowledge, only one case of primary EMCS of the buccal region has been reported previously. In the current study, a case of primary EMCS of the buccal region is presented.
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Affiliation(s)
- Lijiang Yu
- Department of Oral and Maxillofacial Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, P.R. China
| | - Mingliang Li
- Department of Oral and Maxillofacial Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, P.R. China
| | - Runtai Lin
- Department of Oral and Maxillofacial Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, P.R. China
| | - Yue Mu
- Department of Oral and Maxillofacial Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, P.R. China
| | - Jizhi Zhao
- Department of Oral and Maxillofacial Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, P.R. China
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20
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Andersson C, Osterlundh G, Enlund F, Kindblom LG, Hansson M. Primary spinal intradural mesenchymal chondrosarcoma with detection of fusion gene HEY1-NCOA2: A paediatric case report and review of the literature. Oncol Lett 2014; 8:1608-1612. [PMID: 25202377 PMCID: PMC4156271 DOI: 10.3892/ol.2014.2364] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 05/07/2014] [Indexed: 11/09/2022] Open
Abstract
Mesenchymal chondrosarcoma is an extremely rare malignant tumour that most commonly originates in the bone, but is also present in extraskeletal sites. The tumour is morphologically characterized by a biphasic pattern of small round cells and islands of cartilage. Spinal mesenchymal chondrosarcomas are even rarer and, therefore, few investigations exist regarding the biological behaviour of the tumours. In the present study, we report a case of a 10-year-old female presenting with 9 months of back pain and radiographic findings of an intradural lesion measuring 1.5 cm at the level of Th4. The tumour was completely excised and subjected to pathological analyses. Following detection of the HEY1-NCOA2 fusion gene, the tumour was morphologically and immunohistochemically defined as an intradural mesenchymal chondrosarcoma attached to the dura mater. In this study, we validate the recent identification of the fusion gene HEY1-NCOA2 in paediatric extraskeletal mesenchymal chondrosarcomas. The relevant literature is reviewed and further discussed in relation to our findings.
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Affiliation(s)
- Carola Andersson
- Department of Clinical Pathology and Cytology, Sahlgrenska University Hospital, Gothenburg SE-413 45, Sweden
| | - Gustaf Osterlundh
- Department of Pediatrics, The Queen Silvia Children's Hospital, University of Gothenburg, Gothenburg SE-416 85, Sweden
| | - Fredrik Enlund
- Department of Clinical Pathology and Cytology, Sahlgrenska University Hospital, Gothenburg SE-413 45, Sweden
| | - Lars-Gunnar Kindblom
- Department of Musculoskeletal Pathology, Royal Orthopedic Hospital, NHS Foundation Trust, Birmingham B31 2AP, UK
| | - Magnus Hansson
- Department of Clinical Pathology and Cytology, Sahlgrenska University Hospital, Gothenburg SE-413 45, Sweden ; Department of Medical Biosciences, Section for Pathology, Umeå University, SE-901 85 Umeå, Sweden
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21
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Chebib I, Hornicek FJ, Bredella MA, Deshpande V, Nielsen GP. Histologic variants of chondrosarcoma. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.mpdhp.2014.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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22
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Abstract
Mesenchymal chondrosarcoma of the kidney is a very rare entity with no definite treatment protocol. Herein, we describe one such case with discussion of its diagnosis and management. The patient had a well circumscribed mass in right kidney extending into the inferior vena cava and metastasis to both the lungs. Right nephrectomy was performed and the histopathological examination confirmed the diagnosis to be renal mesenchymal chondrosarcoma. After surgical removal of the tumor, the patient was given chemotherapy with Cisplatin and Epirubicin, following which there was significant regression of lung nodules.
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Affiliation(s)
- Ruchita Tyagi
- Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Nandita Kakkar
- Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rakesh Kumar Vasishta
- Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Mayank Mohan Aggarwal
- Department of Urology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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23
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Hu HJ, Liao MY, Xu LY. Primary retroperitoneal extraskeletal mesenchymal chondrosarcoma involving the vena cava: A case report. Oncol Lett 2014; 7:1970-1974. [PMID: 24932271 PMCID: PMC4049765 DOI: 10.3892/ol.2014.2012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 03/04/2014] [Indexed: 11/23/2022] Open
Abstract
The current study presents a case of extraskeletal mesenchymal chondrosarcoma (ESMC) involving the vena cava that originally occurred in the retroperitoneum of a 61-year-old female. Following excision of the masses, pathological examination confirmed a diagnosis of primary ESMC. Mesenchymal chondrosarcomas are extremely rare in comparison to conventional chondrosarcomas and even more so when arising in an extraskeletal location. In the current report, the major characteristics of ESMC are discussed and a review of the current knowledge regarding this rare disease entity is presented.
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Affiliation(s)
- Hui-Juan Hu
- Department of Computed Tomography, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, P.R. China
| | - Mei-Yan Liao
- Department of Computed Tomography, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, P.R. China
| | - Li-Ying Xu
- Department of Computed Tomography, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, P.R. China
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24
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Nugent D, Cheong D, Monforte H, Ayala AG, Letson GD, Keen J. Periosteal Mesenchymal Chondrosarcoma in the Distal Part of the Tibia of a Four-Year-Old Boy: A Case Report. JBJS Case Connect 2013; 3:e117. [PMID: 29252517 DOI: 10.2106/jbjs.cc.m.00044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Dylan Nugent
- Department of Orthopaedics and Rehabilitation, University of Florida College of Medicine-Jacksonville, 655 West 8th Street, Jacksonville, FL 32209.
| | - David Cheong
- Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612-9416
| | - Hector Monforte
- Anatomic Pathology, All Children's Hospital-Johns Hopkins Medicine, 801 6th Avenue South, St. Petersburg, FL 33701
| | - Alberto G Ayala
- Department of Pathology, The Methodist Hospital, 6565 Fannin Street, Houston, TX 77030
| | - G Douglas Letson
- Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612-9416
| | - Jeffrey Keen
- Flagler Orthopaedics and Sports Medicine, 61 Memorial Medical Parkway, Suite 2801, Palm Coast, FL 32164
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25
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O'Neill JP, Bilsky MH, Kraus D. Head and neck sarcomas: epidemiology, pathology, and management. Neurosurg Clin N Am 2013; 24:67-78. [PMID: 23174358 DOI: 10.1016/j.nec.2012.08.010] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Sarcomas of the head, neck, and skull base represent a heterogeneous group of tumors with distinct prognostic features. There have been significant improvements in characterizing these sarcomas using traditional morphologic assessments and more recent immunohistochemical analysis. Surgery is the mainstay of treatment followed by radiation therapy. Treatment modalities have changed in select pediatric sarcomas, for which new chemotherapeutic combinations have improved survival statistics. The high rate of distant failure emphasizes the need for novel systemic and directed molecular therapies. Tumor grade, size, and margin status are key factors in survival.
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Affiliation(s)
- James Paul O'Neill
- Department of Head and Neck Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.
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26
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A rare case of extraskeletal mesenchymal chondrosarcoma with dedifferentiation arising from the buccal space in a young male. J Maxillofac Oral Surg 2013; 14:293-9. [PMID: 25838713 DOI: 10.1007/s12663-013-0500-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Accepted: 03/13/2013] [Indexed: 12/23/2022] Open
Abstract
Extraskeletal mesenchymal chondrosarcoma (EMCS) is a rare and aggressive pathological variant of chondrosarcoma arising from soft tissues of mainly the extremities, meninges/dura, trunk, and orbits. EMCS comprises only 2 % of all soft tissue sarcomas and only 6 % of them arise from soft tissue in the head and neck region. It usually affects in the second and third decade of life and is common in women. It runs a very rapid clinical course with distant metastases and has poor prognosis and survival rates. Histologically it has a dimorphic presentation of small round mesenchymal cells interspersed with foci of cartilaginous differentiation. Radiographically it appears as a soft tissue lobulated mass with various patterns of calcification. This is the first case of primary and recurrent EMCS originating in the buccal space with unusual features of dedifferentiation. The diagnostic challenges in this case were the inconclusive FNAC results, lack of radiographic evidence of characteristic calcifications and presence of areas of myxoid material and dedifferentiation on histopathology. The clinical, cytological, histological, immunohistochemical, radiographic, PET-CT findings and management with review of literature is presented. The diagnostic and management pitfalls of this extremely rare tumor are also discussed.
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27
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Abstract
Mesenchymal chondrosarcoma (MSC) is a very rare sarcoma that is highly malignant with frequent local recurrences and distant metastases leading to a very poor long-term outcome. It differs from classical chondrosarcomas in that it occurs more often in children and commonly in extraskeletal locations. Hardly any evidence-based recommendations for treatment exist. We present the case of a 9-year old boy (pre- and intraoperative findings and histopathological details) who was initially admitted with the diagnosis of a jugular paraganglioma and discuss this case in the light of the recent literature.
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28
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Seo CY, Jung ST, Byun JW. Extraskeletal mesenchymal chondrosarcoma in the axillary region: reports of two cases. KOREAN JOURNAL OF PATHOLOGY 2012; 46:483-8. [PMID: 23136576 PMCID: PMC3490122 DOI: 10.4132/koreanjpathol.2012.46.5.483] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2011] [Revised: 12/01/2011] [Accepted: 12/02/2011] [Indexed: 11/24/2022]
Abstract
Extraskeletal mesenchymal chondrosarcomas (EMCs) are relatively uncommon, and a location in the upper extremity, especially in the shoulder or axillary region, is rare. Furthermore, the radiographic findings of EMCs do not show any features that distinguish them from other neoplasms, and therefore, definitive diagnoses are made based on histological features. EMC is an aggressive tumor with a poor prognosis, and requires wide surgical excision. However, its treatment may involve peculiarities such as a difficulty in obtaining a proper surgical margin in the axillary region or shoulder. In this report, the authors present two rare cases of EMCs in the axillary region.
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Affiliation(s)
- Chang-Young Seo
- Department of Orthopedic Surgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
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29
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Mavrogenis AF, Gambarotti M, Angelini A, Palmerini E, Staals EL, Ruggieri P, Papagelopoulos PJ. Chondrosarcomas revisited. Orthopedics 2012; 35:e379-90. [PMID: 22385450 DOI: 10.3928/01477447-20120222-30] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Chondrosarcomas are malignant bone tumors with pure hyaline cartilage differentiation; myxoid changes, calcification, or ossification may be present. Several subtypes of chondrosarcomas exist. Behavior patterns vary, ranging from slow-growing nonmetastasizing lesions to aggressive metastasizing sarcomas. Symptoms are usually mild, with duration ranging from several months to years, and usually consist of persistent, dull, aching pain or palpable masses. Radiographic findings include bone expansion with cortical thickening, radiolucent areas with variably distributed punctate or ring-like matrix calcifications, cortical erosion or destruction, endosteal scalloping, and scant or absent periosteal reaction; extension into the soft tissue may be present. Histological differential diagnosis from benign cartilaginous lesions can be achieved by increased cellularity, enlarged plump nuclei, binucleated cells, hyperchromatic nuclear pleomorphism, and permeation of cortical or medullary bone. Atypia is usually mild to moderate; necrosis and mitoses can be seen, particularly in high-grade lesions. Adequate surgery is the mainstay of treatment. High-grade and pelvic chondrosarcomas are best managed with wide resection. Because of the low metastatic potential and low local recurrence rate noted with intralesional surgery, low-grade chondrosarcomas can be treated with curettage (with or without treatment of the defect cavity) with a local adjuvant, such as phenol or cryotherapy. Adjuvant chemotherapy may be considered for mesenchymal and dedifferentiated chondrosarcomas. Radiation therapy can be considered after incomplete resection or if resection is not feasible or would cause unacceptable morbidity.
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Affiliation(s)
- Andreas F Mavrogenis
- First Department of Orthopaedics, ATTIKON University Hospital, Athens University Medical School, 41 Ventouri St, 15562 Holargos, Athens, Greece.
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30
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Shakked RJ, Geller DS, Gorlick R, Dorfman HD. Mesenchymal Chondrosarcoma: Clinicopathologic Study of 20 Cases. Arch Pathol Lab Med 2012; 136:61-75. [DOI: 10.5858/arpa.2010-0362-oa] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Context.—Mesenchymal chondrosarcoma is a rare, high-grade malignancy of bone or soft tissue with a unique, biphasic histology and poor prognosis. Because of its rarity and variable length of disease-free survival, the natural history of the disease remains poorly understood.
Objective.—To present clinical, radiographic, and histopathologic features of mesenchymal chondrosarcoma from one of the largest case series collected by a single, senior-level bone pathologist.
Design.—Twenty cases were reviewed in consultations spanning 45 years.
Results.—Eighteen tumors (90%) originated in bone, and 2 tumors (10%) were of extraskeletal origin. Of the skeletal tumors, locations included craniofacial bones (n = 9; 50%), ribs and chest wall (n = 4; 22%), sacrum and spinal elements (n = 3; 17%), and lower extremities (n = 2; 11%), whereas soft tissue tumors were located about the scapula (n = 1; 50%) and lower extremity (n = 1; 50%). Plain radiographs demonstrated calcified, osteolytic lesions with extraosseous extension. Typical histologic features were identified consisting of small, round or spindled cells, interspersed with hyaline cartilage islands. Seventeen patients (85%) were treated surgically, and 8 patients (40%) received adjuvant treatment. Seven patients (35%) were living at last follow-up, 1.8 to 12.5 years after diagnosis, and 8 patients (40%) died between 1.2 and 21.8 years after diagnosis.
Conclusions.—Mesenchymal chondrosarcoma presents multiple challenges. Diagnostic pitfalls include inadequate biopsy samples, which may result in sample error. Sox9 has been proposed as a unique marker for mesenchymal chondrosarcoma which may improve diagnostic specificity. Treatment and prognosis vary considerably. Patients who receive surgery and chemotherapy seem to fare better. Multicenter studies with higher sample numbers may improve our understanding of this malignancy.
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31
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Dai X, Ma W, He X, Jha RK. Review of therapeutic strategies for osteosarcoma, chondrosarcoma, and Ewing's sarcoma. Med Sci Monit 2011; 17:RA177-190. [PMID: 21804475 PMCID: PMC3539609 DOI: 10.12659/msm.881893] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The most prevalent forms of bone cancer are osteosarcoma, chondrosarcoma, and Ewing’s sarcoma. Although chemotherapy and radiotherapy have replaced traditional surgical treatments, survival rates have undergone only marginal improvements. Current knowledge of the molecular pathways involved in each type of cancer has led to better approaches in cancer treatment. A number of cell signaling molecules are involved in tumorigenesis, and specific targets have been identified based on these signal transducers. This review highlights some of the important cellular pathways and potential therapeutic targets, tumor site-specific irradiation techniques, and novel drug delivery systems used to administer these drugs.
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Affiliation(s)
- Xing Dai
- Department of Orthopedic Surgery, 1st Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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32
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Goda JS, Ferguson PC, O'Sullivan B, Catton CN, Griffin AM, Wunder JS, Bell RS, Kandel RA, Chung PW. High-risk extracranial chondrosarcoma. Cancer 2011; 117:2513-9. [DOI: 10.1002/cncr.25806] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2010] [Revised: 09/25/2010] [Accepted: 10/12/2010] [Indexed: 01/02/2023]
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33
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Kurotaki H, Tateoka H, Takeuchi M, Yagihashi S, Kamata Y, Nagai K. Primary Mesenchymal Chondrosarcoma of the Lung: A Case Report with lmmunohistochemical and Ultra structural Studies. Pathol Int 2008. [DOI: 10.1111/j.1440-1827.1992.tb02887.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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34
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Dantonello TM, Int-Veen C, Leuschner I, Schuck A, Furtwaengler R, Claviez A, Schneider DT, Klingebiel T, Bielack SS, Koscielniak E. Mesenchymal chondrosarcoma of soft tissues and bone in children, adolescents, and young adults: experiences of the CWS and COSS study groups. Cancer 2008; 112:2424-31. [PMID: 18438777 DOI: 10.1002/cncr.23457] [Citation(s) in RCA: 114] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Mesenchymal chondrosarcoma (MCS) is a rare tumor with a strong tendency toward late recurrences leading to reported 10-year survival rates below 50%. The recommended treatment is resection with wide margins; the effectiveness of chemo- and radiotherapy remain poorly defined. As reports about MCS in young patients are scarce, treatment and outcomes of children/adolescents/young adults in the CWS and COSS studies were investigated. METHODS Since 1977, 15 of >7000 CWS and COSS patients <or=25 years had a confirmed diagnosis of MCS. RESULTS The median age was 16.6 (range, 1-25) and median follow-up 9.6 years (range, 1-22). Four MCS were osseous and 11 extraosseous. All but 1 patient had nonmetastatic disease. Tumor sites were head/neck (n = 6), paravertebral (n = 3), pelvis (n = 3), limbs (n = 2), and kidney (n = 1). All tumors were resected, but only 8 completely. Thirteen individuals received chemotherapy, 6 were irradiated. Actuarial 10-year event-free and overall survival rates were 53% and 67%, respectively. Four recurrences occurred, all within 4 years from diagnosis (3 local, 1 combined; 2 of these in irradiated patients). One of these patients survived after surgery and radiation for local recurrence. Seven of 8 patients whose tumors were completely resected during primary treatment, but only 4 of 7 patients with incomplete surgery survived disease-free. CONCLUSIONS This series of 15 MCS differs from others: the median age was young, most tumors were extraosseous, most patients received chemotherapy, and the outcome was better than published. Despite long-term follow-up, characteristic late metastatic recurrences were not observed. Treating MCS according to standard multimodal soft tissue/bone sarcoma regimens is proposed.
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Affiliation(s)
- Tobias M Dantonello
- Pediatrics 5 - Oncology, Hematology, Immunology, Olgahospital, Klinikum Stuttgart, Stuttgart, Germany.
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35
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Taori K, Patil P, Attarde V, Chandanshive S, Rangankar V, Rewatkar N. Primary retroperitoneal extraskeletal mesenchymal chondrosarcoma: a computed tomography diagnosis. Br J Radiol 2007; 80:e268-70. [PMID: 17989325 DOI: 10.1259/bjr/13711118] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Mesenchymal chondrosarcomas, although very rare compared with conventional chondrosarcomas, are one of the few primary malignant tumours of bone that sometimes also arise in the soft tissues. Here we present a rare case of retroperitoneal extraskeletal mesenchymal chondrosarcoma (ESMC) in a 50-year-old female that showed characteristic extensive calcification. In this report, we discuss CT features of ESMC with pathological correlation.
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Affiliation(s)
- K Taori
- Department of Radiology, Government Medical College, Nagpur, India 440003.
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36
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Angulo Hervías E, Lample Lacasa C, Crespo Rodríguez AM, Yagüe Romeo D. [Primary mesenchymal chondrosarcoma of the mediastinum]. RADIOLOGIA 2007; 49:358-61. [PMID: 17910876 DOI: 10.1016/s0033-8338(07)73794-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Cartilaginous lesions of the mediastinum are quite rare and primary cartilage forming tumors arising within the mediastinum are even more exceptional. Radiologic findings are unspecific. However, certain characteristics can orient the diagnosis. They are presented one mediastinal chondrosarcoma case in adult patient of patho-anatomical diagnosis. The findings described entail chest radiography, computed tomography and magnetic resonance.
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Affiliation(s)
- E Angulo Hervías
- Servicio de Radiodiagnóstico. Hospital Universitario Miguel Servet. Zaragoza. España.
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D'Andrea G, Caroli E, Capponi MG, Scicchitano F, Osti MF, Bellotti C, Ferrante L. Retroperitoneal mesenchymal chondrosarcoma mimicking a large retroperitoneal sacral schwannoma. Neurosurg Rev 2007; 31:225-9. [PMID: 17912561 DOI: 10.1007/s10143-007-0106-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2007] [Revised: 08/08/2007] [Accepted: 08/18/2007] [Indexed: 11/30/2022]
Abstract
We report a case of retroperitoneal chondrosarcoma in which preoperative radiological study induced to a possible diagnosis of sacral schwannoma. A 25-year-old woman was admitted to our neurosurgical institute for a progressive sciatic pain with gait difficulties with a sudden radicular deficit with right positive Lasegue's sign at 30 degrees, loss of Achilles reflex, sensory deficit on right S1 dermatome, and complete motor deficit of right plantar flexion. We performed an en bloc removal of the lesion via an anterior retroperitoneal approach. We believe that the treatment of choice is radical surgical excision of the tumor with complete en-bloc removal of the lesion; postoperative radiotherapy and chemotherapy should be valuated case by case.
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Affiliation(s)
- Giancarlo D'Andrea
- Chair of Neurosurgery, II Faculty of Medicine, University of Rome La Sapienza, S.Andrea Hospital, Rome, Italy.
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38
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Affiliation(s)
- Fengdong Zhao
- School of Medicine, Zhejiang University, Department of Orthopaedics, Sir Run Run Shaw Hospital, 3rd Qingchun Road East, Hangzhou, Zhejiang, China.
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39
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Pellitteri PK, Ferlito A, Fagan JJ, Suárez C, Devaney KO, Rinaldo A. Mesenchymal chondrosarcoma of the head and neck. Oral Oncol 2007; 43:970-5. [PMID: 17681487 DOI: 10.1016/j.oraloncology.2007.04.007] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2007] [Revised: 04/26/2007] [Accepted: 04/27/2007] [Indexed: 11/23/2022]
Abstract
Mesenchymal chondrosarcoma of the head and neck is an uncommon tumor with a potential for exhibiting highly aggressive behavior. When these tumors arise in the head and neck region, they appear to have a predilection for the maxillofacial skeleton; less often, they may involve other soft tissue sites in the head and neck. The diagnosis is challenging and may be assisted by molecular pathologic techniques when only limited tissue is available for analysis. Management is primarily surgical. Although adjuvant radiation appears to convey some benefit by reducing tumor bulk when these lesions have extended beyond bony confines, there is no evidence to suggest that this is associated with improved outcome. Chemotherapy does not appear to be effective in the limited experience documented thus far. Patients with complete local control following resection should be followed closely for development of distant metastasis, which signifies a worse clinical outcome. Future effective therapy may be found in the identification of molecular targets responsive to adjuvant chemotherapy or biologic modifiers.
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Affiliation(s)
- Phillip K Pellitteri
- Department of Otolaryngology-Head and Neck Surgery, Geisinger Medical Center, Danville, PA, USA
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40
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Anderson JT, Lucas GL. Extraskeletal mesenchymal chondrosarcoma of the forearm: a case report. J Hand Surg Am 2007; 32:389-92. [PMID: 17336849 DOI: 10.1016/j.jhsa.2007.01.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2005] [Revised: 12/26/2006] [Accepted: 01/02/2007] [Indexed: 02/02/2023]
Abstract
Mesenchymal chondrosarcomas represent less than 10% of all chondrosarcomas. The majority of these tumors arise from the skeleton; only 22% have an extraosseous origin. Of the extraskeletal locations, the meninges, brain, and thigh are the most common. Involvement of the forearm is a rare occurrence. This case report describes an extraskeletal mesenchymal chondrosarcoma involving the forearm.
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Affiliation(s)
- John T Anderson
- Department of Surgery, Section of Orthopaedics, University of Kansas School of Medicine-Wichita, Wichita, KS, USA.
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41
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Abstract
Abstract
Context.—Primary small round cell tumors of the bone are a heterogeneous group of malignant neoplasms presenting predominantly in children and adolescents. They include Ewing sarcoma/peripheral neuroectodermal tumor or Ewing family tumors, lymphoma, mesenchymal chondrosarcoma, and small cell osteosarcoma. Even though they share many morphological similarities, their unique biological and genetic characteristics have provided substantial insights into the pathology of these diverse neoplasms.
Objective.—To provide an overview of the clinical, radiologic, pathologic, and genetic characteristics of these tumors along with a pertinent review of the literature.
Data Sources.—A literature search using PubMed and Ovid MEDLINE was performed, and data were obtained from various articles pertaining to clinicopathologic, biological, and genetic findings in these tumors. Additionally, findings from rare cases have been included from author's subspecialty experience.
Conclusion.—The diagnosis of small round cell tumors can be made accurately by applying clinicopathologic criteria, as well as a panel of immunohistochemical and genetic studies in appropriate cases. Molecular genetic studies may provide further insight into the biology, histogenesis, and prognosis of these tumors.
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Affiliation(s)
- Meera Hameed
- Surgical Pathology, UMDNJ-New Jersey Medical School, Newark, NJ 07103, USA.
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42
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Müller S, Söder S, Oliveira AM, Inwards CY, Aigner T. Type II collagen as specific marker for mesenchymal chondrosarcomas compared to other small cell sarcomas of the skeleton. Mod Pathol 2005; 18:1088-94. [PMID: 15731776 DOI: 10.1038/modpathol.3800391] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Mesenchymal chondrosarcoma is a rare, usually highly malignant chondrogenic neoplasm. The diagnosis of mesenchymal chondrosarcoma can be challenging, it nonetheless has important therapeutic and diagnostic implications. Thus, biopsies of mesenchymal chondrosarcomas without conspicuous cartilaginous differentiation cannot be safely distinguished from other small cell mesenchymal neoplasms such as Ewing's sarcoma and peripheral neuroendrocrine tumors, synovial sarcomas and hemangiopericytomas, because all of these neoplasms might show overlapping histological features, and so far, there have been no safe immunohistochemical markers available in order to differentiate these neoplasms. In our study on a large series of mesenchymal chondrosarcomas (n=30) and other small cell sarcomas (Ewing's sarcomas (n=12), synovial sarcomas (n=6), hemangiopericytomas (n=5), small cell osteosarcomas (n=3), and desmoplastic small round cell tumors (n=1)), we could establish the presence of type II collagen in the extracellular tumor matrix of the small cell areas of mesenchymal chondrosarcomas as a specific and sensitive marker to identify mesenchymal chondrosarcomas and to exclude other small cell neoplasms (except chondroblastic areas in small cell osteosarcomas). In contrast, the S-100 protein was less sensitive and vimentin and total collagen content unspecific for discriminating these neoplasms. Thus, the presence of type II collagen in the extracellular tumor matrix significantly facilitates the diagnosis of mesenchymal chondrosarcomas in the absence of histologically visible chondroid matrix formation.
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Affiliation(s)
- Susanna Müller
- Department of Pathology, University of Erlangen-Nürnberg, Erlangen, Germany
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43
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Ikemoto S, Sugimura K, Yoshida N, Nakatani T. Chondrosarcoma of the urinary bladder and establishment of a human chondrosarcoma cell line (OCUU-6). Hum Cell 2005; 17:93-6. [PMID: 15859154 DOI: 10.1111/j.1749-0774.2004.tb00025.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Chondrosarcoma is a very rare tumor of the urinary bladder, with only 4 cases reported to date. In this study, we report on a case of a 73-year-old male who presented bladder mass and right hydroureteronephrosis. Radical cystectomy, right nephrectomy and left ureterocutaneoustomy were performed, and histological study disclosed chondrosarcoma of the urinary bladder. As reported in other cases, the tumor was highly aggressive with a short clinical course, and the patient died of carcinomatous pleuritis at one month after surgery. Subsequently, we successfully established a human chondrosarcoma cell line (OCUU-6) from the pleural effusion of the patient.
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Affiliation(s)
- Shinichi Ikemoto
- Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan
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Abstract
Chondrosarcoma of the head and neck region is a rare disease, representing approximately 0.1% of all head and neck neoplasms. The 5-year survival rate of chondrosarcoma is 70-80%, showing relatively good prognosis; however, it is known to progress slowly and eventually cause multiple metastases. In this study, we reviewed chondrosarcoma cases experienced at Yonsei University Medical College during the last 15 years to investigate its clinical characteristics and treatment outcome. The medical records of 8 patients who were diagnosed with chondrosarcoma of the head and neck region and underwent surgical treatment between December 1990 and December 2002 were retrospectively reviewed. The primary sites were sinus, mastoid, jugular foramen and thyroid cartilage. In all patients, the initial treatment modality was surgery, and postoperative radiation therapy was performed in 4 cases. The pathological findings showed chondrosarcoma in 7 cases and mesenchymal chondrosarcoma in 1 case. The treatment outcome resulted in 3 cases of recurrence, of which 2 cases were treated successfully and the other case expired of disease, indicating a survival rate of 87.5%. In the case that resulted in death, complete excision could not be achieved. Therefore, we concluded that wide excision is a beneficial initial treatment of this rare disease.
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Affiliation(s)
- Sei Young Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, Korea
| | - Young Chang Lim
- Department of Otolaryngology-Head and Neck Surgery, Konkuk University College of Medicine, Seoul, Korea
| | - Mee Hyun Song
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Jae Yeon Seok
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
| | - Won Sang Lee
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Chang Choi
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
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45
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Ikemoto S, Sugimura K, Yoshida N, Nakatani T. Chondrosarcoma of the urinary bladder and establishment of a human chondrosarcoma cell line (OCUU-6). Hum Cell 2004; 17:93-6. [PMID: 15369141 DOI: 10.1111/j.1749-0774.2004.tb00080.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Chondrosarcoma is a very rare tumor of the urinary bladder, with only 4 cases reported to date. In this study, we report on a case of a 73-year-old male who presented bladder mass and right hydroureteronephrosis. Radical cystectomy, right nephrectomy and left ureterocutaneoustomy were performed, and histological study disclosed chondrosarcoma of the urinary bladder. As reported in other cases, the tumor was highly aggressive with a short clinical course, and the patient died of carcinomatous pleuritis at one month after surgery. Subsequently, we successfully established a human chondrosarcoma cell line (OCUU-6) from the pleural effusion of the patient.
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Affiliation(s)
- Shinichi Ikemoto
- Department of Urology, Osaka City University Graduate School of Medicine, Osaka. Japan
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46
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Nussbeck W, Neureiter D, Söder S, Inwards C, Aigner T. Mesenchymal chondrosarcoma: an immunohistochemical study of 10 cases examining prognostic significance of proliferative activity and cellular differentiation. Pathology 2004; 36:230-3. [PMID: 15203726 DOI: 10.1080/00313020410001716669] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
AIMS Mesenchymal chondrosarcoma is a rare malignant chondrogenic neoplasm that tends to affect young adults and teenagers. The prognosis is unpredictable, and the identification of prognostic markers that could aid in determining the behaviour of this tumour would be helpful. There are few studies in the literature that have attempted to address this issue. METHODS AND RESULTS In this study, we explored the prognostic significance of three different parameters: (1) tissue morphology of small cell areas, (2) the expression of tumour differentiation marker genes, and (3) the proliferation rate. Our results did not show a correlation of prognosis with the histological features of the neoplastic small cell areas or the expression of tumour differentiation genes. However, the proliferative activity of the tumour cells appeared to have some prognostic significance as related to patient survival. CONCLUSION Mesenchymal chondrosarcoma is a rare tumour with a wide clinical range of behaviour. Therefore, it is difficult to obtain reliable prognostic parameters. Nevertheless, our study suggests that proliferative activity may be a useful prognostic parameter for mesenchymal chondrosarcomas.
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Affiliation(s)
- W Nussbeck
- Department of Pathology, University of Erlangen-Nürnberg, Erlangen, Germany
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47
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Banks KP, Ly JQ, Thompson LD, Michaelson PG, Davis SW. Mesenchymal chondrosarcoma of sinonasal cavity: a case report and brief literature review. ACTA ACUST UNITED AC 2004. [DOI: 10.1016/s1571-4675(03)00125-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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48
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Acero J, Escrig M, Gimeno M, Montenegro T, Navarro-Vila C. Extraskeletal myxoid chondrosarcoma of the infratemporal fossa: a case report. Int J Oral Maxillofac Surg 2003; 32:342-5. [PMID: 12767886 DOI: 10.1054/ijom.2002.0335] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Extraskeletal myxoid chondrosarcoma is a rare tumour affecting the head and neck. We present a new case located in the midfacial region. Clinical, pathological and therapeutical features are reviewed.
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Affiliation(s)
- J Acero
- Department of Maxillofacial Surgery, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Doctor Esquerdo 46, 28007 Madrid, Spain.
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49
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Knott PD, Gannon FH, Thompson LDR. Mesenchymal chondrosarcoma of the sinonasal tract: a clinicopathological study of 13 cases with a review of the literature. Laryngoscope 2003; 113:783-90. [PMID: 12792311 DOI: 10.1097/00005537-200305000-00004] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES/HYPOTHESIS Mesenchymal chondrosarcoma of the sinonasal tract is a rare, malignant tumor of extraskeletal origin. Isolated cases have been reported in the English literature, with no large series evaluating the clinicopathological aspects of these tumors. STUDY DESIGN Retrospective review. METHODS Thirteen patients with sinonasal mesenchymal chondrosarcoma were retrieved from the Otorhinolaryngologic-Head and Neck Registry of the Armed Forces Institute of Pathology. RESULTS Nine women and 4 men (age range, 11 to 83 y; mean age, 38.8 y) presented with nasal obstruction (n = 8), epistaxis (n = 7), or mass effect (n = 4), or a combination of these. No patients reported prior head and neck irradiation. The maxillary sinus was the most common site of involvement (n = 9), followed by the ethmoid sinuses (n = 7) and the nasal cavity (n = 5). Tumors had an overall mean size of 5.1 cm. Microscopically, the tumors displayed a small, blue, round cell morphology appearance arranged in a hemangiopericytoma-like pattern with foci of cartilaginous matrix. All cases were managed by surgery with adjuvant radiation therapy (n = 4) and/or chemotherapy (n = 3). The overall mean survival was 12.1 years, although five of six patients who developed local recurrences died of disease (mean survival, 6.5 y). Six patients were alive and disease free (mean survival, 17.3 y), and two patients were lost to follow-up. CONCLUSIONS Mesenchymal chondrosarcoma of the sinonasal tract is an aggressive tumor with a predilection for young women. The pattern of growth and scarcity of cartilaginous matrix result in frequent misdiagnosis. Recurrence develops in approximately one-third of patients and seems to predict a poor prognosis. Aggressive, exenterative surgery combined with adjuvant therapy appears to yield the best clinical outcome.
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Affiliation(s)
- P Daniel Knott
- Department of Otolaryngology and Communicative Diseases, Cleveland Clinic Foundation, Ohio, USA
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50
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White DW, Ly JQ, Beall DP, McMillan MD, McDermott JH. Extraskeletal mesenchymal chondrosarcoma: case report. Clin Imaging 2003; 27:187-90. [PMID: 12727057 DOI: 10.1016/s0899-7071(02)00538-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This is a case report of an extraskeletal mesenchymal chondrosarcoma (ESMC) that originally occurred in the retroperitoneum of a 24-year-old female and later metastasized to the left proximal humerus. Mesenchymal chondrosarcomas are very rare in comparison to conventional chondrosarcomas and even more so when arising from an extraskeletal location. In this report, we discuss the major characteristics of ESMC and offer a review of the current knowledge regarding this rare disease entity.
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Affiliation(s)
- Douglas W White
- Department of Radiology and Nuclear Medicine, Wilford Hall Medical Center, 2200 Bergquist Drive, Ste. 1, Lackland AFB, TX 78236-5300, USA.
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