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Qubain L, Hirsch BP, Reddivalla N, Baaj AA, Leddy LR, Ravinsky RA. Metastatic mesenchymal chondrosarcoma of the spine managed with nonsurgical treatment: A case report and review of the literature. Clin Case Rep 2022; 10:e6712. [PMID: 36514464 PMCID: PMC9734085 DOI: 10.1002/ccr3.6712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 11/14/2022] [Accepted: 11/25/2022] [Indexed: 12/14/2022] Open
Abstract
In this report, we present a rare case of a 17-year-old male patient with metastatic mesenchymal chondrosarcoma (MCS) managed with nonsurgical treatment who subsequently demonstrated a favorable response to concurrent chemotherapy and radiation therapy, followed with pazopanib target therapy. Further study regarding nonoperative care for metastatic MCS of spine is warranted.
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Affiliation(s)
- Leeann Qubain
- University of Arizona College of Medicine – PhoenixPhoenixArizonaUSA
| | - Brandon P. Hirsch
- Department of Orthopaedics SurgeryUniversity of Arizona College of Medicine – PhoenixPhoenixArizonaUSA
| | | | - Ali A. Baaj
- Department of NeurosurgeryUniversity of Arizona College of Medicine – PhoenixPhoenixArizonaUSA
| | - Lee R. Leddy
- Department of Orthopaedics and Physical MedicineMedical University of South CarolinaCharlestonSouth CarolinaUSA
| | - Robert A. Ravinsky
- Department of Orthopaedics and Physical MedicineMedical University of South CarolinaCharlestonSouth CarolinaUSA
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2
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To YH, Orme L, Lewin J. The Role of Systemic Therapies in the Management of Bone Sarcoma. Sarcoma 2021. [DOI: 10.1007/978-981-15-9414-4_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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3
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Shafaat O, Chapman PR, Zandifar A, Sotoudeh E, Baumgartner EM, Sotoudeh H. Heavily calcified parapharyngeal space mesenchymal chondrosarcoma: Imaging and pathological findings and a review of the literature. Neuroradiol J 2020; 34:45-48. [PMID: 32998632 DOI: 10.1177/1971400920962821] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Parapharyngeal space (PPS) masses are relatively rare lesions of the head and neck, and account for 0.5-1.5% of head and neck lesions. The most common lesion to occur in the PPS is a benign salivary neoplasm, typically pleomorphic adenoma either from the deep parotid or from ectopic parotid tissue rests within the PPS. A calcified or ossified mass in this location is exceedingly rare, but a calcified variant of pleomorphic adenoma has been reported. In this study, we present a patient with a heavily calcified PPS mesenchymal chondrosarcoma with an unusual presentation. We discuss the imaging and pathologic findings followed by a review of the current literature.
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Affiliation(s)
- Omid Shafaat
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, USA.,Department of Radiology and Interventional Neuroradiology, Isfahan University of Medical Sciences, Iran
| | - Philip R Chapman
- Division of Neuroradiology, Department of Radiology, University of Alabama at Birmingham, USA
| | - Alireza Zandifar
- Department of Radiology and Interventional Neuroradiology, Isfahan University of Medical Sciences, Iran.,Department of Neurology, Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Iran
| | | | | | - Houman Sotoudeh
- Division of Neuroradiology, Department of Radiology, University of Alabama at Birmingham, USA
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4
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de Souza LL, Pontes FSC, Fonseca FP, da Mata Rezende DS, Vasconcelos VCS, Pontes HAR. Chondrosarcoma of the jaw bones: a review of 224 cases reported to date and an analysis of prognostic factors. Int J Oral Maxillofac Surg 2018; 48:452-460. [PMID: 30528199 DOI: 10.1016/j.ijom.2018.11.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 10/25/2018] [Accepted: 11/14/2018] [Indexed: 12/13/2022]
Abstract
The objective was to integrate the available published data on chondrosarcoma (CHS) of the jaw bones into a comprehensive analysis of its clinical and histological features, treatment, and prognostic factors. An electronic search was undertaken in October 2017. To be eligible, the publication had to provide sufficient clinical/histological data to confirm the diagnosis. One hundred and ten publications (224 cases of CHS) were identified and included. There was a slightly higher prevalence of CHS in males than in females. Most subjects with CHS were in the second to fifth decades of life. The most common symptom was swelling and the most commonly observed location was the maxilla. Histologically, most tumours were of the conventional type and were low grade tumours. The treatment of choice was tumour resection. Histological grade, treatment with chemotherapy alone, and the presentation of recurrence or metastasis were found to be significant independent prognostic factors: patients who presented high-grade tumours, who received chemotherapy alone as the treatment of choice, and those who presented recurrence or metastasis were more likely to have a worse prognosis. In addition, radical surgery associated with radiotherapy as the treatment protocol showed a better prognosis.
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Affiliation(s)
- L L de Souza
- Oral Surgery and Pathology Department, João de Barros Barreto University Hospital/Federal University of Pará, Belém, Pará, Brazil.
| | - F S C Pontes
- Oral Surgery and Pathology Department, João de Barros Barreto University Hospital/Federal University of Pará, Belém, Pará, Brazil
| | - F P Fonseca
- Department of Oral Surgery and Pathology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - D S da Mata Rezende
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - V C S Vasconcelos
- Oral Surgery and Pathology Department, João de Barros Barreto University Hospital/Federal University of Pará, Belém, Pará, Brazil
| | - H A R Pontes
- Oral Surgery and Pathology Department, João de Barros Barreto University Hospital/Federal University of Pará, Belém, Pará, Brazil; Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
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5
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Extraosseous Intradural Chondrosarcoma of the Cervical Spine: A Case Report with Brief Review of Literature. Case Rep Radiol 2018; 2018:6921020. [PMID: 29682386 PMCID: PMC5851319 DOI: 10.1155/2018/6921020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 01/30/2018] [Indexed: 12/20/2022] Open
Abstract
Mesenchymal chondrosarcoma (MCS) is a malignant cancer of the cartilage that accounts for less than 1% of all chondrosarcomas and typically occurs within the bone. One-third of all mesenchymal chondrosarcomas are extraosseous soft tissue sarcomas, rendering this as an uncommon entity. We report a rare case of an extraosseous chondrosarcoma with the cervical spinal canal in a 21-year-old male. The purpose of this case report is to discuss the imaging characteristics of this pathology proven diagnosis.
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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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7
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Xu J, Li D, Xie L, Tang S, Guo W. Mesenchymal chondrosarcoma of bone and soft tissue: a systematic review of 107 patients in the past 20 years. PLoS One 2015; 10:e0122216. [PMID: 25849226 PMCID: PMC4388572 DOI: 10.1371/journal.pone.0122216] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2014] [Accepted: 02/19/2015] [Indexed: 12/27/2022] Open
Abstract
Background Mesenchymal chondrosarcoma(MCS) is a rare high-grade variant of chondrosarcoma. Consensus has not been reached on its optimal management. Resection with wide margins is usually recommended, but the effect of margins has been demonstrated by little positive evidence. Moreover, the effectiveness of adjuvant chemo- and/or radiotherapy remains controversial. Objectives To describe the clinical characteristics and outcomes of MCS of bone and soft tissue, to assess the efficacies of surgery, chemotherapy and radiation, and finally to deliver a more appropriate therapy. Materials and Methods We reviewed EMBASE-, MEDLINE-, Cochrane-, Ovid- and PubMed-based to find out all cases of MCS of bone and soft tissue described between April 1994 and April 2014. Description of treatment and regular follow-up was required for each study. Language was restricted to English and Chinese. Issues of age, gender, location, metastasis, and treatment were all evaluated for each case. Kaplan-Meier Method and Cox Proportional Hazard Regression Model were used in the survival analysis. Results From the 630 identified publications, 18 meeting the inclusion criteria were selected, involving a total of 107 patients. Based on these data, the 5-, 10-and 20-year overall survival are 55.0%, 43.5% and 15.7% respectively. The 5-, 10-, 20- year event-free survival rates are 45.0%, 27.2% and 8.1%, respectively. Treatment without surgery is associated with poorer overall survival and event-free survival. Negative surgical margins could significantly bring down the local-recurrence rate and are associated with a higher event-free survival rate. Chemotherapy regime based on anthracyclines does not benefit the overall survival. The addition of radiation therapy is not significantly associated with the overall or event-free survival. However, we recommend radiation as the salvage therapy for patients with positive margin so as to achieve better local control. Conclusions This review shows that surgery is essential in the management of MCS of bone and soft tissue. Appropriate adjuvant therapy may reduce local recurrence, but cannot benefit the overall survival.
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Affiliation(s)
- Jie Xu
- Musculoskeletal Tumour Centre, People’s Hospital, Peking University, Beijing, China
| | - Dasen Li
- Musculoskeletal Tumour Centre, People’s Hospital, Peking University, Beijing, China
| | - Lu Xie
- Musculoskeletal Tumour Centre, People’s Hospital, Peking University, Beijing, China
| | - Shun Tang
- Musculoskeletal Tumour Centre, People’s Hospital, Peking University, Beijing, China
| | - Wei Guo
- Musculoskeletal Tumour Centre, People’s Hospital, Peking University, Beijing, China
- * E-mail:
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Frezza AM, Cesari M, Baumhoer D, Biau D, Bielack S, Campanacci DA, Casanova J, Esler C, Ferrari S, Funovics PT, Gerrand C, Grimer R, Gronchi A, Haffner N, Hecker-Nolting S, Höller S, Jeys L, Jutte P, Leithner A, San-Julian M, Thorkildsen J, Vincenzi B, Windhager R, Whelan J. Mesenchymal chondrosarcoma: prognostic factors and outcome in 113 patients. A European Musculoskeletal Oncology Society study. Eur J Cancer 2014; 51:374-81. [PMID: 25529371 DOI: 10.1016/j.ejca.2014.11.007] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 11/03/2014] [Accepted: 11/11/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Mesenchymal chondrosarcoma (MCS) is a distinct, very rare sarcoma with little evidence supporting treatment recommendations. PATIENTS AND METHODS Specialist centres collaborated to report prognostic factors and outcome for 113 patients. RESULTS Median age was 30 years (range: 11-80), male/female ratio 1.1. Primary sites were extremities (40%), trunk (47%) and head and neck (13%), 41 arising primarily in soft tissue. Seventeen patients had metastases at diagnosis. Mean follow-up was 14.9 years (range: 1-34), median overall survival (OS) 17 years (95% confidence interval (CI): 10.3-28.6). Ninety-five of 96 patients with localised disease underwent surgery, 54 additionally received combination chemotherapy. Sixty-five of 95 patients are alive and 45 progression-free (5 local recurrence, 34 distant metastases, 11 combined). Median progression-free survival (PFS) and OS were 7 (95% CI: 3.03-10.96) and 20 (95% CI: 12.63-27.36) years respectively. Chemotherapy administration in patients with localised disease was associated with reduced risk of recurrence (P=0.046; hazard ratio (HR)=0.482 95% CI: 0.213-0.996) and death (P=0.004; HR=0.445 95% CI: 0.256-0.774). Clear resection margins predicted less frequent local recurrence (2% versus 27%; P=0.002). Primary site and origin did not influence survival. The absence of metastases at diagnosis was associated with a significantly better outcome (P<0.0001). Data on radiotherapy indications, dose and fractionation were insufficiently complete, to allow comment of its impact on outcomes. Median OS for patients with metastases at presentation was 3 years (95% CI: 0-4.25). CONCLUSIONS Prognosis in MCS varies considerably. Metastatic disease at diagnosis has the strongest impact on survival. Complete resection and adjuvant chemotherapy should be considered as standard of care for localised disease.
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Affiliation(s)
- Anna Maria Frezza
- The London Sarcoma Service, University College of London Hospital, London, United Kingdom; University Campus Bio-Medico, Rome, Italy
| | | | - Daniel Baumhoer
- Bone Tumor Reference Centre at the Institute of Pathology, University Hospital Basel, Basel, Switzerland
| | | | - Stephen Bielack
- The Cooperative German-Austrian-Swiss Osteosarcoma Study Group (COSS Group), Germany
| | | | - José Casanova
- Coimbra University Medical Center, Coimbra, Portugal
| | - Claire Esler
- Leicester Royal Infirmary, Leicester, United Kingdom
| | | | - Philipp T Funovics
- Universitätsklinik für Orthopädie der Medizinischen, Universität Wien, Wien, Austria
| | | | - Robert Grimer
- The Royal Orthopaedic Hospital, Birmingham, United Kingdom
| | | | | | | | - Sylvia Höller
- Bone Tumor Reference Centre at the Institute of Pathology, University Hospital Basel, Basel, Switzerland
| | - Lee Jeys
- The Royal Orthopaedic Hospital, Birmingham, United Kingdom
| | - Paul Jutte
- University Medical Center Groningen, Groningen, The Netherlands
| | | | | | | | | | - Reinhard Windhager
- Universitätsklinik für Orthopädie der Medizinischen, Universität Wien, Wien, Austria
| | - Jeremy Whelan
- The London Sarcoma Service, University College of London Hospital, London, United Kingdom.
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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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10
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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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11
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Cates JMM, Coffin CM. Extraskeletal cartilaginous, osseous, and chordoid tumors in children and adolescents. Pediatr Dev Pathol 2012; 15:255-66. [PMID: 22420731 DOI: 10.2350/10-07-0875-pb.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Extraskeletal cartilaginous, osseous, and chordoid tumors are extraordinarily rare in children and adolescents. These lesions are diagnostically challenging due to their rarity and their overlap with metastatic osteosarcoma, reactive or metabolic calcifying and bone-forming masses, various pseudosarcomatous proliferations such as myositis ossificans, and other rare genetic or metabolic disorders. This article reviews the clinicopathologic features and differential diagnosis of extraskeletal cartilaginous, osseous, and chordoid neoplasms in the first two decades of life and highlights the use of diagnostic adjuncts.
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Affiliation(s)
- Justin M M Cates
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, TN, USA
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12
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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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Darling EM, Guilak F. A neural network model for cell classification based on single-cell biomechanical properties. Tissue Eng Part A 2009; 14:1507-15. [PMID: 18620486 DOI: 10.1089/ten.tea.2008.0180] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The potential success of tissue engineering or other cell-based therapies is dependent on factors such as the purity and homogeneity of the source cell populations. The ability to enrich cell harvests for specific phenotypes can have significant effects on the overall success of such therapies. While most techniques for cell sorting or enrichment have relied on cell surface markers, recent studies have shown that single-cell mechanical properties can serve as identifying markers of phenotype. In this study, a neural network modeling approach was developed to classify mesenchymal-derived primary and stem cells based on their biomechanical properties. Cell sorting was simulated using previously published data characterizing the mechanical properties of several different cell types as measured by atomic force microscopy. Neural networks were trained using combined data sets, with the resultant groupings analyzed for their purity, efficiency, and enrichment. Heterogeneous populations of zonal chondrocytes, chondrosarcoma cells, and mesenchymal-lineage cells, respectively, could all be classified into enriched subpopulations. Additionally, adult stem cells (adipose-derived or bone marrow-derived) separated disproportionately into nodes associated with the three primary mesenchymal lineages examined. These findings suggest that mathematical approaches such as neural network modeling, in combination with novel measures of cell properties, may provide a means of classifying and eventually sorting mixed populations of cells that are otherwise difficult to identify using more established techniques. In this respect, the identification of biomechanically based cell properties that increase the percentage of stem cells capable of differentiating into predictable lineages may improve the overall success of cell-based therapies.
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Affiliation(s)
- Eric M Darling
- Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA
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14
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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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15
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De Cecio R, Migliaccio I, Falleti J, Del Basso De Caro M, Pettinato G. Congenital intracranial mesenchymal chondrosarcoma: case report and review of the literature in pediatric patients. Pediatr Dev Pathol 2008; 11:309-13. [PMID: 17990930 DOI: 10.2350/07-05-0279.1] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2007] [Accepted: 08/21/2007] [Indexed: 11/20/2022]
Abstract
In this paper we report the 1st case of a congenital intracranial mesenchymal chondrosarcoma in a 2-month-old infant, apparently present at birth. A magnetic resonance image showed a large left parietal solid mass, while microscopy revealed a mixture of undifferentiated small cells and mature hyaline cartilage islands, positive for vimentin, S-100, and CD99. A surgical excision was performed but the patient died after a few weeks as a result of a rapid relapse of the tumor. We also review the pediatric cases (in patients less than 20 years old) of extraskeletal (intracranial) mesenchymal chondrosarcomas of the literature, with a focus on the most recent cytogenetic and immunohistochemical studies.
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Affiliation(s)
- Rossella De Cecio
- Dipartimento di Scienze Biomorfologiche e Funzionali, Università degli Studi di Napoli Federico II, Naples, Italy
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16
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Affiliation(s)
- Jay Pahade
- Department of Radiology, Musculoskeletal Section, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, E/CC-4, Boston, MA 02215, USA
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17
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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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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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19
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Abstract
Primary cartilage-forming tumors of the bone are a large group among the rare bone tumors. The clinical and radiographic findings of the different entities show similar findings. Bone biopsy is still the most relevant examination in the final diagnosis of the lesion. The requirements for a correct biopsy and the main features of the macroscopic and histologic findings of cartilage tumors are presented from the viewpoint of the pathologist. Differentiation between benign enchondroma and grade I chondrosarcoma requires close interdisciplinary cooperation to avoid over-treatment and relapse. Rare low-grade malignant cartilage tumors such as clear-cell chondrosarcoma need to be diagnosed in specialized centres to arrive at the correct therapy. The morphologic features of mesenchymal chondrosarcoma, clear-cell chondrosarcoma and secondary chondrosarcoma in osteochondroma are demonstrated. The aim is to correlate the morphologic and radiographic features. The same applies to benign entities such as osteochondroma, chondroblastoma and chondromyxoid fibroma.
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Affiliation(s)
- G Delling
- Institut für Osteopathologie -- Zentrum Klinische Pathologie, Universitätsklinikum Hamburg-Eppendorf.
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