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Yin J, Ren P. New advances in the treatment of chondrosarcoma under the PD-1/PD-L1 pathway. J Cancer Res Ther 2024; 20:522-530. [PMID: 38687921 DOI: 10.4103/jcrt.jcrt_2269_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 02/02/2024] [Indexed: 05/02/2024]
Abstract
ABSTRACT Bone sarcomas encompass a group of spontaneous mesenchymal malignancies, among which osteosarcoma, Ewing sarcoma, chondrosarcoma, and chordoma are the most common subtypes. Chondrosarcoma, a relatively prevalent malignant bone tumor that originates from chondrocytes, is characterized by endogenous cartilage ossification within the tumor tissue. Despite the use of aggressive treatment approaches involving extensive surgical resection, chemotherapy, and radiotherapy for patients with osteosarcoma, chondrosarcoma, and chordoma, limited improvements in patient outcomes have been observed. Furthermore, resistance to chemotherapy and radiation therapy has been observed in chondrosarcoma and chordoma cases. Consequently, novel therapeutic approaches for bone sarcomas, including chondrosarcoma, need to be uncovered. Recently, the emergence of immunotherapy and immune checkpoint inhibitors has garnered attention given their clinical success in various diverse types of cancer, thereby prompting investigations into their potential for managing chondrosarcoma. Considering that circumvention of immune surveillance is considered a key factor in the malignant progression of tumors and that immune checkpoints play an important role in modulating antitumor immune effects, blockers or inhibitors targeting these immune checkpoints have become effective therapeutic tools for patients with tumors. One such checkpoint receptor implicated in this process is programmed cell death protein-1 (PD-1). The association between PD-1 and programmed cell death ligand-1 (PD-L1) and cancer progression in humans has been extensively studied, highlighting their remarkable potential as biomarkers for cancer treatment. This review comprehensively examines available studies on current chondrosarcoma treatments and advancements in anti-PD-1/PD-L1 blockade therapy for chondrosarcoma.
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Affiliation(s)
- Jiawei Yin
- Trauma Department of Orthopedics, The Second Hospital of Shandong University, Jinan, China
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2
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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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Hayashida S, Ikenaga N, Nakata K, Nakamura S, Abe T, Ideno N, Endo M, Noguchi S, Oda Y, Nakamura M. Repeated robotic pancreatectomy for recurrent pancreatic metastasis of mesenchymal chondrosarcoma: A case report. Asian J Endosc Surg 2023; 16:795-799. [PMID: 37574440 DOI: 10.1111/ases.13240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 07/31/2023] [Indexed: 08/15/2023]
Abstract
Mesenchymal chondrosarcoma is a rare subset of sarcomas accounting for 3%-10% of all cases of chondrosarcomas. Radical resection is the only curative strategy, even in patients with metastatic tumors. However, data regarding treatment strategies remain limited owing to the small number of cases. Herein, we report a patient who underwent repeated robotic pancreatectomy for recurrent pancreatic metastasis originating from extraskeletal mesenchymal chondrosarcoma of the pelvis. First, robotic pancreaticoduodenectomy with a reconstruction of pancreaticogastrostomy was performed for synchronous pancreatic metastasis 5 months after the primary resection of mesenchymal chondrosarcoma. Ten months after robotic pancreaticoduodenectomy, tumor recurrence was observed at the tail end of the pancreas, which was removed by reperforming robotic distal pancreatectomy. Given the precise tissue manipulation that can be achieved with robotic articulated forceps, the peripheral splenic artery and pancreas were easily isolated and divided in close proximity to the tumor. The central part of the pancreas was preserved. Robotic surgery allowed safe and effective resection of the reconstructed remnant pancreas. The patient survived for 28 months after primary tumor resection. Repeated pancreatectomy with minimally invasive techniques is a feasible and curative treatment for metastatic mesenchymal chondrosarcoma.
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Affiliation(s)
- Sayuri Hayashida
- Departments of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Naoki Ikenaga
- Departments of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kohei Nakata
- Departments of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - So Nakamura
- Departments of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshiya Abe
- Departments of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Noboru Ideno
- Departments of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Makoto Endo
- Department of Orthopedics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shoko Noguchi
- Department of Diagnostic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshinao Oda
- Department of Diagnostic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masafumi Nakamura
- Departments of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Dudzisz-Śledź M, Kondracka M, Rudzińska M, Zając AE, Firlej W, Sulejczak D, Borkowska A, Szostakowski B, Szumera-Ciećkiewicz A, Piątkowski J, Rutkowski P, Czarnecka AM. Mesenchymal Chondrosarcoma from Diagnosis to Clinical Trials. Cancers (Basel) 2023; 15:4581. [PMID: 37760551 PMCID: PMC10527018 DOI: 10.3390/cancers15184581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 09/08/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
Mesenchymal chondrosarcoma (MCS) is a rare subtype of chondrosarcoma with a poor prognosis. Although these tumors are sensitive to radiotherapy/chemotherapy, the standard treatment for localized MCS is only surgical resection, and there are no established treatment guidelines for patients with advanced and metastatic MCS. Due to the low incidence of MCS, the pathology of these tumors is still unknown, and other therapeutic options are lacking. Some studies show the potential role of the PDGF/PPI3K/AKT, PKC/RAF/MEK/ERK, and pRB pathways, and BCL2 overexpression in the pathogenesis of MCS. These findings provide an opportunity to use protein kinases and BCL2 inhibitors as potential therapy in MCS. In this review, we summarize the current knowledge about MCS diagnosis and treatment options. We show the immunological and molecular biomarkers used in the diagnosis of MCS. In addition, we discuss the known prognostic and predictive factors in MCS. Finally, we present the novel trends, including targeted therapies and ongoing clinical trials using protein kinase inhibitors and the death receptor 5 (DR5) agonist, which may be the focus of future MCS treatment studies.
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Affiliation(s)
- Monika Dudzisz-Śledź
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (M.D.-Ś.); (M.K.); (M.R.); (A.E.Z.); (W.F.); (A.B.); (B.S.); (P.R.)
| | - Monika Kondracka
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (M.D.-Ś.); (M.K.); (M.R.); (A.E.Z.); (W.F.); (A.B.); (B.S.); (P.R.)
- Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Monika Rudzińska
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (M.D.-Ś.); (M.K.); (M.R.); (A.E.Z.); (W.F.); (A.B.); (B.S.); (P.R.)
- Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Agnieszka E. Zając
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (M.D.-Ś.); (M.K.); (M.R.); (A.E.Z.); (W.F.); (A.B.); (B.S.); (P.R.)
| | - Wiktoria Firlej
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (M.D.-Ś.); (M.K.); (M.R.); (A.E.Z.); (W.F.); (A.B.); (B.S.); (P.R.)
- Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Dorota Sulejczak
- Department of Experimental Pharmacology, Mossakowski Medical Research Centre Polish Academy of Sciences, 02-106 Warsaw, Poland;
| | - Aneta Borkowska
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (M.D.-Ś.); (M.K.); (M.R.); (A.E.Z.); (W.F.); (A.B.); (B.S.); (P.R.)
| | - Bartłomiej Szostakowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (M.D.-Ś.); (M.K.); (M.R.); (A.E.Z.); (W.F.); (A.B.); (B.S.); (P.R.)
| | - Anna Szumera-Ciećkiewicz
- Department of Pathology, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland;
- Department of Diagnostic Hematology, Institute of Hematology and Transfusion Medicine, 02-776 Warsaw, Poland
| | - Jakub Piątkowski
- Institute of Genetics and Biotechnology, Faculty of Biology, University of Warsaw, 02-106 Warsaw, Poland;
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (M.D.-Ś.); (M.K.); (M.R.); (A.E.Z.); (W.F.); (A.B.); (B.S.); (P.R.)
| | - Anna M. Czarnecka
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (M.D.-Ś.); (M.K.); (M.R.); (A.E.Z.); (W.F.); (A.B.); (B.S.); (P.R.)
- Department of Experimental Pharmacology, Mossakowski Medical Research Centre Polish Academy of Sciences, 02-106 Warsaw, Poland;
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Bernard M, Samargandi R. Unusual Presentation of Extraskeletal Mesenchymal Chondrosarcoma: A Case Report. Cureus 2023; 15:e45974. [PMID: 37900409 PMCID: PMC10600616 DOI: 10.7759/cureus.45974] [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] [Accepted: 09/25/2023] [Indexed: 10/31/2023] Open
Abstract
Mesenchymal chondrosarcomas are extremely rare and aggressive tumors that primarily affect patients between the ages of 20 and 30. These neoplasms are typically found in the lower limbs and cranial region. Their occurrence within soft tissues is exceedingly rare, and the initial presentation often includes immediate metastatic dissemination. Given the extraordinarily low prevalence of extraskeletal mesenchymal chondrosarcoma, treatment approaches remain non-standardized. Surgical resection combined with neoadjuvant chemotherapy or radiotherapy is the most commonly favored strategy by medical teams. In this case report, we present the case of a 72-year-old patient with no specific medical history, who presented with a non-metastatic extraskeletal mesenchymal chondrosarcoma located in the popliteal fossa. The therapeutic intervention encompassed surgical resection followed by adjuvant radiotherapy. After 18 months of follow-up period, there was no evidence of local recurrence or distant metastases. The disparity between the patient's clinical characteristics and the existing medical literature may provide new insights into understanding this neoplastic entity.
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Affiliation(s)
- Mathilde Bernard
- Orthopedic Surgery Department, Centre Hospitalier Régional Universitaire (CHRU) de Tours, Tours, FRA
| | - Ramy Samargandi
- Orthopedic Surgery Department, Centre Hospitalier Régional Universitaire (CHRU) de Tours, Tours, FRA
- Orthopedic Surgery Department, Faculty of Medicine, University of Jeddah, Jeddah, SAU
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Pan SY, Lai CZ, Chen WC, Chen YH, Lin CH, Chang H, Huang CP, Yeh CC. Chondrosarcoma of Ureter in an Elderly Patient: A Case Report. Medicina (B Aires) 2023; 59:medicina59030454. [PMID: 36984455 PMCID: PMC10051176 DOI: 10.3390/medicina59030454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/15/2023] [Accepted: 02/21/2023] [Indexed: 02/26/2023] Open
Abstract
Chondrosarcoma is a rare type of cancer that can affect the upper urinary tract. Because of its rarity, the clinical presentation of chondrosarcoma can be similar to other urinary tract conditions, such as renal colic, hematuria, and urothelial carcinoma. The primary treatment for chondrosarcoma is the surgical removal of the tumor, and radiation or chemotherapy may be used for advanced cases. However, because of the limited number of patients with this condition, there are no established guidelines for chemotherapy, and the outcomes are unclear. In this case, we present a 71-year-old female patient who was diagnosed with ureteral chondrosarcoma. She presented with abdominal pain and hydronephrosis, and a tumor was found beneath a small stone. The patient underwent nephroureterectomy and received oral fluorouracil chemotherapy due to the advanced stage of the disease. Fortunately, the patient survived, and at the 7 months post-operative follow-up there was no evidence of recurrence. In conclusion, the chondrosarcoma of the upper urinary tract is a rare condition that can be difficult to diagnose due to its similarity to other urinary tract conditions. Treatment typically involves the surgical removal of the tumor, with radiation or chemotherapy reserved for advanced cases. However, because of the limited number of patients, there are no established guidelines for chemotherapy, and the outcomes of treatment are unclear.
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Affiliation(s)
- Szu-Ying Pan
- Department of Urology, China Medical University Hospital, Taichung 404332, Taiwan
| | - Chien-Zhi Lai
- School of Medicine, College of Medicine, China Medical University, Taichung 404333, Taiwan
| | - Wen-Chi Chen
- Department of Urology, China Medical University Hospital, Taichung 404332, Taiwan
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung 404333, Taiwan
| | - Yung-Hsiang Chen
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung 404333, Taiwan
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung 413305, Taiwan
| | - Che-Hung Lin
- Division of Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung 404332, Taiwan
| | - Han Chang
- School of Medicine, College of Medicine, China Medical University, Taichung 404333, Taiwan
- Department of Pathology, China Medical University Hospital, Taichung 404332, Taiwan
| | - Chi-Ping Huang
- Department of Urology, China Medical University Hospital, Taichung 404332, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung 404333, Taiwan
| | - Ching-Chung Yeh
- Department of Urology, China Medical University Hospital, Taichung 404332, Taiwan
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7
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Chu B, Jiang S, Sun Q, Chen Q, Peng X. Extraskeletal mesenchymal chondrosarcoma of the distal thumb: A case report. Int J Surg Case Rep 2023; 103:107903. [PMID: 36652820 PMCID: PMC9860411 DOI: 10.1016/j.ijscr.2023.107903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 01/06/2023] [Accepted: 01/11/2023] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Chondrosarcoma is the most common primary malignant bone tumor of the hand, Mesenchymal chondrosarcoma (MCS) is a rare subtype of chondrosarcoma, extraosseous mesenchymal chondrosarcoma (EMCS) is even rarer. CASE PRESENTATION We presented a case of primary EMCS involving the distal thumb in a 59-year-old man. The patient had abnormally grown nails and a higher skin temperature than the contralateral finger. After admission to our hospital, we found that the tumor has the possibility of malignant transformation, but imageological examinations did not reveal invasive bone lesions and calcification. Finally, due to the patient's strong desire to preserve the thumb, a conservative surgical approach was selected to preserve the patient's finger function, and histological examination indicated MCS. CONCLUSION EMCS is a highly malignant tumor with strong tendency of invasion and metastasis. Imaging is sometimes difficult to diagnose, and pathology is a necessary part of distinguishing between benign and malignant tumors. Operation is the major treatment to EMCS, meanwhile, adjuvant radiotherapy and chemotherapy also be effective. The overall prognosis is poor.
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Affiliation(s)
- Bin Chu
- Department of Orthopedics, Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei, Anhui, China
| | - Shifeng Jiang
- Department of Orthopedics, Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei, Anhui, China
| | - Quanqiu Sun
- Department of Orthopedics, Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei, Anhui, China
| | - Qi Chen
- Department of Radiology, Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei, Anhui, China
| | - Xin Peng
- Department of Orthopedics, Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei, Anhui, China.
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Xu B, Rooper LM, Dermawan JK, Zhang Y, Suurmeijer AJH, Dickson BC, Demicco EG, Antonescu CR. Mesenchymal chondrosarcoma of the head and neck with HEY1::NCOA2 fusion: A clinicopathologic and molecular study of 13 cases with emphasis on diagnostic pitfalls. Genes Chromosomes Cancer 2022; 61:670-677. [PMID: 35672279 PMCID: PMC9813803 DOI: 10.1002/gcc.23075] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/24/2022] [Accepted: 05/26/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Mesenchymal chondrosarcoma (MCS) is a rare translocation-associated sarcoma, driven by a canonical HEY1::NCOA2 fusion. The tumors typically have a biphasic phenotype of primitive small blue round cells intermixed with hyaline cartilage. The head and neck (HN) region is a common site for MCS, accounting for 12-45% of all cases reported. AIMS We assembled a relatively large cohort of 13 molecularly confirmed HN MCS for a detailed clinicopathologic analysis. The underlying fusion events were determined using fluorescence in situ hybridization and/or targeted RNA sequencing. RESULTS The median age of presentation was 19 years. Five MCSs (39%) had an intraosseous presentation (skull, maxilla, palate, and mandible), while the remaining eight cases occurred in the brain/meninges, orbit, and nasal cavity. Microscopically, HN MCSs were characterized by primitive round cells arranged in a distinctive nested architecture and a rich staghorn vasculature. A cartilaginous component of hyaline cartilage islands and/or single chondrocytes were present in 69% cases. A combined immunoprofile of CD99(+)/SATB2(+)/CD34(-)/STAT6(-) was typically noted. As this immunoprofile is non-specific, the referral diagnoses in cases lacking a cartilaginous component included Ewing sarcoma family and osteosarcoma. Among the seven patients with follow-up data, three developed distant metastasis and one died of disease. CONCLUSION HN MCS may arise at intra- or extra-osseous sites. The HN MCS appears to have a more prolonged survival compared other MCS sites. Testing for HEY1::NCOA2 fusion is recommended in HN tumors with nested round cell morphology and staghorn vasculature that lack a distinctive cartilaginous component.
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Affiliation(s)
- Bin Xu
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Lisa M Rooper
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Josephine K Dermawan
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Yanming Zhang
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Albert JH Suurmeijer
- Department of Pathology and Laboratory Medicine, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Brendan C Dickson
- Department of Pathology & Laboratory Medicine, Mount Sinai Hospital & Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Elizabeth G. Demicco
- Department of Pathology & Laboratory Medicine, Mount Sinai Hospital & Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Cristina R. Antonescu
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Safaric Tepes P, Segovia D, Jevtic S, Ramirez D, Lyons SK, Sordella R. Patient-derived xenografts and in vitro model show rationale for imatinib mesylate repurposing in HEY1-NCoA2-driven mesenchymal chondrosarcoma. J Transl Med 2022; 102:1038-1049. [PMID: 36775418 DOI: 10.1038/s41374-021-00704-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 11/05/2021] [Accepted: 11/06/2021] [Indexed: 01/17/2023] Open
Abstract
Mesenchymal chondrosarcoma (MCS) is a high-grade malignancy that represents 2-9% of chondrosarcomas and mostly affects children and young adults. HEY1-NCoA2 gene fusion is considered to be a driver of tumorigenesis and it has been identified in 80% of MCS tumors. The shortage of MCS samples and biological models creates a challenge for the development of effective therapeutic strategies to improve the low survival rate of MCS patients. Previous molecular studies using immunohistochemical staining of patient samples suggest that activation of PDGFR signaling could be involved in MCS tumorigenesis. This work presents the development of two independent in vitro and in vivo models of HEY1-NCoA2-driven MCS and their application in a drug repurposing strategy. The in vitro model was characterized by RNA sequencing at the single-cell level and successfully recapitulated relevant MCS features. Imatinib, as well as specific inhibitors of ABL and PDGFR, demonstrated a highly selective cytotoxic effect targeting the HEY1-NCoA2 fusion-driven cellular model. In addition, patient-derived xenograft (PDX) models of MCS harboring the HEY1-NCoA2 fusion were developed from a primary tumor and its distant metastasis. In concordance with in vitro observations, imatinib was able to significantly reduce tumor growth in MCS-PDX models. The conclusions of this study serve as preclinical results to revisit the clinical efficacy of imatinib in the treatment of HEY1-NCoA2-driven MCS.
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Affiliation(s)
- Polona Safaric Tepes
- Cold Spring Harbor Laboratory, 1 Bungtown Road, Cold Spring Harbor, NY, 11724, USA.
- Faculty of Pharmacy, University of Ljubljana, Kongresni trg 12, 1000, Ljubljana, Slovenia.
| | - Danilo Segovia
- Cold Spring Harbor Laboratory, 1 Bungtown Road, Cold Spring Harbor, NY, 11724, USA
- Graduate Program in Molecular and Cellular Biology, Stony Brook University, 100 Nicolls Rd, Stony Brook, NY, 11794, USA
| | - Sania Jevtic
- Phytoform Labs Ltd., Lawes Open Innovation Hub, West Common, Harpenden, Hertfordshire, England, UK
| | - Daniel Ramirez
- Hospital for Special Surgery, Pathology and Laboratory Medicine, 535 E 70th St, New York, NY, 10021, USA
| | - Scott K Lyons
- Cold Spring Harbor Laboratory, 1 Bungtown Road, Cold Spring Harbor, NY, 11724, USA
| | - Raffaella Sordella
- Cold Spring Harbor Laboratory, 1 Bungtown Road, Cold Spring Harbor, NY, 11724, USA
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10
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Strach MC, Grimison PS, Hong A, Boyle R, Stalley P, Karim R, Connolly EA, Bae S, Desai J, Crowe P, Singhal N, Bhadri VA. Mesenchymal chondrosarcoma: An Australian multi-centre cohort study. Cancer Med 2022; 12:368-378. [PMID: 35603739 PMCID: PMC9844591 DOI: 10.1002/cam4.4849] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 04/29/2022] [Accepted: 05/04/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Mesenchymal chondrosarcoma (MCS) is an ultra-rare sarcoma that follows a more aggressive course than conventional chondrosarcoma. This study evaluates prognostic factors, treatments (surgery, chemotherapy, and radiation), and outcomes in an Australian setting. METHODS We collected demographics, clinicopathological variables, treatment characteristics, and survival status from patients with MCS registered on the national ACCORD sarcoma database. Outcomes include overall survival (OS) and progression-free survival (PFS). RESULTS We identified 22 patients with MCS between 2001-2022. Median age was 28 (range 10-59) years, 19 (86%) had localised disease at diagnosis of whom 16 had surgery (84%), 11 received radiation (58%), and 10 chemotherapy (53%). Ten (52%) developed recurrence and/or metastases on follow-up and three patients with initial metastatic disease received surgery, radiation, and chemotherapy. At a median follow-up of 50.9 (range 0.4-210) months nine patients had died. The median OS was 104.1 months (95% CI 25.8-182.3). There was improved OS for patients with localised disease who had surgical resection of the primary (p = 0.003) and those with ECOG 0-1 compared to 2-3 (p = 0.023) on univariate analysis. CONCLUSIONS This study demonstrates contemporary Australian treatment patterns of MCS. The role of chemotherapy for localised disease remains uncertain. Understanding treatment patterns and outcomes help support treatment decisions and design of trials for novel therapeutic strategies.
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Affiliation(s)
- Madeleine C. Strach
- Chris O'Brien LifehouseSydneyNew South WalesAustralia,Royal Prince Alfred HospitalSydneyNew South WalesAustralia,The University of SydneyFaculty of Medicine and HealthSydneyNew South WalesAustralia,Present address:
The Christie NHS Foundation TrustManchesterUK
| | - Peter S. Grimison
- Chris O'Brien LifehouseSydneyNew South WalesAustralia,Royal Prince Alfred HospitalSydneyNew South WalesAustralia
| | - Angela Hong
- Chris O'Brien LifehouseSydneyNew South WalesAustralia
| | - Richard Boyle
- Chris O'Brien LifehouseSydneyNew South WalesAustralia,Royal Prince Alfred HospitalSydneyNew South WalesAustralia
| | - Paul Stalley
- Chris O'Brien LifehouseSydneyNew South WalesAustralia,Royal Prince Alfred HospitalSydneyNew South WalesAustralia
| | | | | | - Susie Bae
- Peter MacCallum Cancer CentreMelbourneVictoriaAustralia,Sir Peter MacCallum Department of OncologyThe University of MelbourneMelbourneVictoriaAustralia
| | - Jayesh Desai
- Peter MacCallum Cancer CentreMelbourneVictoriaAustralia,Sir Peter MacCallum Department of OncologyThe University of MelbourneMelbourneVictoriaAustralia
| | - Philip Crowe
- Prince of Wales HospitalSydneyNew South WalesAustralia
| | - Nimit Singhal
- Cancer Centre, Royal Adelaide Hospital and Department of MedicineUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - Vivek A. Bhadri
- Chris O'Brien LifehouseSydneyNew South WalesAustralia,Royal Prince Alfred HospitalSydneyNew South WalesAustralia,The University of SydneyFaculty of Medicine and HealthSydneyNew South WalesAustralia
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11
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Chen JJ, Chou CW. A Rare Case Report of Mesenchymal Chondrosarcoma with Pancreatic Metastasis. Medicina (B Aires) 2022; 58:medicina58050639. [PMID: 35630056 PMCID: PMC9144319 DOI: 10.3390/medicina58050639] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/28/2022] [Accepted: 05/03/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Mesenchymal chondrosarcoma is a rare but aggressive subtype of sarcoma. The majority of involvement locates in the axial skeleton. Treatment modalities include radical surgery, local radiotherapy, and systemic chemotherapy. However, the long-term survival outcome remains poor. Case presentation: We present the case of a 33-year-old male with a palpable chest wall mass for one year, diagnosed with mesenchymal chondrosarcoma with surgical removal. Later, he had an unusual pancreatic tail tumor as the first presentation of disease metastasis which was proven by surgical resection one year later. Conclusion: Although mesenchymal chondrosarcoma locates mainly in the axial skeletal system, extra-skeletal soft tissue or organ involvement might be seen occasionally. Active surveillance with multidisciplinary team management could significantly prolong survival outcomes.
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Affiliation(s)
- Jian-Jiun Chen
- Division of Hematology/Medical Oncology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan;
| | - Cheng-Wei Chou
- Division of Hematology/Medical Oncology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan;
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung 404333, Taiwan
- Correspondence:
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12
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Mahajan A, Shukla S, Agarwal U, Patil V, Rane S, Menon N, Noronha V, Patil V, Prabhash K. Diagnostic quandary over a cheek(y) neoplasm. CANCER RESEARCH, STATISTICS, AND TREATMENT 2022. [DOI: 10.4103/crst.crst_274_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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13
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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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14
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Zając AE, Kopeć S, Szostakowski B, Spałek MJ, Fiedorowicz M, Bylina E, Filipowicz P, Szumera-Ciećkiewicz A, Tysarowski A, Czarnecka AM, Rutkowski P. Chondrosarcoma-from Molecular Pathology to Novel Therapies. Cancers (Basel) 2021; 13:2390. [PMID: 34069269 PMCID: PMC8155983 DOI: 10.3390/cancers13102390] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 05/01/2021] [Accepted: 05/04/2021] [Indexed: 12/16/2022] Open
Abstract
Chondrosarcoma (CHS) is the second most common primary malignant bone sarcoma. Overall survival and prognosis of this tumor are various and often extreme, depending on histological grade and tumor subtype. CHS treatment is difficult, and surgery remains still the gold standard due to the resistance of this tumor to other therapeutic options. Considering the role of differentiation of CHS subtypes and the need to develop new treatment strategies, in this review, we introduced a multidisciplinary characterization of CHS from its pathology to therapies. We described the morphology of each subtype with the role of immunohistochemical markers in diagnostics of CHS. We also summarized the most frequently mutated genes and genome regions with altered pathways involved in the pathology of this tumor. Subsequently, we discussed imaging methods and the role of currently used therapies, including surgery and the limitations of chemo and radiotherapy. Finally, in this review, we presented novel targeted therapies, including those at ongoing clinical trials, which can be a potential future target in designing new therapeutics for patients with CHS.
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Affiliation(s)
- Agnieszka E. Zając
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.E.Z.); (S.K.); (B.S.); (M.J.S.); (E.B.); (P.F.); (P.R.)
| | - Sylwia Kopeć
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.E.Z.); (S.K.); (B.S.); (M.J.S.); (E.B.); (P.F.); (P.R.)
| | - Bartłomiej Szostakowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.E.Z.); (S.K.); (B.S.); (M.J.S.); (E.B.); (P.F.); (P.R.)
| | - Mateusz J. Spałek
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.E.Z.); (S.K.); (B.S.); (M.J.S.); (E.B.); (P.F.); (P.R.)
| | - Michał Fiedorowicz
- Small Animal Magnetic Resonance Imaging Laboratory, Mossakowski Medical Research Institute, Polish Academy of Sciences, 02-106 Warsaw, Poland;
| | - Elżbieta Bylina
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.E.Z.); (S.K.); (B.S.); (M.J.S.); (E.B.); (P.F.); (P.R.)
- Department of Clinical Trials, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Paulina Filipowicz
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.E.Z.); (S.K.); (B.S.); (M.J.S.); (E.B.); (P.F.); (P.R.)
- Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Anna Szumera-Ciećkiewicz
- Department of Pathology and Laboratory Diagnostics, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland;
- Department of Diagnostic Hematology, Institute of Hematology and Transfusion Medicine, 02-776 Warsaw, Poland
| | - Andrzej Tysarowski
- Department of Pathology and Laboratory Medicine, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland;
- Department of Molecular and Translational Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Anna M. Czarnecka
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.E.Z.); (S.K.); (B.S.); (M.J.S.); (E.B.); (P.F.); (P.R.)
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.E.Z.); (S.K.); (B.S.); (M.J.S.); (E.B.); (P.F.); (P.R.)
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15
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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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16
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Yapıcıer Ö, Nanah AR, Taskapılıoglu MÖ, Demir MK. Intracranial extra-axial mesenchymal chondrosarcoma in a 16-month-old patient with a literature review of pediatric patients. Childs Nerv Syst 2021; 37:649-657. [PMID: 32382867 DOI: 10.1007/s00381-020-04652-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 04/28/2020] [Indexed: 10/24/2022]
Abstract
Mesenchymal chondrosarcoma is a rare high-grade malignant subtype of chondrosarcoma that is characterized by undifferentiated, round, or spindled mesenchymal cells, interspersed with islands of hyaline cartilage. We report a primary intracranial extra-axial mesenchymal chondrosarcoma in a 16-month-old patient with a review of the literature focusing on intracranial extra-axial MCs with or without skull involvement in pediatric patients, including differential diagnosis. The patient was admitted with a swelling in the right temporooccipital region. There was intracranial extra-dural extension of the mass, which abuts the neural parenchyma without any invasion. A complete tumor resection was performed. Pathological diagnosis was mesenchymal chondrosarcoma. The patient was free of symptoms after surgery.
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Affiliation(s)
- Özlem Yapıcıer
- Department of Pathology, Bahçeşehir University School of Medicine, Göztepe Medical Park Training and Education Hospital, Istanbul, Turkey
| | | | | | - Mustafa Kemal Demir
- Department of Radiology, Bahçeşehir University School of Medicine, Göztepe Medical Park Training and Education Hospital, 11 kisim, Yasemin Apt, D blok, Daire 35 Ataköy, 34158, Istanbul, Turkey.
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17
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Gopakumar S, Steele WJ, Muir M, Bhogani Z, Britz G. Intraspinal mesenchymal chondrosarcoma: An argument for aggressive local resection and adjuvant therapy based on review of the literature. Surg Neurol Int 2020; 11:95. [PMID: 33030461 PMCID: PMC7265351 DOI: 10.25259/sni_130_2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 04/08/2020] [Indexed: 11/04/2022] Open
Abstract
Background Mesenchymal chondrosarcoma is a rare cartilaginous neoplasm that typically involves the axial skeleton. Despite a well-circumscribed appearance, this tumor has a tendency to recur both locally and with distant metastases. Case Description A 17-year-old patient presented with numbness and paresthesias in the lower extremities attributed to a T10-T11 intradural extramedullary mesenchymal chondrosarcoma. The patient was treated with aggressive local resection and adjuvant therapy. Here, this case and present literature are appropriately reviewed. Conclusion Although uncommon, intraspinal mesenchymal chondrosarcomas warrant both radical local resection and aggressive adjuvant therapy with chemoradiation to provide the greatest chance of progression-free survival.
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Affiliation(s)
- Sricharan Gopakumar
- Department of Neurosurgery, Baylor College of Medicine, One Baylor Plaza, United States
| | - William J Steele
- Department of Neurosurgery, Houston Methodist Hospital Neurological Institute, Houston, TX, United States
| | - Matthew Muir
- Department of Neurosurgery, Baylor College of Medicine, One Baylor Plaza, United States
| | - Zain Bhogani
- Department of Neurosurgery, Houston Methodist Hospital Neurological Institute, Houston, TX, United States
| | - Gavin Britz
- Department of Neurosurgery, Houston Methodist Hospital Neurological Institute, Houston, TX, United States
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18
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Nachawi N, Lew M, Konopka K, Sandouk Z. A challenging case of Mesenchymal Chondrosarcoma involving the thyroid and special considerations for diagnosis. Clin Diabetes Endocrinol 2020; 6:6. [PMID: 32180995 PMCID: PMC7065336 DOI: 10.1186/s40842-020-00094-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 02/10/2020] [Indexed: 11/17/2022] Open
Abstract
Background Thyroid ultrasound is usually used to risk-stratify incidental thyroid nodules. Nodules with high risk sonographic features for malignancy are evaluated by fine-needle aspiration. The role of core needle biopsy for thyroid nodules is limited to cases where the fine needle aspiration is inconclusive. Case presentation We describe a rare case of mesenchymal chondrosarcoma of the thyroid gland with uncertain primary origin. Thyroid ultrasound showed right sided large, solid, hypoechoic nodule with calcifications and peripheral vascularity and unremarkable isthmus and left thyroid lobe. Fine needle aspiration of the right nodule suggested lymphocytic thyroiditis. The sonographic findings contradicted the typical bilateral clinical and sonographic picture of lymphocytic thyroiditis. A core needle biopsy showed mesenchymal chondrosarcoma. Conclusion This case highlights the importance of correlating pathologic diagnosis with sonographic findings, the appropriate utilization of fine needle aspiration and core needle biopsy to evaluate thyroid nodules and the rare incidence of mesenchymal chondrosarcoma involving the thyroid.
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Affiliation(s)
- Noura Nachawi
- 1Department of Internal Medicine, Saint Joseph Mercy Hospital Ann Arbor, Ann Arbor, MI USA
| | - Madelyn Lew
- 2Department of Pathology, University of Michigan, Ann Arbor, MI USA
| | - Kristine Konopka
- 2Department of Pathology, University of Michigan, Ann Arbor, MI USA
| | - Zahrae Sandouk
- 3Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes, University of Michigan, Ann Arbor, MI USA
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19
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Bartzsch S, Corde S, Crosbie JC, Day L, Donzelli M, Krisch M, Lerch M, Pellicioli P, Smyth LML, Tehei M. Technical advances in x-ray microbeam radiation therapy. Phys Med Biol 2020; 65:02TR01. [PMID: 31694009 DOI: 10.1088/1361-6560/ab5507] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
In the last 25 years microbeam radiation therapy (MRT) has emerged as a promising alternative to conventional radiation therapy at large, third generation synchrotrons. In MRT, a multi-slit collimator modulates a kilovoltage x-ray beam on a micrometer scale, creating peak dose areas with unconventionally high doses of several hundred Grays separated by low dose valley regions, where the dose remains well below the tissue tolerance level. Pre-clinical evidence demonstrates that such beam geometries lead to substantially reduced damage to normal tissue at equal tumour control rates and hence drastically increase the therapeutic window. Although the mechanisms behind MRT are still to be elucidated, previous studies indicate that immune response, tumour microenvironment, and the microvasculature may play a crucial role. Beyond tumour therapy, MRT has also been suggested as a microsurgical tool in neurological disorders and as a primer for drug delivery. The physical properties of MRT demand innovative medical physics and engineering solutions for safe treatment delivery. This article reviews technical developments in MRT and discusses existing solutions for dosimetric validation, reliable treatment planning and safety. Instrumentation at synchrotron facilities, including beam production, collimators and patient positioning systems, is also discussed. Specific solutions reviewed in this article include: dosimetry techniques that can cope with high spatial resolution, low photon energies and extremely high dose rates of up to 15 000 Gy s-1, dose calculation algorithms-apart from pure Monte Carlo Simulations-to overcome the challenge of small voxel sizes and a wide dynamic dose-range, and the use of dose-enhancing nanoparticles to combat the limited penetrability of a kilovoltage energy spectrum. Finally, concepts for alternative compact microbeam sources are presented, such as inverse Compton scattering set-ups and carbon nanotube x-ray tubes, that may facilitate the transfer of MRT into a hospital-based clinical environment. Intensive research in recent years has resulted in practical solutions to most of the technical challenges in MRT. Treatment planning, dosimetry and patient safety systems at synchrotrons have matured to a point that first veterinary and clinical studies in MRT are within reach. Should these studies confirm the promising results of pre-clinical studies, the authors are confident that MRT will become an effective new radiotherapy option for certain patients.
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Affiliation(s)
- Stefan Bartzsch
- Department of Radiation Oncology, School of Medicine, Technical University of Munich, Klinikum rechts der Isar, Munich, Germany. Helmholtz Centre Munich, Institute for Radiation Medicine, Munich, Germany
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20
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Le QV, Nguyen DV, Nguyen HV, Hoang TD, Ngo DQ, Ngo TT. Surgery and radiation management for chondrosarcoma of the temporo-mandibular joint: A Vietnamese case report. Int J Surg Case Rep 2019; 66:211-214. [PMID: 31869705 PMCID: PMC6931127 DOI: 10.1016/j.ijscr.2019.11.067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 11/21/2019] [Accepted: 11/28/2019] [Indexed: 12/03/2022] Open
Abstract
The temporo-mandibular joint chondrosarcoma is extremely rare, and can be misdiagnosed as parotid gland tumor. Surgery is standard treatment with the aim of preserving the temporo-mandibular joint function. Adjuvant radiation is used in certain cases to improve local control.
Introduction Chondrosarcoma is a malignant tumor originated from cartilage cells. The most common sites of chondrosarcoma are pelvis, femur and ribs. The temporo-mandibular joint (TMJ) chondrosarcoma is extremely rare, with approximately 30 cases reported in worldwide. Presentation of case In this report, we present a case of chondrosarcoma in the left TMJ, which was successfully treated with surgery and radiation therapy. A 47 year-old women was admitted to our hospital with a mass in left pre-auricular region. On examination and para-clinical test results, the initial diagnosis was parotid gland cancer. In operation, the lesion was a mass originating from the left TMJ. Tumor resection was performed with close margin. The post-operative pathological result was well-differentiated chondrosarcoma. She was indicated adjuvant radiation therapy due to inadequate surgical therapy. There was no evidence of recurrence after 6 months follow-up. Conclusion The TMJ chondrosarcoma is needed to distinguish from other diseases especially parotid gland tumor. Surgery and adjuvant radiation therapy are standard care with the aim of preserving joint function.
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Affiliation(s)
- Quang Van Le
- Department of Oncology, Hanoi Medical University, Hanoi, Viet Nam; Department of Head and Neck Surgery, Vietnam National Cancer Hospital, Hanoi, Viet Nam.
| | - Dang Van Nguyen
- Department of Oncology, Hanoi Medical University, Hanoi, Viet Nam; Department of Head and Neck Radiation, Vietnam National Cancer Hospital, Hanoi, Viet Nam.
| | - Hung Van Nguyen
- Department of Oncology, Hanoi Medical University, Hanoi, Viet Nam; Department of Head and Neck Radiation, Vietnam National Cancer Hospital, Hanoi, Viet Nam.
| | - Thanh Duc Hoang
- Department of Oncology, Hanoi Medical University, Hanoi, Viet Nam.
| | - Duy Quoc Ngo
- Department of Head and Neck Surgery, Vietnam National Cancer Hospital, Hanoi, Viet Nam.
| | - Tung Thanh Ngo
- Department of Head and Neck Radiation, Vietnam National Cancer Hospital, Hanoi, Viet Nam.
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21
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Huang R, Sun Z, Zheng H, Yan P, Hu P, Yin H, Zhang J, Meng T, Huang Z. Identifying the Prognosis Factors and Predicting the Survival Probability in Patients with Non-Metastatic Chondrosarcoma from the SEER Database. Orthop Surg 2019; 11:801-810. [PMID: 31663279 PMCID: PMC6819193 DOI: 10.1111/os.12521] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 07/27/2019] [Accepted: 07/28/2019] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To identify prognostic factors and establish nomograms for predicting overall survival (OS) and cause specific survival (CSS) of patients with non-metastatic chondrosarcoma. METHODS We collected information on patients with non-metastatic chondrosarcoma from the Surveillance, Epidemiology, and End Results (SEER) database between 2005 and 2014, together with data from the First Affiliated Hospital of Zhengzhou University from 2011 to 2016. Variables including patients' baseline demographics (age, race, and gender), tumor characteristics (tumor size and extension, histology subtype, primary site, and American Joint Committee on Cancer [AJCC] stage), therapy (surgery, chemotherapy, and radiotherapy), and socioeconomic status (SES) were extracted for further analysis. OS and CSS were retrieved as our researching endpoints. Patients from the database were regarded as the training set, and univariate analysis, Lasso regression and multivariate analysis as well as the random forest were used to explore the predictors and establish nomograms. To validate nomograms internally and externally, we applied bootstrapped validation internally with the training dataset, while the dataset for external validation was obtained from the First Affiliated Hospital of Zhengzhou University. We estimated the discriminative ability of nomograms based on Cox proportional hazard regression models by means of calibration curves and the concordance index (C-index) of internal and external validation. RESULTS After the implementation of exclusion criteria, there were 1267 patients in the training set and 72 patients in the testing set with non-metastatic chondrosarcomas. Age, gender, grade, histological subtype, primary site, surgery, radiation, chemotherapy, being employed/unemployed, tumor size, and tumor extension were significantly associated with prognosis in the univariate analysis. Age, gender, tumor size and extension, primary site, surgery, radiotherapy, chemotherapy, histological grade, and subtype were independent prognostic factors in the Cox models. The C-index of nomograms (internal: OS, 0.787; CSS, 0.821; external: OS, 0.777; CSS, 0.821) were higher than following conventional systems: AJCC sixth (OS, 0.640; CSS, 0.673) and seventh edition (OS, 0.675; CSS, 0.711). CONCLUSIONS Age, gender, tumor size and extension, surgery, histological grade, and subtype were independent prognostic factors for both OS and CSS. In addition, we revealed that chondrosarcomas in the trunk, radiotherapy, and chemotherapy were correlated with poor prognosis. Our nomograms based on significant clinicopathologic features can well predict the 3-year and 5-year survival probability of patients with non-metastatic chondrosarcoma and assist oncologists in making accurate survival evaluation.
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Affiliation(s)
- Runzhi Huang
- Department of OrthopaedicsThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
- Division of Spine Surgery, Department of Orthopaedics, Tongji HospitalTongji University School of MedicineShanghaiChina
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration, Tongji UniversityMinistry of EducationShanghaiChina
| | - Zhao Sun
- Department of OrthopaedicsThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
| | - Huimin Zheng
- Department of OrthopaedicsThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
| | - Penghui Yan
- Department of OrthopaedicsThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
| | - Peng Hu
- Department of OrthopaedicsThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
| | - Huabin Yin
- Department of Orthopedics, Shanghai Bone Tumor Institute, Shanghai General Hospital, School of MedicineShanghai Jiaotong UniversityShanghaiChina
| | - Jie Zhang
- Shanghai East Hospital, Key Laboratory of Arrhythmias, Ministry of EducationTongji University School of MedicineShanghaiChina
| | - Tong Meng
- Division of Spine Surgery, Department of Orthopaedics, Tongji HospitalTongji University School of MedicineShanghaiChina
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration, Tongji UniversityMinistry of EducationShanghaiChina
| | - Zongqaing Huang
- Department of OrthopaedicsThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
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22
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MacDonald F, Gupta S. Has the Scottish Managed Clinical Network for Sarcoma influenced the survival outcomes for primary malignant bone tumours? J Orthop 2019; 16:254-259. [PMID: 30923423 PMCID: PMC6423303 DOI: 10.1016/j.jor.2019.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 02/17/2019] [Indexed: 10/27/2022] Open
Abstract
Primary malignant bone tumours (PMBT) are rare. We have reviewed patient outcomes in Scotland over a 20 year period and provided an update on the principles of current management strategies for the non-specialist practitioner. The Scottish Managed Clinical Network for Sarcoma (MCN) connects the three main management centres for sarcoma in Scotland: Glasgow, Aberdeen and Edinburgh. Prior to the formation of the MCN, all centres were connected via the Scottish Bone Tumour Registry (SBTR), where they would meet on a quarterly basis and all the bone/soft tissue tumour cases were discussed retrospectively. The MCN was introduced in 2006. Our primary aims were to assess the impact of the MCN on patient outcomes and to update clinicians on the recognition, assessment and staging of PMBT. A secondary aim was to compare results from the Scottish centres with other UK sites. The patient information was gathered from the Scottish Bone Tumour Registry, held at the Queen Elizabeth University Hospital in Glasgow. All patients with diagnoses of Osteosarcoma, Chondrosarcoma and Ewing Sarcoma between 1994 and 2014 were included. Results showed that there was no significant change in outcome following the formation of the Scottish Managed Clinical Network for Sarcoma, and that there were little differences in outcome amongst the three major management centres in Scotland. Findings also show Scotland to have similar outcomes to that of the rest of the UK following diagnosis of a primary malignant bone tumour.
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23
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Deng W, Zhou J, Liu X, Chen L, Guo G, Fu B. Robot-assisted radical nephrectomy for primary renal mesenchymal chondrosarcoma: case report and literature review. Ren Fail 2019; 41:98-103. [PMID: 30909775 PMCID: PMC6442158 DOI: 10.1080/0886022x.2019.1583111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
As an extremely rare malignant neoplasm, only 12 mesenchymal chondrosarcoma (MC) arising in kidney have been reported to date. Herein, we reported a case of primary renal MC resected with robot assistance, which has not been reported before. According to the cases reported in English literature, we analyzed the characteristics of this rare malignancy and systematically review its treatment.
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Affiliation(s)
- Wen Deng
- a Department of Urology , The First Affiliated Hospital of Nanchang University , Nanchang , Jiangxi Province , China
| | - Jinxiu Zhou
- b Department of Burns , The First Affiliated Hospital of Nanchang University , Nanchang , Jiangxi Province , China
| | - Xiaoqiang Liu
- a Department of Urology , The First Affiliated Hospital of Nanchang University , Nanchang , Jiangxi Province , China
| | - Luyao Chen
- a Department of Urology , The First Affiliated Hospital of Nanchang University , Nanchang , Jiangxi Province , China
| | - Guanghua Guo
- b Department of Burns , The First Affiliated Hospital of Nanchang University , Nanchang , Jiangxi Province , China
| | - Bin Fu
- a Department of Urology , The First Affiliated Hospital of Nanchang University , Nanchang , Jiangxi Province , China
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Paasch C, De Santo G, Boettge KR, Strik MW. Mesenchymal chondrosarcoma metastasising to the pancreas. BMJ Case Rep 2018; 11:11/1/e226369. [PMID: 30598468 DOI: 10.1136/bcr-2018-226369] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The mesenchymal chondrosarcoma (MC) is a rare malignant tumour and accounts for less than 3% of primary chondrosarcomas. Mostly MC arises from the craniofacial bones, the ribs, the ilium, the femur and the vertebrae. A 54-year-old man was treated due to an icterus of unknown origin. The medical history of the patient consists of a multimodal treated MC of the thoracic vertebrae. A CT imaging identified a 2×4 cm sized mass of the pancreatic head. Suspecting a pancreatic head carcinoma surgical removal was performed. Histopathological a metastasis of MC was diagnosed. Our patient left the hospital after 17 days and died 23 month after surgery. Metastases of MC to the pancreas are rare. When detecting a mass of the pancreas in patients with a medical history of an MC, a metastasis of these tumour should be taken in consideration.
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Affiliation(s)
| | | | | | - Martin W Strik
- General Surgery, Helios Klinikum Berlin-Buch, Berlin, Germany
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25
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Abstract
Extraskeletal mesenchymal chondrosarcoma is a rare soft tissue sarcoma arising from soft tissues, mainly of the lower extremities, meninges, and orbits. It usually presents during the second to third decades of life, and has a slight predominance in females. Histologically, it has a typical biphasic pattern comprising small cells and islands of hyaline cartilage. It can pose a diagnostic challenge in small biopsy specimens where 1 of the 2 components can be absent. The prognosis is extremely variable; survival varies depending on the location of the tumor.
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Affiliation(s)
| | - Nicole D. Riddle
- From the Department of Pathology, University of Texas Health Science Center, San Antonio. Dr Arora is now with the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas. Dr Riddle is now with the Department of Pathology, Cunningham Pathology, Birmingham, Alabama
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26
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Lu P, Xiao W, Gao Y, Mao Y. Primary orbital mesenchymal chondrosarcoma. Can J Ophthalmol 2018; 53:e205-e207. [PMID: 30340745 DOI: 10.1016/j.jcjo.2017.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 11/15/2017] [Accepted: 11/20/2017] [Indexed: 11/25/2022]
Affiliation(s)
- Peng Lu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Wei Xiao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yang Gao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yuxiang Mao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
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27
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Nazeri E, Gouran Savadkoohi M, Majidzadeh-A K, Esmaeili R. Chondrosarcoma: An overview of clinical behavior, molecular mechanisms mediated drug resistance and potential therapeutic targets. Crit Rev Oncol Hematol 2018; 131:102-109. [PMID: 30293700 DOI: 10.1016/j.critrevonc.2018.09.001] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 04/28/2018] [Accepted: 09/03/2018] [Indexed: 12/24/2022] Open
Abstract
Sarcomas are known as a heterogeneous class of cancers arisen in the connective tissues and demonstrated various histological subtypes including both soft tissue and bone origin. Chondrosarcoma is one of the main types of bone sarcoma that shows a considerable deficiency in response to chemotherapy and radiotherapy. While conventional treatment based on surgery, chemo-and radiotherapy are used in this tumor, high rate of death especially among children and adolescents are reported. Due to high resistance to current conventional therapies in chondrosarcoma, there is an urgent requirement to recognize factors causing resistance and discover new strategies for optimal treatment. In the past decade, dysregulation of genes associated with tumor development and therapy resistance has been studied to find potential therapeutic targets to overcome resistance. In this review, clinical aspects of chondrosarcoma are summarized. Moreover, it gives a summary of gene dysregulation, mutation, histone modifications and non-coding RNAs associated with tumor development and therapeutic response modulation. Finally, the probable role of tumor microenvironment in chondrosarcoma drug resistance and targeted therapies as a promising molecular therapeutic approach are summarized.
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Affiliation(s)
- Elahe Nazeri
- Genetics Department, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran.
| | | | - Keivan Majidzadeh-A
- Genetics Department, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran.
| | - Rezvan Esmaeili
- Genetics Department, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran.
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28
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van Maldegem A, Conley AP, Rutkowski P, Patel SR, Lugowska I, Desar IME, Bovée JVMG, Gelderblom H. Outcome of First-Line Systemic Treatment for Unresectable Conventional, Dedifferentiated, Mesenchymal, and Clear Cell Chondrosarcoma. Oncologist 2018; 24:110-116. [PMID: 30082492 DOI: 10.1634/theoncologist.2017-0574] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 05/10/2018] [Accepted: 06/05/2018] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Chondrosarcoma is a heterogeneous group of primary bone sarcoma with an excellent overall survival after local therapy. However, the small percentage of patients who have no surgical treatment options have a very poor prognosis. We retrospectively collected data from these patients in four sarcoma centers and compared the progression-free survival (PFS) for the different treatment regimens used for the four chondrosarcoma subtypes. MATERIALS AND METHODS Patients diagnosed with unresectable chondrosarcoma in all four major sarcoma centers were included, and data on first-line systemic therapy were retrospectively collected for analysis. RESULTS A total of 112 patients were enrolled in this retrospective analysis: 50 conventional, 25 mesenchymal, 34 dedifferentiated, and 3 clear cell chondrosarcoma patients. In conventional chondrosarcoma patients, the longest mean PFS (6.7 months) was found in the group treated with antihormonal therapy. Patients diagnosed with mesenchymal chondrosarcoma were all treated with multidrug chemotherapy, and the mean PFS was 6.7 months. Doxorubicin monotherapy seems to have an unexplained better PFS than doxorubicin-based combination therapy in patients with dedifferentiated chondrosarcoma (5.5 vs. 2.8 months, respectively; p = .275). CONCLUSION Prospective studies need to be conducted based on preclinical work to develop a uniform regimen to treat advanced chondrosarcoma patients according to the diagnosed subtype and improve survival. IMPLICATIONS FOR PRACTICE Currently, there are no uniform treatment lines for advanced chondrosarcoma patients, which results in a very diverse group of treatment regimens being used. In this study, the data of 112 patients was collected. It was concluded that some treatment regimens seem to have a better progression-free survival compared with others, and that these results also differ between the chondrosarcoma subtypes. Prospective studies need to be conducted based on preclinical work to develop a uniform regimen to treat advanced chondrosarcoma patients according to the diagnosed histological subtype to improve their survival.
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Affiliation(s)
- Annemiek van Maldegem
- Department of Medical Oncology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Anthony P Conley
- Department of Sarcoma Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Institute - Oncology Center, Warsaw, Poland
| | - Shreyaskumar R Patel
- Department of Sarcoma Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Iwona Lugowska
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Institute - Oncology Center, Warsaw, Poland
| | - Ingrid M E Desar
- Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Judith V M G Bovée
- Department of Pathology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Hans Gelderblom
- Department of Medical Oncology, Leiden University Medical Centre, Leiden, The Netherlands
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29
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Intracranial Mesenchymal Chondrosarcoma: Report of 16 Cases. World Neurosurg 2018; 116:e691-e698. [DOI: 10.1016/j.wneu.2018.05.069] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 05/09/2018] [Accepted: 05/10/2018] [Indexed: 02/03/2023]
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El Beaino M, Roszik J, Livingston JA, Wang WL, Lazar AJ, Amini B, Subbiah V, Lewis V, Conley AP. Mesenchymal Chondrosarcoma: a Review with Emphasis on its Fusion-Driven Biology. Curr Oncol Rep 2018; 20:37. [PMID: 29582189 DOI: 10.1007/s11912-018-0668-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Mesenchymal chondrosarcoma is a rare but deadly form of chondrosarcoma that typically affects adolescents and young adults. While curative intent is possible for patients with localized disease, few options exist for patients in the unresectable/metastatic setting. Thus, it is imperative to understand the fusion-driven biology of this rare malignant neoplasm so as to lead to the future development of better therapeutics for this disease. This manuscript will briefly review the clinical and pathologic features of mesenchymal chondrosarcoma followed by an appraisal of existing data linked to the fusions, HEY1-NCOA2 and IRF2BP2-CDX1, and the associated downstream pathways.
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Affiliation(s)
- Marc El Beaino
- Department of Orthopaedic Oncology, MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Jason Roszik
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - John A Livingston
- Department of Sarcoma Medical Oncology, MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Wei-Lien Wang
- Department of Pathology, MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Alexander J Lazar
- Department of Pathology, MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Behrang Amini
- Department of Diagnostic Radiology, MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Vivek Subbiah
- Department of Investigational Therapeutics, MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Valerae Lewis
- Department of Orthopaedic Oncology, MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Anthony P Conley
- Department of Sarcoma Medical Oncology, MD Anderson Cancer Center, Houston, TX, 77030, USA.
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31
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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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32
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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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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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Chemotherapy and Other Systemic Approaches to Adult Sarcomas. Sarcoma 2017. [DOI: 10.1007/978-3-319-43121-5_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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35
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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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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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Chondrosarcoma of the hyoid bone - Report of a case and a literature review of the suitable treatment strategy. Auris Nasus Larynx 2016; 44:629-634. [PMID: 27769535 DOI: 10.1016/j.anl.2016.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 08/24/2016] [Accepted: 09/08/2016] [Indexed: 11/20/2022]
Abstract
Chondrosarcoma is a rare malignant tumor occurring in the trunk and long bones. We present an extremely rare case of chondrosarcoma of the hyoid bone with clinical and pathological correlation and a literature review. We searched all cases of the hyoid chondrosarcoma in PubMed (MEDLINE) between 1990 and 2015. Eighteen cases were analyzed, including the present case. Most of them were low grade type. In 12 cases where intraoperative findings were recorded, no adhesion to the surrounding tissue was observed. Chondrosarcoma of the hyoid bone is usually low grade type, and there may be no invasion to the adjacent structures even if invasion is suspected by imaging findings. In order to preserve swallowing and laryngeal function, total hyoidectomy without laryngectomy should be indicated according to the intraoperative findings. Needle biopsy is an effective diagnostic technique, but open biopsy should be avoided to prevent the dissemination. To the best of our knowledge, this is the first presentation of hyoid bone chondrosarcoma with the investigation of intraoperative findings and pre-operative diagnostic modality.
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38
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de Jong Y, van Maldegem AM, Marino-Enriquez A, de Jong D, Suijker J, Briaire-de Bruijn IH, Kruisselbrink AB, Cleton-Jansen AM, Szuhai K, Gelderblom H, Fletcher JA, Bovée JVMG. Inhibition of Bcl-2 family members sensitizes mesenchymal chondrosarcoma to conventional chemotherapy: report on a novel mesenchymal chondrosarcoma cell line. J Transl Med 2016; 96:1128-37. [PMID: 27617402 DOI: 10.1038/labinvest.2016.91] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 07/08/2016] [Indexed: 11/09/2022] Open
Abstract
Mesenchymal chondrosarcomas are rare and highly aggressive sarcomas occurring in bone and soft tissue, with poor overall survival. Bcl-2 expression was previously shown to be upregulated in mesenchymal chondrosarcomas. We here report on a newly derived mesenchymal chondrosarcoma cell line, MCS170, in which we investigated treatment with the BH3 mimetic ABT-737 alone or in combination with conventional chemotherapy as a possible new therapeutic strategy. The presence of the characteristic HEY1-NCOA2 fusion was confirmed in the MCS170 cell line using FISH, RT-PCR, and sequencing. The MCS170 cell line was treated with ABT-737 alone or in combination with doxorubicin or cisplatin. Cell viability and proliferation was determined using WST-1 viability assays and the xCELLigence system. Expression of Bcl-2 family members was studied using immunohistochemistry. Apoptosis was determined using the caspase-glo 3/7 assay and western blot for PARP cleavage. The MCS170 cell line was sensitive to doxorubicin treatment with an IC50 of 0.09 μM after 72 h, but more resistant to cisplatin treatment with an IC50 of 4.5 μM after 72 h. Cells showed little sensitivity toward ABT-737 with an IC50 of 1.8 μM after 72 h. Combination treatments demonstrated ABT-737 synergism with cisplatin as well as doxorubicin as shown by induction of apoptosis and reduction in cell proliferation. Restoration of the apoptotic machinery by inhibition of Bcl-2 family members sensitizes MCS170 mesenchymal chondrosarcoma cells to conventional chemotherapy. This indicates that combining the inhibition of Bcl-2 family members with conventional chemotherapy can be a possible therapeutic strategy for patients with mesenchymal chondrosarcoma.
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Affiliation(s)
- Yvonne de Jong
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Adrian Marino-Enriquez
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Danielle de Jong
- Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, The Netherlands
| | - Johnny Suijker
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | | | | | | | - Karoly Szuhai
- Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, The Netherlands
| | - Hans Gelderblom
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jonathan A Fletcher
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Judith V M G Bovée
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
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Chen S, Wang Y, Su G, Chen B, Lin D. Primary intraspinal dumbbell-shaped mesenchymal chondrosarcoma with massive calcifications: a case report and review of the literature. World J Surg Oncol 2016; 14:203. [PMID: 27487949 PMCID: PMC4973031 DOI: 10.1186/s12957-016-0963-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 07/25/2016] [Indexed: 11/10/2022] Open
Abstract
Background Mesenchymal chondrosarcoma is a rare malignant tumor arising from bone or soft tissues. Instraspinal dumbbell-shaped mesenchymal chondrosarcoma is even rarer; however, it should not be neglected by clinicians. Case presentation A 26-year-old female was referred to our hospital with a 1.5-month history of sciatic pain and numbness in the left leg. Computed tomography and magnetic resonance imaging scans revealed an intraspinal dumbbell-shaped mass which had distinguishing features of neurogenic tumors, surprisingly, with massive calcifications, and no tumor metastasis was found. Then the patient underwent a total resection of the tumor, and during the operation, we found that the right nerve root of the fifth lumbar almost disappeared. The tumor was diagnosed as mesenchymal chondrosarcoma by histopathological examination after operation. Adjuvant therapies were not performed. However, recurrence of the tumor occurred 5 months later, and she underwent a total resection again combined with radiotherapy after second surgery. Conclusions To the best of our knowledge, this case study presents the first report in literature about primary instraspinal dumbbell-shaped mesenchymal chondrosarcoma with massive calcifications, which may provide some evidence for clinical practice. As the clinical symptoms and radiographic findings of mesenchymal chondrosarcoma are usually not specific, clinicians should consider it as a possible case and diagnose it through careful histopathological examination. Sometimes, calcification could be seen in tumors, which may influence or reflect the growth of tumor and disease prognosis. Although prognosis in mesenchymal chondrosarcoma varies from person to person, generally, complete resection, adjuvant therapy, and regular examinations are recommended to perform for patients with mesenchymal chondrosarcoma.
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Affiliation(s)
- Shudong Chen
- Guangdong Provincial Hospital of Chinese Medicine, No. 111 Dade Road, Yuexiu District, Guangzhou, 510120, China.,Guangzhou University of Chinese Medicine, Guangzhou, China.,Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Yufeng Wang
- Guangdong Provincial Hospital of Chinese Medicine, No. 111 Dade Road, Yuexiu District, Guangzhou, 510120, China.,Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Guoyi Su
- Guangdong Provincial Hospital of Chinese Medicine, No. 111 Dade Road, Yuexiu District, Guangzhou, 510120, China.,Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Bolai Chen
- Guangdong Provincial Hospital of Chinese Medicine, No. 111 Dade Road, Yuexiu District, Guangzhou, 510120, China.,Guangzhou University of Chinese Medicine, Guangzhou, China.,Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Dingkun Lin
- Guangdong Provincial Hospital of Chinese Medicine, No. 111 Dade Road, Yuexiu District, Guangzhou, 510120, China. .,Guangzhou University of Chinese Medicine, Guangzhou, China. .,Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China.
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40
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Kamal AF, Husodo K, Prabowo Y, Hutagalung EU. Correlation between survival and tumour characteristics in patients with chondrosarcoma. J Orthop Surg (Hong Kong) 2015; 23:365-9. [PMID: 26715720 DOI: 10.1177/230949901502300323] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
PURPOSE To evaluate the correlation between survival and tumour characteristics in 23 patients with chondrosarcoma. METHODS Records of 15 men and 8 women aged 14 to 66 (mean, 37) years who were diagnosed with primary (n=19) or secondary (n=4) chondrosarcoma of the axial skeleton (n=8), proximal extremity (n=9), or distal extremity (n=6) were reviewed. The tumour diameter was <10 cm in 4 patients, 10-19 cm in 12, and 20-30 cm in 7. The tumour involved the intramedullary in 17 and the periosteum in 6 patients; tumour extension was intracompartmental in 5 and extracompartmental in 18 patients. The Evans histological grade for the tumours was grade 1 in 6 patients, grade 2 in 10, and grade 3 in 7. The mean tumour size was 12.3 cm for grade 1 tumours, 18.2 cm for grade 2 tumours, and 18.3 cm for grade 3 tumours. 13 patients had no metastasis and 3 of 10 patients with grade 2 tumours and all 7 patients with grade 3 tumours had metastasis to the lung at presentation. 17 patients underwent surgery, one underwent adjuvant treatment only, and 5 declined treatment. RESULTS The mean follow-up period for the 23 patients was 3.1 years (range, 3 weeks to 9 years). The 5-year survival rate was 43% overall, 83.3% for grade 1 tumours, 50% for grade 2 tumours, and 0% for grade 3 tumours. The median survival duration was 20 (95% confidence interval, 11-29) months. Two patients had local recurrence and 16 did not, and the 5 patients who declined treatment died. Survival correlated with Evans histological grading (p=0.004), the presence of metastasis at presentation (p=0.026) and local recurrence (p=0.004). CONCLUSION The survival rate was lower in patients with higher Evan grading, metastasis, or local recurrence.
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Affiliation(s)
- Achmad Fauzi Kamal
- Department of Orthopaedic and Traumatology, Ciptomangunkusumo National Central Hospital / Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
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41
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Ali N, Vanel D, Righi A, Colangeli M, Manfrini M. Imaging features of extraskeletal mesenchymal chondrosarcoma of the hand. Diagn Interv Imaging 2015; 96:965-7. [DOI: 10.1016/j.diii.2015.02.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 02/12/2015] [Accepted: 02/16/2015] [Indexed: 10/23/2022]
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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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Rothberg MB, Bhalodi AA, Reda EF, Zelkovic P, Franco I. Primary renal mesenchymal chondrosarcoma: a case report. Urology 2015; 85:676-8. [PMID: 25733289 DOI: 10.1016/j.urology.2014.11.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 11/05/2014] [Accepted: 11/07/2014] [Indexed: 10/23/2022]
Abstract
A 16-year-old female patient presented to our emergency department with a left upper extremity radiculopathy prompting several imaging studies. Magnetic resonance imaging of the neck revealed multiple cervical vertebrae lesions and computed tomography imaging demonstrated a 15-cm calcified mass originating from the left kidney and extending into the surrounding structures. Pathologic assessment of the open left radical nephrectomy specimen revealed a primary renal mesenchymal chondrosarcoma, a tumor that has only been documented in 5 prior case reports in the literature.
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Affiliation(s)
- Michael B Rothberg
- Section of Pediatric Urology, Department of Urology, New York Medical College, Valhalla, NY
| | - Amul A Bhalodi
- Section of Pediatric Urology, Department of Urology, New York Medical College, Valhalla, NY
| | - Edward F Reda
- Section of Pediatric Urology, Department of Urology, New York Medical College, Valhalla, NY
| | - Paul Zelkovic
- Section of Pediatric Urology, Department of Urology, New York Medical College, Valhalla, NY
| | - Israel Franco
- Section of Pediatric Urology, Department of Urology, New York Medical College, Valhalla, NY.
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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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Bone sarcomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2015; 25 Suppl 3:iii113-23. [PMID: 25210081 DOI: 10.1093/annonc/mdu256] [Citation(s) in RCA: 171] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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Tinoco G, Wilky BA, Paz-Mejia A, Rosenberg A, Trent JC. The biology and management of cartilaginous tumors: a role for targeting isocitrate dehydrogenase. Am Soc Clin Oncol Educ Book 2015:e648-e655. [PMID: 25993236 DOI: 10.14694/edbook_am.2015.35.e648] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Chondrosarcomas are rare mesenchymal neoplasms defined by the production of abnormal cartilaginous matrix. Conventional chondrosarcoma is the most common histology. The management of primary conventional chondrosarcoma generally is surgical with the possible addition of radiation therapy. Treatment of conventional chondrosarcoma is problematic in unresectable or metastatic disease because the tumors tend to be resistant to standard sarcoma chemotherapy regimens. Previous attempts at targeted therapy, including inhibitors of Hedgehog signaling, the mTOR pathway, and platelet-derived growth factor receptor (PDGFR) have been largely disappointing. However, heterozygous mutations in isocitrate dehydrogenase (IDH) enzymes recently have been identified in chondrogenic neoplasms, with mutations reported in approximately 87% of benign enchondromas, 70% of conventional chondrosarcomas, and 54% of dedifferentiated chondrosarcomas. The normal IDH protein continues to produce alpha-ketoglutarate (alpha-KG) whereas the mutant IDH protein converts KG to the oncometabolite 2-hydroxyglutarate (2-HG). Clinical trials of novel IDH inhibitors are ongoing, with evidence of early activity in IDH-mutant leukemias. IDH inhibitors show antitumor effects against IDH-mutant chondrosarcoma cell lines, supporting the inclusion of patients with chondrosarcoma with IDH mutations on IDH inhibitor clinical trials for solid tumors. Targeting IDH mutations may offer hope of a novel antineoplastic strategy not only for patients with chondrosarcomas, but also for other solid tumors with aberrant IDH activity.
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Affiliation(s)
- Gabriel Tinoco
- From the Sylvester Comprehensive Cancer Center, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL; Sylvester Comprehensive Cancer Center, Department of Pathology, University of Miami Miller School of Medicine, Miami, FL
| | - Breelyn A Wilky
- From the Sylvester Comprehensive Cancer Center, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL; Sylvester Comprehensive Cancer Center, Department of Pathology, University of Miami Miller School of Medicine, Miami, FL
| | - Ana Paz-Mejia
- From the Sylvester Comprehensive Cancer Center, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL; Sylvester Comprehensive Cancer Center, Department of Pathology, University of Miami Miller School of Medicine, Miami, FL
| | - Andrew Rosenberg
- From the Sylvester Comprehensive Cancer Center, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL; Sylvester Comprehensive Cancer Center, Department of Pathology, University of Miami Miller School of Medicine, Miami, FL
| | - Jonathan C Trent
- From the Sylvester Comprehensive Cancer Center, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL; Sylvester Comprehensive Cancer Center, Department of Pathology, University of Miami Miller School of Medicine, Miami, FL
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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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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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van Maldegem AM, Bovée JV, Gelderblom H. Comprehensive analysis of published studies involving systemic treatment for chondrosarcoma of bone between 2000 and 2013. Clin Sarcoma Res 2014; 4:11. [PMID: 25126409 PMCID: PMC4131227 DOI: 10.1186/2045-3329-4-11] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 08/01/2014] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND The majority of patients with chondrosarcoma of bone have an excellent overall survival after local therapy. However, in case of unresectable locally advanced or metastatic disease the outcome is poor and limited treatment options exist. Therefore we conducted a survey of clinical phase I or II trials and retrospective studies that described systemic therapy for chondrosarcoma patients. MATERIALS AND METHODS Using PubMed, clinicaltrials.gov, the Cochrane controlled trial register and American Society of Clinical Oncology (ASCO) abstracts a literature survey was conducted. From the identified items, data were collected by a systematic analysis. We limited our search to semi-recent studies published between 2000 and 2013 to include modern drugs, imaging techniques and disease evaluations. RESULTS A total of 31 studies were found which met the criteria: 9 phase I trials, 11 phase II and 8 retrospective studies. In these studies 855 chondrosarcoma patients were reported. The tested drugs were mostly non-cytotoxic, either alone or in combination with another non-cytotoxic agent or chemotherapy. Currently two phase I trials, one phase IB/II trial and three phase II trials are enrolling chondrosarcoma patients. CONCLUSION Because chondrosarcoma of bone is an orphan disease it is difficult to conduct clinical trials. The meagre outcome data for locally advanced or metastatic patients indicate that new treatment options are needed. For the phase I trials it is difficult to draw conclusions because of the low numbers of chondrosarcoma patients enrolled, and at different dose levels. Some phase II trials show promising results which support further research. Retrospective studies are encouraged as they could add to the limited data available. Efforts to increase the number of studies for this orphan disease are urgently needed.
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Affiliation(s)
- Annemiek M van Maldegem
- Department of Clinical Oncology, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Judith Vmg Bovée
- Department of Pathology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Hans Gelderblom
- Department of Clinical Oncology, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
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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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