BONE PATHOLOGY CASE STUDIES

CASE 8 - Low grade chondrosarcoma

Clinical History:

This is a 46 year old male who presents with progressive pain and swelling of his right lower thigh region. Swelling is worse than the pain. On physical examination, he is obese and it is difficult to assess the right leg. A radiograph showed a mass arising in the distal right femur. A bone scan (Slide 8.1) showed an expansile area of increased uptake in the distal right medial femur. A resection was performed of distal right femur.
  1. What is the lesion?

    2. This is a low-grade chondrosarcoma. It is called "low-grade" because the cellular anaplasia is not marked. In fact, this is a difficult lesion to distinguish from a benign process. In general, a helpful fact to know is that more centrally located cartilagenous tumors tend to be more aggressive than distal ones.

    Chondrosarcomas have a male predominance and are seen over a broad age spectrum from teenage to the elderly, but with a peak in middle age. They are more common in "central" locations of the axial skeletal system, rather than at "peripheral" sites such as the bones of the hands, where benign chondromas occur.

  2. Name a condition in which multiple cartilagenous tumors are found.

    3. This is Ollier's disease. In about a third to half of such cases, there is malignant transformation to chondrosarcoma.