Chondrosarcoma

What is chondrosarcoma?

Chondrosarcoma is a type of cancer closely related to bone cancer. However, chondrosarcoma forms in cartilage, the tough but flexible tissue that pads the ends of bones and lines joints, not in the bone tissue itself.

This cancer usually develops in the cartilage that lines the bones of the pelvis, thigh, shoulder, ribs, or arm. However, one rare type of chondrosarcoma develops in the soft tissues, such as the muscles, nerves, or fat, of the arms and legs. The disease can also develop from an existing noncancerous (benign) tumor close to the bone. But in most cases, doctors don't know why it develops.

Once a chondrosarcoma has formed, it may grow rapidly or slowly. It can invade nearby tissues and spread (metastasize) to cartilage and bones elsewhere in the body. It can also spread to other tissues and organs, such as the lungs.

If cancer spreads (metastasizes) to the bones or cartilage from a cancer in another part of the body, such as the breast, it is not a chondrosarcoma. Rather, it is called metastatic breast cancer.

Chondrosarcoma can occur at any age, but it mainly affects adults over age 40. It rarely occurs in children.

Symptoms of chondrosarcoma

The most common symptoms of chondrosarcoma are

pain in the affected area that may worsen at night or during physical activity
swelling in the painful area
a lump or mass
enlargement of an existing growth
limping
difficulty moving the affected limb.

These symptoms do not necessarily mean you have cancer. Still, it is important to see a doctor if you experience any of them.

Diagnosing chondrosarcoma

Diagnosis usually begins with a physical examination and medical history. Your doctor will check for signs of disease. He or she will ask about your health habits and previous illnesses and treatments.

Other tests may be performed to diagnose chondrosarcoma:

X-rays use high-energy radiation to take pictures inside the body. They can show the location, size, and shape of a bone tumor.
Bone scans use a scanner and low-level radioactive material. They detect cancer cells in bones.
Computed tomography (CT) scans use a rotating x-ray camera. They take detailed, cross-sectional pictures of tissues and organs.
Magnetic resonance imaging (MRI) uses a powerful magnet and radio waves to take detailed images inside the body.
Positron emission tomography (PET) and PET/CT scans use positively charged particles (radioactive positrons) to detect subtle changes in the body's metabolism and chemical activities. It then creates images that show how the body is working, rather than its structure.
Biopsy is a procedure to remove tissue to check for cancer. Biopsies can be done using a needle or by making an incision in the skin. The doctor may remove an entire tumor during the biopsy.

If you are diagnosed with chondrosarcoma, your medical team will stage the tumor. Staging assesses whether the cancer has spread and how quickly it is growing.

The cancer receives a TNM rating, which is based on

the tumor's size (T)
whether the cancer has spread to lymph nodes (N)
whether the cancer has spread to distant organs (M).

Chondrosarcomas also receive a tumor grade (G). The grade is based on

how tumor cells look under a microscope
how many cancer cells are dividing
how much of the tumor is dying.

Higher-grade cancers are likely to grow and spread faster than lower-grade cancers.

Finally, the chondrosarcoma is assigned a stage, from I to IV. The stage is based on

the TNM rating
the tumor grade
whether the cancer has spread to nearby or distant lymph nodes
whether the cancer has spread to other parts of the body.

Expected duration of chondrosarcoma

Chondrosarcoma will continue to grow—and possibly spread—until treated.

Preventing chondrosarcoma

There is no known way to prevent chondrosarcoma.

People with uncommon bone-related conditions may be more likely to develop chondrosarcoma. Also, some scientists have noted a connection between chondrosarcoma and injury to the affected area. However, they do not know whether the trauma triggers the cancer or simply draws attention to an undetected cancer.

Treating chondrosarcoma

Treatment for chondrosarcoma depends on several factors. These include

the type, size, location, and stage of the disease
your age
your overall health.

Surgery is the standard treatment for chondrosarcoma. The surgeon removes the tumor along with some surrounding healthy tissue. Surgical options for chondrosarcoma include biopsy (described above), limb-sparing surgery, and amputation. The best procedure for you will be determined by the cancer's stage and location.

Limb-sparing surgery: The surgeon removes the cancerous bone and cartilage, along with some muscle. The bone may be replaced by a bone transplant or metal prosthesis. Most patients need significant rehabilitation to regain full use of the limb.
Amputation: All or part of a limb is removed. (Most patients do not lose the entire limb.) The patient receives a temporary artificial limb and then a permanent prosthesis. This enables the patient to be physically active.

High-grade tumors may require additional therapy, such as radiation therapy. Radiation therapy uses high-energy x-ray beams to kill cancer cells.

Supportive care treatments help reduce side effects and prevent or treat infections. Regular follow-up care is an important part of treatment, too. Your doctor will monitor your response to treatment, watch for a recurrence of chondrosarcoma, and see if other cancers develop.

When to call a professional

Call your doctor if you experience any symptoms of chondrosarcoma. These include

pain or swelling in the affected area
a lump or mass
enlargement of an existing growth
limping
difficulty moving the affected limb.

Prognosis

The outlook for patients with chondrosarcoma varies from person to person. It depends on a number of factors. These include

the size, location, and grade of the tumor
how much the tumor has spread
the tumor's response to therapy
your age and overall health.

Additional information

National Cancer Institute (NCI)
www.cancer.gov/

American Cancer Society (ACS)
www.cancer.org/

Sarcoma Foundation of America
www.curesarcoma.org/

Boston Children's Hospital
www.childrenshospital.org/

Dana-Farber Cancer Institute
www.dana-farber.org/