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. 2013 Jun;14(2):101-7.
doi: 10.1007/s10195-013-0230-6. Epub 2013 Mar 6.

Surgical treatment of central grade 1 chondrosarcoma of the appendicular skeleton

Domenico Andrea Campanacci  1 , Guido Scoccianti, Alessandro Franchi, Giuliana Roselli, Giovanni Beltrami, Massimiliano Ippolito, Giuseppe Caff, Filippo Frenos, Rodolfo Capanna
Affiliations

Surgical treatment of central grade 1 chondrosarcoma of the appendicular skeleton

Domenico Andrea Campanacci et al. J Orthop Traumatol. 2013 Jun.

Abstract

Background: Diagnosis and treatment of low-grade chondrosarcoma remain controversial. We performed a review of a single-center series with the aims of assessing the oncologic outcome of these patients, verifying if intralesional curettage can be adequate treatment, and defining clinical criteria to support the surgeon and the oncologist in decision-making for surgery and subsequent follow-up.

Materials and methods: A retrospective review of 85 patients was performed (61 females and 24 males, age range 20-76 years). The site of the lesion was the femur in 35 cases, humerus in 33, tibia in 15, and fibula in 2. Sixty-four patients were treated by intralesional curettage. Twenty-one patients with aggressive radiological patterns were treated with wide resection.

Results: Mean follow-up was 67 months (range 24-206 months). Two patients developed local recurrence, both after intralesional curettage. The difference in incidence of recurrence was not statistically significant between the two groups. No distant metastases were observed. Postsurgical complications were significantly higher in the resection group.

Conclusions: Low-grade chondrosarcoma of the appendicular skeleton without aggressive radiological patterns can be treated with intralesional surgery with good oncological outcome and very low rate of postsurgical complications. Wide resection, following surgical principles of malignant bone tumors, should be considered only when aggressive biologic behavior is evident on imaging.

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Figures

Fig. 1
Fig. 1
a, b Grade 1 CS of the proximal tibia involving the whole metaepiphysis. The anteroposterior (AP) radiographic view and magnetic resonance imaging (MRI) show the endosteal scalloping and cortical thinning consistent with aggressive imaging features. c, d Proximal tibia resection with wide margins and allograft–prosthesis composite reconstruction was performed
Fig. 2
Fig. 2
a Grade 1 CS of the distal femur. MRI lateral view. b Positive positron emission tomography (PET) scan. c, d AP and lateral (LL) radiographs at 5.5 years from surgery. Curettage, filling with allografts, and plate and screws fixation were performed
See this image and copyright information in PMC

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