Chondrosarcoma - Types, Causes, Symptoms, Diagnosis and Treatment

What Is Sarcoma?

Sarcoma is a tumor that can occur on cartilage, muscles, blood vessels, and nerves. It is classified into different types depending on the site of occurrence. Many types of sarcoma are identified and studied. They are named according to the site of occurrence because it makes it easy for medical professionals to communicate and discuss them.

What Is Chondrosarcoma?

Chondrosarcoma is a type of cancer that affects the hard and soft tissues. The hard tissues involve the bone, and the soft tissue comprises cartilage. The cancer is known to occur in pelvic bones, shoulder, and hip commonly. Skull bones are also involved. But it is only a rare occurrence. It is known to affect males more than females. It affects people between the ages of 10 to 80 years. Diagnosis requires precise tools, and the treatment is usually a long-term process.

What Are the Types of Chondrosarcoma?

There are two types of chondrosarcoma. They are:

• Primary Chondrosarcoma: Primary chondrosarcoma occurs anywhere outside the bone. It is generally referred to as extraskeletal chondrosarcoma.

• Secondary Chondrosarcoma: Secondary chondrosarcoma occurs primarily in the bone and cartilage. The age of occurrence is relatively earlier than primary chondrosarcoma.

Other Variants:

• Mesenchymal Chondrosarcoma: Mesenchymal chondrosarcoma most commonly occurs in the jaws and ribs. It affects people between the ages of 10 and 30. In this type, both men and women are equally affected.

• Clear Cell Chondrosarcoma: Clear cell chondrosarcoma can be identified using clinical signs. The growth of the tumor is prolonged. With proper treatment, the prognosis is good. The surgical option is helpful.

• Dedifferentiated Chondrosarcoma: Dedifferentiated chondrosarcoma is the most severe type. Histological examination is beneficial for diagnosing this type of chondrosarcoma. Patients with differentiated chondrosarcoma are expected to live only five years.

What Are the Causes of Chondrosarcoma?

Chondrosarcoma is caused due to genetic mutations. The important function of genes is deciding the appearance and functions of an individual. It is made up of DNA, a deciding factor in heredity. All the information required for growth and development is happening in an organized way, and if there is any alteration, it will result in genetic mutations. Most of the genetic mutations are permanent, and they might cause severe complications. Patients who had a previous history of treatment with radiation therapy or chemotherapy.

Chondrosarcoma is known to occur due to a few other health disorders. They could result in severe high-grade chondrosarcoma.

They are:

• Multiple hereditary exostoses.

• Maffucci syndrome.

• Ollier's disease

• Wilms’ tumor

• Paget’s disease.

Chondrosarcoma is classified into three categories based on the severity of the condition. They are:

• Grade I: Low grade.

• Grade II: Intermediate grade.

• Grade III: High grade.

What Are the Symptoms of Chondrosarcoma?

There are no exact signs or symptoms to identify chondrosarcoma. Only some of the patients experience pain. Pain might be severe or mild, depending on the intensity of the tumor. People between 30 and 39 years old are more likely to get chondrosarcoma. Generally, chondrosarcoma is known to progress very slowly.

The common symptoms:

• Frequent fractures of the bone due to weakness.

• Pain in the affected area.

• Swelling.

• Loss of functioning of the nerves.

What Is a Low-Grade Chondrosarcoma?

Low-grade chondrosarcoma is a variant with slow growth and less aggressiveness than other forms of chondrosarcoma. This grade 1 tumor grows more slowly than higher-grade (grade 2 and 3) tumors. Low-grade chondrosarcoma generally does not metastasize or spread to other body parts and stays in place. Despite this, as with all cancers, it is potentially life-threatening if not managed correctly.

Key characteristics of low-grade chondrosarcoma:

• Metastasis is less likely to occur.

• Most often, it affects the pelvis, the femur, or other long bones.

• Most common in individuals between ages 40 and 70.

• Typically, it has a more favorable prognosis than higher-grade forms.

How Is Chondrosarcoma Diagnosed?

The doctor will test the patient in a clinical setting, noting the patient's health condition and medical history. The following tests would be required to support the clinical examination.

• Positron Emission Tomography (PET): Positron emission tomography uses highly radioactive substances for imaging. All the metabolic processes could be identified in this procedure. It is known to be helpful for identifying the condition of chondrosarcoma.

• X-Rays: An X-ray is a reliable tool when it comes to bone-related disorders. You must check your medical conditions because X-rays can be harmful to some patients. Otherwise, it is the best diagnostic tool, and doctors use it to explain the condition to patients.

• MRI Scan (Magnetic Resonance Imaging Scan): It helps in the identification of the involvement of the tumor. After getting the MRI reports, the surgery is planned.

• Biopsy: Biopsy can be obtained by either an open technique or a closed technique. The closed technique uses the needle aspiration method for diagnosis. The specimen is collected from the patient, and the laboratory will produce the diagnosis results.

• Bone Scan: The structures of the bone can be visualized well with bone scans.

What Are the Stages of Chondrosarcoma?

Chondrosarcoma staging is necessary to guide treatment and provide prognostic information. The stage of cancer depends on things like how big the tumor is, if and how quickly it is growing (the grade), and if it has spread to other parts of your body. Stages of chondrosarcoma are defined by the TNM system, from the American Joint Committee on Cancer (AJCC).

• T (Tumor): It shows the size of the tumor and whether it has spread to nearby structures.

• N (Nodes): This tells you if the cancer has spread to any lymph nodes near your prostate.

• M (Metastasis): It tells us whether the cancer has spread to distant organs or bones.

The Stages of Chondrosarcoma:

• Stage I:

  • IA: Grade 1, less than 3.15 inches in size, nonmetastatic tumor.

  • IB: High-grade tumor; tumor larger than 3.15 inches, still localized.

• Stage II:

  • IIA: Grade 2 or 3, smaller than 3.15 inches in size, and not metastatic.

  • IIB: Tumor with intermediate or high grade, more than 3.15 inches.

• Stage III: The tumor has spread to regional lymph nodes and possibly become high-grade but has not metastasized to distant organs.

• Stage IV:

  • IVA: More cancer is found in the lungs.

  • IVB: The tumor has metastasized to another distant organs, e.g., liver, bones, or lymph nodes.

What Is the Life Expectancy With Chondrosarcoma?

Chondrosarcoma survival rates overall depend solely on the location and grade of chondrosarcoma. Low-grade chondrosarcoma (stage I)- is easier to treat as low-grade chondrosarcomas tend to grow slowly and spread less. When diagnosed and treated early, low-grade chondrosarcoma (grade 1) has an excellent prognosis with 5-year survival rates in the range of 80 to 90 percent.

In low-grade chondrosarcoma (grades 1 and 2), the survival rate is around an excess of 80 percent over a period of five years. For grade 3 high-grade chondrosarcoma, the survival becomes significantly reduced with an upper limit at 30 to 50 percent chance of living longer than five years, depending on whether treatment begins and if metastasis has occurred.

The stats, although they give some general guidelines, are by no means indicative of what to expect every time. More assertive chondrosarcoma can be kept under control with the proper therapy, but nonchalant tumors are life-threatening more willingly if that cancer is not runnable early.

What Are the Treatment Options for Chondrosarcoma?

The treatment protocol for chondrosarcoma involves the following.

• Radiation Therapy: Radiation therapy is usually planned along with chemotherapy or surgical options. There are many side effects of radiation therapy, and it is necessary to communicate well with your doctor before going for it.

• Surgery: Limb salvage surgery is recommended for chondrosarcoma patients. Amputation is also one of the treatment methods.

• Curettage: An intralesional curettage surgery is recommended for low-grade chondrosarcoma. A bony window is made, and thermal curettes are used to remove the lesion. It requires highly skilled professionals for successful curettage.

• Chemotherapy: It is the least preferred treatment method. But, it is beneficial for chondrosarcoma in the initial stages. The dosage and drug regimen are planned by the doctor. There are some complications associated with chemotherapy treatment. You have to be clear on your treatment plan before going for it.

What Are the Risk Factors of Chondrosarcoma?

The condition of chondrosarcoma can occur at any age. There is no age-related risk. If the patient has a poor immune system, it would be difficult for the patient to handle the condition. The patient should also have the strength to bear the radiation therapy procedures in treatment.

How Is Prognosis?

The prognosis helps to predict the rate of recovery after the treatment. For chondrosarcoma, it is difficult to predict the outcome because it depends on the health and healing capacity of the individual. In low-grade cases of chondrosarcoma, the prognosis is good. Only in complicated cases, the life expectancy is reduced.

Conclusion

Although less aggressive, low-grade chondrosarcoma is a potentially malignant tumor requiring definitive surgery for curative therapy. Early detection and surgical excision results in a favorable long-term prognosis, as it is highly curable. The better we understand the stage of the disease as well as our recognition of symptoms, this will allow us to treat chondrosarcoma more effectively.