Peripheral Chondrosarcoma
What is Peripheral chondrosarcoma?
Peripheral chondrosarcoma is chondrosarcoma that origin of periosteum and cultivation in the bone. It is less than central chondrosarcoma. Mainly occur in Men, rate for men and women is 2:1. Adult onset, general arise after the 20-year-old, pre-adolescency don't onset.
What is Pathology of Peripheral Chondrosarcoma?
The major components of Chondrosarcoma is cartilage cell tumor, calcified cartilage and bone cartilage. In the main tumor tissues, can be seen even a small amount of blood or bone-like tissue of the small islands of bone tumor, in addition to, or there is a small amount of mucus-like tissue and fibrous tissue, in a few cases, an increase in mucus-like tissue, pathological diagnosis of mucus sometimes sarcoma. Observed within the eye, tumor location in a slight expansion of bone shape, the surface of cortical bone thickening, rough, and depression. Some cases, we can see the complete partial destruction of cortical bone, the formation of prominent tumor enlargement block connected with the bone tissue. Part of the tumor formed by degeneration or myxoid pseudocyst change. Peripheral chondrosarcoma showed the ball may be thick or nodular. Section shows that many of the multi-faceted body, a solid mass, a blue and white.
Which classification of Peripheral chondrosarcoma are there?
Type 1: the most common, accounting for about 2 / 3. In some cases, can be seen in the early days of osteochondroma of the malignant transformation process, but in most cases, a larger tumor volume, can not see the original osteochondroma. Marked and diffuse tumor calcification - ossification, and as a result of necrosis, cartilage cells, rare in these regions, often non-malignant characteristics of cells. The surface of tumor and non-calcified regions of cartilage, there are a large number of cells, these cells larger, there are moderate pleomorphic, often binucleated cell.
Type 2: the more common, accounting for about 1 / 3. Its calcification - the intensity and extent of ossification than the surrounding Type 1 chondrosarcoma small, in the performance of imaging for invasive tumors. Cells have a nuclear, staining deep, large and small, pleomorphic clear that common dual-core.
Type 3: rare. Imaging studies showed strong invasive or invasive tumors, calcification rare. The tumor was well-differentiated cartilage composition, pleomorphic nuclei obviously, deep dyeing, and sometimes strange enormous nuclear or nuclear, or multi-core trinuclear common.
What are Symptoms of peripheral chondrosarcoma?
The main peripheral chondrosarcoma symptoms are located in the surface of bone mass, and its slow growth. Surrounded by soft tissue mass, but with no soft tissue adhesions. Mass often round or spherical, hard texture, as in osteoporosis.
Occur in the pelvis, followed by proximal femur, spine, sacrum, proximal humerus, ribs, clavicle, distal femur and proximal tibia with chondrosarcoma central compared to peripheral chondrosarcoma better in the pelvis and trunk fat bones, and almost to the knee and elbow but not the remote.
In the spine and sacrum, the origin of peripheral chondrosarcoma in the vertebral posterior arch: In the pelvis, the iliac wing of origin or former arch; in the clavicle, the clavicular origin of the body; in the long bones, originated in the metaphysis of long bone epiphyseal end of the last (the location of warts with the bone).
Peripheral chondrosarcoma of the growth in domestic and foreign inflation, violation of pre-existing osteochondroma, such as the further development of peripheral chondrosarcoma can plant in the bone.
Tumor may be pain, but more than half of the patients have pain, mild pain that can be secondary to swelling after. Such as chondrosarcoma is located around the pelvis, may occur lumbosacral plexus and peripheral nerve compression symptoms; such as the vertebral body is located, can cause paraplegia.
As a result of peripheral chondrosarcoma slow growth, the symptoms over a period of time, at least not serious, and because patients have been suffering from years of osteochondroma that osteochondroma is harmless, so at first, around the size of chondrosarcoma often great, and the strange shape.
How is diagnosis for peripheral chondrosarcoma?
Peripheral chondrosarcoma is diagnosed by X-ray test. X-ray images can to make the confirm diagnosis. The basic image is impenetrable density of the X-ray images, is due to the calcified cartilage within the tumor, caused by ossification. Chondrosarcoma with central compared to peripheral chondrosarcoma of the calcification is more common and more widely, in many cases, the density of the image is almost throughout the tumor. As a result, peripheral chondrosarcoma, a bone can be seen outside the tumor, was vague lobulated, cauliflower-like surface as rugged, high density. Thick region in the tumor is not caused by the ivory-like high-density image, we can see a certain degree of non-calcified structures, showed a typical nodular, punctate and ring (corresponding to the cartilage-like leaves and the surrounding sub-formation). Less calcified tumor surface, to make soft tissue tumor with fuzzy boundaries. Other diagnosis for Peripheral chondrosarcoma is based on CT, MRI, general pathology and tissue pathology.
How is treatment for peripheral chondrosarcoma?
Peripheral chondrosarcoma is treated by wide excision. Ⅰ level in peripheral chondrosarcoma or borderline tumors, because of its low rate of relapse, and recurrence of the tumor can be cured, so in certain areas may be marginal excision, limb salvage surgery often used. After resection of lesions within a taboo, such as open pseudocapsule from torn cartilage on the tumor pseudocapsule and fragmentation.
In early peripheral chondrosarcoma, when the tumor is not too great, can remove the tumor from the base of the host bone; but in most cases, peripheral chondrosarcoma of the larger, enveloping the host bone in the the origin is to be tumor line tumor resection, segmental resection for tumor of the limbs, scapula, ribs and most of the surrounding pelvic chondrosarcoma, rarely used in parts of the surrounding spinal chondrosarcoma. Amputation for a huge tumor, surgery can not visit other peripheral chondrosarcoma required extensive resection margin.
Anti-differentiation in a small number of peripheral chondrosarcoma in the use of extensive surgery or radical resection margin, often breaking away from the surgery can be combined with chemotherapy.
What is Prognosis of peripheral chondrosarcoma?
peripheral chondrosarcoma Prognosis depends on the peripheral chondrosarcoma of malignant grade and the possibility of wide excision. Ⅰ grade chondrosarcoma around almost non-transfer; Ⅱ grade peripheral chondrosarcoma can be transferred, but the onset of symptoms 5 years from a rare occurrence; Ⅲ grade peripheral chondrosarcoma often transferred, but also less early.
Peripheral grade chondrosarcoma central chondrosarcoma than low, not only because of the surrounding grade Ⅰ chondrosarcoma, while Ⅲ grade chondrosarcoma rarely around, but also because in the same histological grade, the peripheral chondrosarcoma grade than the lower central chondrosarcoma.
Located around the trunk chondrosarcoma (approximately more than half of all cases), irrespective of how grade, can lead to death, is located in ribs, pelvis, around the scapular chondrosarcoma can be cured by surgical resection, spine and sacrum of peripheral chondrosarcoma rarely cured.