Chondrosarcoma is one of the most common primary bone cancers in adults over 50 years old. It can be diagnosed at different levels of the body. Surgery is the treatment of first choice.

Definition of chondrosarcoma

Chondrosarcoma is a type of bone cancer. The malignant tumor has the specificity of starting at the junction between two bones at the level of the articular cartilage (flexible and resistant tissue covering the joints).

Chondrosarcoma can develop in any joint cartilage. It is more frequently observed at the level of:

• long bones such as the femur (thigh bone), tibia (leg bone), and humerus (arm bone);
• flat bones like the scapula (back bone), ribs, spine and pelvic bones.

Classification of chondrosarcomas

Cancers can be classified according to many parameters.

For example, it is possible to distinguish primary chondrosarcoma from secondary chondrosarcoma. It is said to be secondary when it is due to the development of another tumor.

Cancers are also classified according to their extent. We speak of staging in medical parlance. The extent of bone cancer is assessed in four stages. The higher the stage, the more cancer has spread throughout the body.

In the majority of cases, chondrosarcomas are at low stages. Stages 1 to 3 correspond to localized forms. Stage 4 designates metastatic forms: cancer cells have migrated to other structures in the body.

Note: bone cancer staging is not applied to tumors in the spine and pelvis.

Causes of chondrosarcoma

Like many other types of cancer, chondrosarcomas have an origin that is not yet fully understood.

To date, it has been observed that the development of chondrosarcoma could be due or favored by:

• benign (non-cancerous) bone tumors such as chondroma or osteochondroma;
• bilateral retinoblastoma, a type of eye cancer;
• Paget’s disease, a benign bone disease;
• Li-Fraumeni syndrome, a rare condition predisposing to different types of tumors.

Diagnostic of chondrosarcome

This type of cancer can be suspected in the cases mentioned above, or in the face of certain clinical signs. The diagnosis of chondrosarcoma can be confirmed and deepened by:

• medical imaging tests such as x-rays, CT scans, magnetic resonance imaging (MRI) and bone scintigraphy;
• a biopsy which consists of taking a piece of tissue for analysis, especially if cancer is suspected.

These tests can be used to confirm the diagnosis of osteosarcoma, to measure its extent and to check for the presence or absence of metastases.

Persons concerned

Chondrosarcomas are usually diagnosed in adults over the age of 50. These cancers can nevertheless appear from the age of thirty. They are rarely seen in children and adolescents.

Bone pain

Bone pain is usually the first sign of bone cancer. The pain can be permanent or transient, more or less intense, localized or diffuse.

Local swelling

The development of chondrosarcoma can lead to the appearance of a lump or palpable mass in the affected tissue.

Other associated signs

The pain may be accompanied by other signs depending on the location, type and course of the cancer. For example :

• motor disorders, especially when the bones of the pelvis are affected;
• breathing problems when cancer develops in the ribs.

Surgical intervention

Surgery is the treatment of first choice. The intervention can use different methods including:

• wide excision, which is the removal of the tumor along with part of the bone and normal tissue surrounding it;
• curettage, which is the removal of the tumor by scraping without affecting the bone.

Radiotherapy

This method involves using radiation to destroy cancer cells. It is considered when the chondrosarcoma cannot be removed by surgery.

Surgery and chemotherapy

When the chondrosarcoma is aggressive, chemotherapy may be considered in addition to the surgery. Chemotherapy treatment uses chemicals to stop cancer cells from growing.

Immunotherapy

This is a new avenue of cancer treatment. It could be a complement or an alternative to the treatments mentioned above. Much research is underway. The goal of immunotherapy is to stimulate the body’s immune defenses to fight the development of cancer cells.

The origin of chondrosarcomas is still poorly understood. Generally speaking, cancer prevention currently relies on maintaining a healthy lifestyle.

It is also recommended to seek medical advice in the slightest doubt. Early diagnosis promotes successful treatment and limits the risk of complications.