Abstract
Periosteal chondrosarcoma (PC) is a rare low-grade malignant cartilaginous tumor originating on the bone surface. Wide surgical resection is the recommended treatment. Prognosis is usually good if surgery is adequate. Metastasis is late and very rare. We present the clinical, radiographic, and pathological features of a PC accompanied with fibular cortical invasion in a 30-year-old woman. Wide resection was performed at presentation, but a whole-body positron emission tomography/computed tomography (PET/CT) examination 10 months after operation showed multiple bone metastases (MBM) especially in the spine, pelvis, bilateral femurs, and humeri without local recurrence. To the best of our knowledge, the present report is the first concerning a PC with so extensive postoperative MBM but without local recurrence.
Highlights
Periosteal chondrosarcoma (PC) is a rare low-grade malignant cartilaginous tumor originating on the bone surface, accounting for less than 2% of all chondrosarcomas and about 0.2% of all bone tumors [1,2,3]
We report a grade 2 PC with cortical invasion in the left proximal fibula of a 30-year-old woman
positron emission tomography (PET)/computed tomography (CT) showed focal F-18 2-fluoro [fluorine-18]-2-deoxy-Dglucose (FDG) uptake especially in the spine, pelvis, bilateral femurs, and humeri, with a maximum SUV of 10.8, but with no signs of local recurrence and no focal F-18 FDG uptake in the brain, head, neck, chest, and abdomen except a small nodule in the liver which was suspected as a calcification (Figure 5)
Summary
PC is a rare low-grade malignant cartilaginous tumor originating on the bone surface, accounting for less than 2% of all chondrosarcomas and about 0.2% of all bone tumors [1,2,3]. We report a grade 2 PC with cortical invasion in the left proximal fibula of a 30-year-old woman. MRI showed a vaguely lobulated solid mass measuring 5.5 × 5.0 × 4.5 cm on the posterolateral aspect of the left proximal fibula. PET/CT showed focal F-18 FDG uptake especially in the spine, pelvis, bilateral femurs, and humeri, with a maximum SUV of 10.8, but with no signs of local recurrence and no focal F-18 FDG uptake in the brain, head, neck, chest, and abdomen except a small nodule in the liver which was suspected as a calcification (Figure 5). The histopathological result of the needle biopsy of the ilium confirmed the diagnosis of MBM of chondrosarcoma, and the grade of metastatic chondrosarcoma was similar to that of primary PC (Figure 4D, E). Hematoxylin and eosin (H&E) staining indicated a vaguely lobulated neoplastic hyaline cartilage separated by fibrous bands and focal myxoid change
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