Abstract
BackgroundTo investigate the clinical, imaging and pathological features of dedifferentiated chondrosarcoma for better diagnosis.MethodsPatients who had been confirmed to have dedifferentiated chondrosarcoma were enrolled in this study and analyzed in the clinical, imaging and pathological data.ResultsTwenty-five patients had pathologically confirmed dedifferentiated chondrosarcoma including 15 males and 10 females with an age range of 24–74 (median 58, interquartile range 49–65). Ten patients had the tumor at the femur, four at the ilium, two at the humerus, two at the tibia, two at cotyle, and one at each of the following locations: scapula, sacrum, rib, pubic branch, and calcaneus. Twenty-one patients had local pain and a soft tissue mass while the other four patients had only local pain without a soft tissue mass. Four patients had pathological fractures. Imaging showed extensive bone destruction with calcification inside the lesion and possible pathological fractures. On gross observation of the specimen, the chondrosarcoma components were usually located inside the bone, and the dedifferentiated sarcoma components were mainly located outside the bone. Microscopy showed the dedifferentiated tumor had two components: well-differentiated chondrosarcoma and poorly differentiated non-chondral sarcoma including malignant fibrous histiocytoma in eleven cases, osteosarcoma in ten cases, fibrosarcoma in two, liomyosarcoma in one, and lipoblastoma in the remaining one.. Followed up from 3 moths to 60 months (mean 15.6), eight patients died with a survival time of 10–23 months (mean 16), and the other 17 patients survived with the survival duration from three to 60 months (15).ConclusionDedifferentiated chondrosarcoma is a fatal disease with multiple components, and most of the cases have dual morphological and imaging features of chondrosarcoma and non-chondrosarcoma. The imaging presentations are primarily of common central chondrosarcoma, combined with cortical destruction, soft tissue mass, and pathological fractures.
Highlights
To investigate the clinical, imaging and pathological features of dedifferentiated chondrosarcoma for better diagnosis
This study investigated the clinical, pathological and imaging features of patients with dedifferentiated chondrosarcoma confirmed by pathology so as to improve the knowledge of this disease for better diagnosis
Between 2004 and 2018, patients with dedifferentiated chondrosarcoma confirmed by pathology were included in this study
Summary
To investigate the clinical, imaging and pathological features of dedifferentiated chondrosarcoma for better diagnosis. Cao et al BMC Musculoskeletal Disorders (2021) 22:189 features of the dedifferentiated components which underly the chondrosarcoma lesion and determine the growth of the lesion, metastasis, and prognosis of the patients. Even though some radiologic and magnetic resonance imaging features of dedifferentiated chondrosarcoma have been described [10,11,12,13], individual radiologists are still not familiar with the features of this tumor in regard to its multiple malignant mesenchymal components which may have different imaging features. This study investigated the clinical, pathological and imaging features of patients with dedifferentiated chondrosarcoma confirmed by pathology so as to improve the knowledge of this disease for better diagnosis
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