Chondrosarcoma

What is it?

Chondrosarcoma is a malignant bone tumor that arises from the cartilage-producing cells around bones. Chondrosarcomas of the spine represent about 5-10% of chondrosarcomas. It can occur in the bones of the lumbar spine, thoracic spine, cervical spine, and on the top of the spine. It is most common in the 4th and 5th decades of life and is slightly more common in men than women.

Symptoms

Chondrosarcomas of the spine usually cause pain that is not relieved by rest. Other complaints include a palpable mass and neurologic deficits in half of the patients.

Diagnosis

Plain X-rays are not typically useful in visualizing chondrosarcomas. Computed tomography (CT) scans and Magnetic resonance (MRI) are used to distinguish the tumor from other sensitive structures in the area. A contrast agent is often injected before a CT or MRI so that doctor can better visualize the tumor. Spinal angiography reveals blood flow in the area around the tumor and can show which blood vessels are affected.

Treatment

Chondrosarcomas are very resistant to chemotherapy and radiation therapy, so surgery is of critical importance when treating spinal chondrosarcomas. Although the goal of chondrosarcoma surgery is complete tumor removal, preserving or even improving functionality, relieving pain, and controlling local tumor recurrence, the location of these tumors and their involvement with important structures may make complete removal difficult or impossible.

Depending on the tumor location, surgical options include:

  • microsurgical tumor removal
  • anterior cervical corpectomy
  • cervical laminectomy
  • lumbar laminectomy
  • thoracic corpectomy
  • thoracic laminectomy

Spinal fusion and stabilization with metallic implants are often performed following chondrosarcoma removal.

Recovery

The recovery depends on a host of factors, including tumor size and location, presence and degree of metastasis, patient age, and tumor grade.