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Cartilage tumors: evaluation and treatment
R A Marco1, S Gitelis, G T Brebach
1M.D. Anderson Cancer Center, Houston, USA.
The Journal of the American Academy of Orthopaedic Surgeons
|October 13, 2000
Summary
Treatment for cartilaginous tumors like enchondroma and chondrosarcoma depends on tumor type and symptoms. Benign tumors are often managed nonoperatively, while malignant tumors require surgical intervention tailored to grade, balancing recurrence risk with joint preservation.
Area of Science:
- Orthopedics
- Oncology
- Radiology
Background:
- Cartilaginous tumors encompass a spectrum from benign enchondromas to malignant chondrosarcomas.
- Accurate diagnosis relies on integrating clinicopathologic and radiologic data.
- Treatment strategies vary significantly based on tumor grade and symptomatology.
Purpose of the Study:
- To outline the appropriate management strategies for various cartilaginous tumors.
- To differentiate treatment approaches for enchondromas versus low-, intermediate-, and high-grade chondrosarcomas.
- To emphasize the importance of a multidisciplinary team in managing these bone lesions.
Main Methods:
- Review of clinicopathologic and radiologic findings for tumor classification.
- Analysis of treatment outcomes for different surgical modalities (intralesional excision vs. wide excision).
- Consideration of adjuvant therapies for malignant lesions.
Main Results:
- Enchondromas, typically asymptomatic, are managed nonoperatively; symptomatic cases may undergo intralesional excision.
- Low-grade chondrosarcomas can be treated with intralesional excision (higher preservation, higher recurrence) or wide excision.
- Intermediate- and high-grade chondrosarcomas necessitate wide excisions.
Conclusions:
- Treatment decisions for cartilaginous tumors must be individualized based on precise diagnosis.
- Surgical approach for chondrosarcoma requires balancing oncologic control with functional preservation.
- Optimal management necessitates collaboration among musculoskeletal surgeons, radiologists, and pathologists.