Grade 1 chondrosarcoma of bone: a diagnostic and treatment dilemma

Cartilaginous lesions of bone are relatively common and cover a large spectrum from latent enchondroma to aggressive dedifferentiated chondrosarcoma. Differentiating among these lesions, particularly benign enchondroma and low-grade chondrosarcoma, can be challenging. Differentiating involves assimilation and interpretation of clinical, radiographic, and histologic criteria. Molecular techniques to assist in distinguishing among the various subtypes are being developed, but these techniques have not yielded any clinically significant contribution. As a result of an imperfect diagnostic schema, a consensus on treatment algorithms has been elusive. This review highlights the specific clinical, radiographic, and histologic criteria currently used clinically to differentiate between benign enchondroma and low-grade chondrosarcoma. We discuss the promise of emerging molecular technologies. Finally, we provide a review of the available literature on treatment outcomes, along with a discussion of our own particular preferences.