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Mesenchymal chondrosarcoma: imaging features and clinical findings
Soleen Ghafoor1, Meera R Hameed2, William D Tap3
1Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA. ghafoors@mskcc.org.
Skeletal Radiology
|August 1, 2020
Summary
Mesenchymal chondrosarcoma (MCS) often appears as aggressive lytic bone lesions with calcifications. About one-third of MCS cases show a biphasic pattern on imaging, with metastases common in larger tumors.
Area of Science:
- Oncology
- Radiology
- Pathology
Background:
- Mesenchymal chondrosasarcoma (MCS) is a rare bone tumor.
- Distinct imaging features of MCS are not well-established.
Purpose of the Study:
- To characterize the imaging and clinical features of primary mesenchymal chondrosarcoma (MCS).
- To determine the prevalence of a biphasic pattern in MCS on imaging.
Main Methods:
- Retrospective review of 23 patients with pathologically confirmed MCS.
- Analysis of tumor size, location, imaging appearance (lytic, sclerotic, mixed), calcifications, cortical destruction, soft tissue extension, periosteal reaction, contrast enhancement, and radiotracer uptake.
- Assessment for T2-hyperintense lobules on MRI and biphasic morphology on CT.
Main Results:
- Skeletal MCS commonly presented as aggressive lytic or mixed lytic/sclerotic lesions with chondroid calcifications (80%).
- A biphasic morphology was observed in 30% of cases.
- Metastases were present in 52% of patients, more frequent in larger tumors (mean size 13.2 cm vs 7.1 cm).
Conclusions:
- Skeletal mesenchymal chondrosarcoma (MCS) typically presents as aggressive lytic bone lesions with chondroid calcifications.
- A biphasic imaging pattern is present in approximately one-third of MCS cases.
- Metastases are common at initial presentation, particularly with larger tumors.
