Chondrosarcoma of small bones of the hands and feet

Cartilaginous tumors of the hands and feet are not uncommon. Most are enchondromas, but they tend to show high cellularity, enlargement of nuclei, and many double-nucleated cells. Hence, differentiation between a benign lesion and chondrosarcoma may be difficult.

The files of patients treated at the Mayo Clinic and the consultation files were reviewed for examples of chondrosarcoma of small bones of the hands and feet. Histologic features and clinical charts were reviewed in all cases, and radiographs were reviewed in 111 cases.

Seventy-five lesions involved the feet and 88 involved the hands. Bones of the fifth finger and the calcaneus were the most common sites of involvement. Nineteen tumors were secondary. Of the 104 intramedullary lesions studied radiologically, 96 showed cortical destruction, 83 a soft tissue mass, and 52 a permeative lytic pattern. Histologically, soft tissue extension and permeation of preexisting bone indicated malignant disease. One hundred sixteen tumors were Grade 1, 44 were Grade 2, and 3 were Grade 3. Of the 12 patients with distant metastasis from chondrosarcoma, 7 died of disease. Chondrosarcomas of the calcaneus and the talus were more likely to metastasize.

Chondrosarcoma of small bones of the hands and feet has the potential to be fatal.