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Chondrosarcoma Facts
By peace | December 15, 2006
Chondrosarcoma is a type of bone cancer that develops in cartilage cells. Cartilage is the specialized, gristly connective tissue that is present in adults and the tissue from which most bones develop. Cartilage plays an important role in the growth process. There are many different types of cartilage that are present throughout the body. Chondrosarcoma is a malignant type of bone cancer that primarily affects the cartilage cells of the femur (thighbone), arm, pelvis, knee, and spine. Although less frequent, other areas (such as the ribs) may be affected.
Chondrosarcoma is the second most common type of primary bone cancer. A primary bone cancer is one that originates from bone versus another organ. This type of cancer rarely affects individuals under age 20 and is most common between the ages of 50 and 70. The incidence between males and females is equal.
The aggressiveness of chondrosarcoma is graded based on how fast it grows and its likelihood to metastasize or spread to other parts of the body. Grade 1 is a low grade (slow growing) cancer, and grades 2 and 3 are higher grades (fast growing) cancers. Depending on the grading system used by your medical facility, it’s also possible to have grade 4 which would be even more aggressive than lower grade tumors. The most common bones for chondrosarcoma to grow are the pelvic and shoulder bones along with the superior regions of the arms and legs. But they can also be found in any bones of the body, even in the base of the skull.
Two non-cancerous diseases, Maffuci disease and Ollier disease, are similar to chondrosarcoma. Ollier disease, also known as enchondromatosis or dyschondroplasia, is a disorder affecting the growth plates of bone where new bone is deposited. The cartilage laid down is not reabsorbed and masses form near the ends of the long bones such as the thigh bone (femur) and upper arm bone (humerus). Maffucci disease has the same abnormalities as Ollier disease as well as soft tissue destruction including the skin. Patients with Maffucci or Ollier disease should have bone scans every three to five years to monitor potential malignant transformations.
Cause Of Chondrosarcoma
Most chondrosarcomas are low-grade lesions. They are typically seen in adults in their late 20s to 60s. They occur more commonly in men than women. Chondrosarcoma is not contagious. It cannot be passed on to another person by exposure to a chondrosarcoma patient.
The exact cause of chondrosarcoma is not known. There may be a genetic or chromosomal component that predisposes certain individuals to this type of malignancy.
Risk Factor
A risk factor is anything that may increase a person’s chance of developing a disease. It may be an activity, such as smoking, diet, family history, or many other things. Different diseases have different risk factors.
Although these factors can increase a person’s risk, they do not necessarily cause the disease. Some people with one or more risk factors never develop a disease, while others develop the disease and have no known risk factors.
But, knowing your risk factors to any disease can help to guide you into the appropriate actions, including changing behaviors and being clinically monitored for the disease.
Most often, chondrosarcoma occurs from normal cartilage cells, but it may also stem from a preexisting benign (non-cancerous) bone or cartilage tumor. The following is a list of some benign conditions that may be present when chondrosarcoma occurs:
- enchondromas – a type of benign bone tumor that originates from cartilage and usually affects the hands (can also affect other areas).
- osteochondromas – an overgrowth of cartilage and bone near the end of the bone near the growth plate.
- multiple exostoses – the presence of multiple osteochondromas (an overgrowth of cartilage and bone near the end of the growth plate).
- Ollier’s disease – a cluster of enchondromas (benign cartilage tumor that usually affects the hands).
- Maffucci’s syndrome – a combination of multiple enchondroma (benign cartilage tumors that usually affects the hands) tumors and angiomas (benign tumors made up of blood vessels).
Symptoms of Chondrosarcoma
Symptoms of chondrosarcoma may vary depending on the location of the tumor. The following are the most common symptoms of chondrosarcoma. However, each individual may experience symptoms differently. Symptoms may include:
- large mass on the affected bone
- feeling of pressure around the mass
- pain that is usually worse at night and may be relieved by taking anti-inflammatory medications such as ibuprofen
- pain that is not usually relieved through rest
- pain that may be present for years but increases gradually over time
Diagnosis Of Chondrosarcoma
In addition to a complete medical history and physical examination, diagnostic procedures for chondrosarcoma may include the following:
- biopsy – a procedure in which tissue samples are removed (with a needle or during surgery) from the body for examination under a microscope; to determine if cancer or other abnormal cells are present.
- x-ray – a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
- computed tomography scan (Also called a CT or CAT scan.) – a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.
- magnetic resonance imaging (MRI) – a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.
Treatment For Chondrosarcoma
Specific treatment for chondrosarcoma will be determined by your physician based on:
* your age, overall health, and medical history
* extent of the disease
* your tolerance for specific medications, procedures, and therapies
* expectation for the course of the disease
* your opinion or preference
The goal for treatment of chondrosarcoma is to remove the mass and reduce the likelihood that it will return. Close follow-up with your physician may be necessary. Treatment may include:
* surgery (to remove the tumor)
* physical therapy (to regain strength and use of the affected area after surgery)
* chemotherapy- Chemotherapy, although is not the primary treatment, may be required if the cancer has spread to other areas of the body.
Definition Of Diseases
Ollier’s Disease (a.k.a multiple enchondromatosis) is a disease of multiple benign bone tumors (enchondromas) within the bones which cause affected bones to swell. The disease often primarily affects one side of the body. It may affect the hands or feet, or be generalized. It is not an inherited disease. Patients have bony swellings, limb shortening and mechanical difficulties, associated with joint disruption and short stature. The condition usually presents before age 10. These typically occur in the bone metaphyses and can lead to secondary deformity of the growth plates. A secondary Madelung deformity may occur at the wrists. There is a small increased risk of malignant transformation to chondrosarcoma, particularly in flat bones, during adult life. Ollier’s is often diagnosed at the time chondrosarcoma is diagnosed.
Maffucci Syndrome is a rare genetic disorder characterized by benign enlargements of cartilage (enchondromas), bone deformities, and dark, irregularly shaped hemangiomas within the body or on the skin). The disease manifests early in life, usually around the age of 4 or 5 years, with 25% of cases being congenital. There is relatively high risk of malignant transformation to chondrosarcoma in adult life (reportedly 20-30%). Relatively few cases have been published in the English literature.
Multiple Hereditary Exostoses (MHE, a.k.a., osteochondromatoses) is a hereditary skeletal disorder in which there are numerous cartilage-capped excrescences (sp) in areas of actively growing bone (osteochondromas). The condition is genetically heterogeneous, and at least three genes (ext1 and ext2) have been demonstrated to be involved. The reported risk for malignant transformation to chondrosarcoma has been from 0.6% to 2.8% The lesions most at risk for malignant transformation are those occurring near the pelvis, scapula, proximal humerus, proximal femur, and spine. Change in size of the exostosis or onset of pain in an affected adult is cause for further investigation.
Wilms Tumor is a neoplasm of the kidneys that typically occurs in children. It is also known as a nephroblastoma. Although rare, chondrosarcoma of bone has been described as secondary tumor after diffuse anaplastic Wilms’ tumor.
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