peripheral chondrosarcoma
Introduction
Introduction to peripheral chondrosarcoma Peripheral chondrosarcoma is a chondrosarcoma that originates from the bone and is implanted on the bone. The incidence is less than central chondrosarcoma. Occurs in men, the ratio of men to women is 2:1. Adult onset, generally seen after the age of 20, no morbidity before puberty. Some patients may have multiple hereditary osteochondromas or a single osteochondroma, but most patients have no similar history. A history of multiple operations and repeated recurrences of the mass is not uncommon. In this case, one or more soft tissue masses or nodules that are completely separated from the bone can be touched. The main symptom of this disease is a mass located on the bone surface. The growth is slow, the mass is surrounded by soft tissue, but it has no adhesion to the soft tissue. The mass is often round or spherical, and the texture is hard, like bone. When the peripheral chondrosarcoma is located on the torso At the time of bone, the original osteochondroma traces are rarely observed, probably because the osteochondroma is small or unknown. basic knowledge The proportion of illness: 0.004%-0.008% Susceptible people: good for men Mode of infection: non-infectious Complications: paraplegia
Cause
Causes of peripheral chondrosarcoma
Cause:
The main components of chondrosarcoma are neoplastic chondrocytes, calcified cartilage and cartilage bone. In the main tumor tissues, a small amount of bone-like bone-like tissue or small islands of tumor bones may be seen, or there may be a small amount of mucin-like tissue and fibrous tissue. In a few cases, mucinous tissue is increased, and pathologically sometimes diagnosed as mucus. Sarcoma.
Prevention
Peripheral chondrosarcoma prevention
Prognosis depends on the malignant grading of peripheral chondrosarcoma and the possibility of extensive resection. Grade I peripheral chondrosarcoma is almost non-metastatic; grade II peripheral chondrosarcoma can metastasize, but it is rare in 5 years after symptoms appear; grade III peripheral chondrosarcoma often metastasizes, but few occur early.
Peripheral chondrosarcoma is less malignant than central chondrosarcoma, not only because of grade I peripheral chondrosarcoma, but also because of grade III peripheral chondrosarcoma, but also because of the same histological grade, peripheral chondrosarcoma Malignancy is also lower than central chondrosarcoma.
Peripheral chondrosarcoma located in the trunk (about half of all cases), regardless of its malignancy, can lead to death. Peripheral chondrosarcoma located in the ribs, pelvis, and scapula can be cured by surgical resection, spine and humerus. Peripheral chondrosarcoma is rarely cured.
Complication
Peripheral chondrosarcoma complications Complications
The most common disease is the formation of a mass at the disease site, the tumor can be painless, but more than half of the patients have pain, this pain is mild, can occur after the swelling, such as peripheral chondrosarcoma in the pelvis, Compression symptoms of the lumbosacral plexus and peripheral nerves, such as located in the vertebral body, can cause paraplegia.
Symptom
Peripheral chondrosarcoma symptoms Common symptoms Bone mass nodules slow growth central calcification
The main symptom of this disease is a mass located on the bone surface. The growth is slow, the mass is surrounded by soft tissue, but it has no adhesion to the soft tissue. The mass is often round or spherical, and the texture is hard, like bone. When the peripheral chondrosarcoma is located on the torso At the time of bone, the original osteochondroma traces are rarely observed, probably because the osteochondroma is small or unknown.
Examine
Examination of peripheral chondrosarcoma
X-ray examination is helpful for the diagnosis of this disease. CT, MRI and pathological examination can also be used in a few cases:
1. The images seen on the X-ray are typical, and generally will not be misdiagnosed, and even diagnosed before the histological diagnosis.
The basic image is an image of increased density and impervious X-ray. It is caused by calcification and ossification of cartilage in the tumor. Calcification of peripheral chondrosarcoma is more common and more extensive than central chondrosarcoma. In many cases, This increased density of images spreads almost throughout the tumor. Therefore, in peripheral chondrosarcoma, an extra-bone mass can be seen, which is fuzzy and lobulated, and the surface is uneven like broccoli. The density is high. The thick area does not cause high-density images of ivory shape. It can be seen that calcification has no specific structure, typical nodular shape, point and ring shape (corresponding to cartilage-like lobes and peripheral formation), calcification of the surface of the tumor. Less, so that the boundaries between tumors and soft tissues are blurred.
2. In very rare cases, peripheral chondrosarcoma still appears as an image of osteochondroma on the image, and its malignant evolution can be determined by CT, MRI, gross pathology and histopathology. Adults should be negative, but strong positive.
Diagnosis
Diagnosis and diagnosis of peripheral chondrosarcoma
diagnosis
The diagnosis of this disease is generally easier, and it can even be diagnosed from imaging alone.
Differential diagnosis
Sometimes, it is necessary to identify between large, X-ray-free osteochondromas and peripheral chondrosarcoma.
1. The radiopaque image of osteochondroma has high density and irregularity, and has obvious boundary with soft tissue. On the contrary, the boundary between soft tissue and soft tissue is unclear. CT and MRI help to find peripheralness. The cartilage cap of chondrosarcoma thickens and can be differentiated from the effusion of the top of the osteochondroma. The bone scan is weakly positive in adult osteochondroma and is strongly positive in peripheral chondrosarcoma. In addition, the tumor is Continued growth in adulthood also supports the diagnosis of peripheral chondrosarcoma, which can be observed continuously by X-ray film.
2, the differential diagnosis of peripheral chondrosarcoma and paracortical osteosarcoma is easier, the paracortical osteosarcoma may have cartilage area, but it has its own good hair, the base of the host bone is different from the surrounding chondrosarcoma, bone-like It is impervious to X-ray images and has typical histopathology in the non-chondral area.
3, peripheral chondrosarcoma need to be differentiated from synovial chondromatosis, the gross pathology and histopathology of synovial chondromatosis is very similar to grade I, or even grade II peripheral chondrosarcoma, but synovial chondromatosis originates from the joint Cavity or tendon sheath, and its clinical, imaging is different from peripheral chondrosarcoma.
Finally, in special cases, peripheral chondrosarcoma needs to be differentiated from the osteophytes of reactive or pseudotumor osteochondral, which have the characteristics of active proliferative and proliferating cells.
