Curettage of biopsy-diagnosed grade 1 periacetabular chondrosarcoma

Clin Orthop Relat Res. 2007 Jun:459:146-9. doi: 10.1097/BLO.0b013e3180619554.

Abstract

Intralesional excision of intraosseous grade 1 periacetabular chondrosarcoma may seem an attractive alternative to the current recommendation of joint-sacrificing, en bloc resection. We report eight patients who initially underwent this treatment to identify if local tumor control can be achieved consistently. All patients had a percutaneous biopsy that was interpreted as grade 1 chondrosarcoma. The final histology after curettage indicated Grade 1 chondrosarcoma in five patients, Grade 2 in two, and dedifferentiated chondrosarcoma in one. Three of the five patients with true grade 1 chondrosarcoma have been free of disease at a median followup of 108 months. The other two patients with grade 1 chondrosarcoma on the curettage specimen recurred as higher-grade tumors. Three patients died of high-grade chondrosarcoma at a median of 23 months (range 17-72 months). Overall, the majority of patients in this cohort had either a misdiagnosis or recurrence of higher-grade disease. Based on these observations, in the absence of a predictable method to identify the true intraosseous grade 1 chondrosarcomas of the pelvis, curettage must be undertaken with the understanding that a percutaneous biopsy may misrepresent the histologic grade and that curettage may result in a higher risk of recurrence.

MeSH terms

  • Adult
  • Bone Neoplasms / pathology
  • Bone Neoplasms / surgery*
  • Chondrosarcoma / pathology
  • Chondrosarcoma / surgery*
  • Curettage*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Orthopedic Procedures
  • Pelvic Bones*
  • Reoperation
  • Retrospective Studies
  • Treatment Outcome