Top

European Journal of Orthopaedic Surgery & Traumatology

Published in:

01-01-2020 | Chondrosarcoma | Original Article • PELVIS - TUMORS

Differential diagnosis and treatment of enchondromas and atypical cartilaginous tumours of the pelvis: analysis of 21 patients

Authors: Patricio A. Alfaro, Giovanni Ciani, Carlos A. Herrera, Davide Maria Donati, Costantino Errani

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 1/2020

Abstract

Introduction

Studies focusing on enchondroma and atypical cartilaginous tumour (ACT) of the pelvis are lacking. The purpose of this study was to verify possible clinical and radiological findings with regard to distinguishing enchondromas from ACT of the pelvis. In addition, this study analysed functional and oncological outcomes in patients with enchondromas or ACT of the pelvis treated with curettage or resection.

Materials and methods

We retrospectively reviewed the medical records of 21 patients with confirmed enchondroma or ACT of the pelvis treated by curettage or resection from 1985 to 2018. The minimum follow-up was 18 months. The relationship between clinical and radiological factors and tumour type or local recurrence was assessed using Fisher exact test and Mann–Whitney U test.

Results

Endosteal scalloping (p = 0.039), tumour size (0.005) and age (0.006) were shown to statistically favour ACT over enchondroma; by contrast, enchondroma and ACT patients had no difference in pain frequency (p = 0.5528). All patients with enchondroma had no local recurrence; in contrast, local recurrence occurred in one patient with ACT, initially treated with resection. The patient with local recurrence had a disease progression with a higher histological grade than the original tumour. Patients treated with curettage had better functional outcomes than patients treated with resection (p = 0.001).

Discussion

Endosteal scalloping, tumour size and age could be helpful in the differential diagnosis between enchondroma and ACT of the pelvis. In addition, our study showed that ACT of the pelvis can be safely treated with curettage due to a low risk of local recurrence and better functional results compared with resection. In case of recurrence, we suggest to treat these patients with resection for the risk of disease progression.

Eefting D, Schrage Y, Geirnaerdt M et al (2009) Assessment of interobserver variability and histologic parameters to improve reliability in classification and grading of central cartilaginous tumors. Am J Surg Pathol 33:50–57. https://doi.org/10.1097/PAS.0b013e31817eec2b CrossRefPubMed

Parlier-Cuau C, Bousson V, Ogilvie CM et al (2011) When should we biopsy a solitary central cartilaginous tumor of long bones? Literature review and management proposal. Eur J Radiol 77:6–12. https://doi.org/10.1016/j.ejrad.2010.06.051 CrossRefPubMed

Murphey MD, Flemming DJ, Boyea SR et al (1998) Enchondroma versus chondrosarcoma in the appendicular skeleton: differentiating features. RadioGraphics 18:1213–1237. https://doi.org/10.1148/radiographics.18.5.9747616 CrossRefPubMed

Errani C, Tsukamoto S, Ciani G et al (2017) Risk factors for local recurrence from atypical cartilaginous tumour and enchondroma of the long bones. Eur J Orthop Surg Traumatol 27:805–811. https://doi.org/10.1007/s00590-017-1970-4 CrossRefPubMed

Sheth DS, Yasko AW, Johnson ME et al (1996) Chondrosarcoma of the pelvis: prognostic factors for 67 patients treated with definitive surgery. Cancer 78:745–750. https://doi.org/10.1002/(SICI)1097-0142(19960815)78:4%3c745:AID-CNCR5%3e3.0.CO;2-D CrossRefPubMed

Bus MPA, Campanacci DA, Albergo JI et al (2018) Conventional primary central chondrosarcoma of the pelvis: prognostic factors and outcome of surgical treatment in 162 patients. J Bone Joint Surg Am 100:316–325. https://doi.org/10.2106/JBJS.17.00105 CrossRefPubMed

Ferrer-Santacreu EM, Ortiz-Cruz EJ, Díaz-Almirón M, Pozo Kreilinger JJ (2016) Enchondroma versus chondrosarcoma in long bones of appendicular skeleton: clinical and radiological criteria-a follow-up. J Oncol 2016:8262079. https://doi.org/10.1155/2016/8262079 CrossRefPubMedPubMedCentral

Choi B-B, Jee W-H, Sunwoo H-J et al (2013) MR differentiation of low-grade chondrosarcoma from enchondroma. Clin Imaging 37:542–547. https://doi.org/10.1016/j.clinimag.2012.08.006 CrossRefPubMed

Stihsen C, Panotopoulos J, Puchner SE et al (2017) The outcome of the surgical treatment of pelvic chondrosarcomas: a competing risk analysis of 58 tumours from a single centre. Bone Joint J 99-B:686–696. https://doi.org/10.1302/0301-620x.99b5.bjj-2016-0761.r1 CrossRefPubMed

10.

Pring ME, Weber KL, Unni KK, Sim FH (2001) Chondrosarcoma of the pelvis. A review of sixty-four cases. J Bone Joint Surg Am 83:1630–1642CrossRef

11.

Normand AN, Cannon CP, Lewis VO et al (2007) Curettage of biopsy-diagnosed grade 1 periacetabular chondrosarcoma. Clin Orthop 459:146–149. https://doi.org/10.1097/BLO.0b013e3180619554 CrossRefPubMed

12.

Weber KL, Pring ME, Sim FH (2002) Treatment and outcome of recurrent pelvic chondrosarcoma. Clin Orthop 397:19–28CrossRef

13.

Staats K, Panotopoulos J, Tiefenboeck TM et al (2017) Computer navigation-assisted surgery for musculoskeletal tumors: a closer look into the learning curve. Eur J Orthop Surg Traumatol Orthop Traumatol 27:851–858. https://doi.org/10.1007/s00590-017-2004-y CrossRef

14.

Hickey M, Farrokhyar F, Deheshi B et al (2011) A systematic review and meta-analysis of intralesional versus wide resection for intramedullary grade I chondrosarcoma of the extremities. Ann Surg Oncol 18:1705–1709. https://doi.org/10.1245/s10434-010-1532-z CrossRefPubMed

15.

Giuffrida AY, Burgueno JE, Koniaris LG et al (2009) Chondrosarcoma in the United States (1973 to 2003): an analysis of 2890 cases from the SEER database. J Bone Joint Surg Am 91:1063–1072. https://doi.org/10.2106/JBJS.H.00416 CrossRefPubMed

16.

Crim J, Schmidt R, Layfield L et al (2015) Can imaging criteria distinguish enchondroma from grade 1 chondrosarcoma? Eur J Radiol 84:2222–2230. https://doi.org/10.1016/j.ejrad.2015.06.033 CrossRefPubMed

17.

Geirnaerdt MJ, Hermans J, Bloem JL et al (1997) Usefulness of radiography in differentiating enchondroma from central grade 1 chondrosarcoma. AJR Am J Roentgenol 169:1097–1104. https://doi.org/10.2214/ajr.169.4.9308471 CrossRefPubMed

18.

Enneking WF, Spanier SS, Goodman MA (1980) A system for the surgical staging of musculoskeletal sarcoma. Clin Orthop 153:106–120

19.

Enneking W (1993) A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system. Clin Orthop Relat Res 286(1993):241–246

20.

Enneking WF, Dunham WK (1978) Resection and reconstruction for primary neoplasms involving the innominate bone. J Bone Joint Surg Am 60:731–746CrossRef

21.

Mavrogenis AF, Angelini A, Drago G et al (2013) Survival analysis of patients with chondrosarcomas of the pelvis: chondrosarcomas of the Pelvis. J Surg Oncol 108:19–27. https://doi.org/10.1002/jso.23351 CrossRefPubMed

22.

Donati D, Ghoneimy AE, Bertoni F et al (2005) Surgical treatment and outcome of conventional pelvic chondrosarcoma. J Bone Joint Surg Br 87-B:1527–1530. https://doi.org/10.1302/0301-620x.87b11.16621 CrossRef

23.

Björnsson J, McLeod RA, Unni KK et al (1998) Primary chondrosarcoma of long bones and limb girdles. Cancer 83:2105–2119CrossRef

Title: Differential diagnosis and treatment of enchondromas and atypical cartilaginous tumours of the pelvis: analysis of 21 patients
Authors: Patricio A. Alfaro
Giovanni Ciani
Carlos A. Herrera
Davide Maria Donati
Costantino Errani
Publication date: 01-01-2020
Publisher: Springer Paris
Keyword: Chondrosarcoma
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 1/2020
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-019-02547-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Differential diagnosis and treatment of enchondromas and atypical cartilaginous tumours of the pelvis: analysis of 21 patients

Abstract

Introduction

Materials and methods

Results

Discussion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Discussion

Please log in to get access to this content

Other articles of this Issue 1/2020

Septic arthritis of the lumbar facet joint presenting as spontaneous bacterial peritonitis: a rare case requiring surgical intervention

Can Denosumab cure giant cell tumors of the spine? A case report and literature review

“Tomydesis” might be a reliable technique for lesions of the long head of the biceps tendon associated with rotator cuff tears: a minimum 6-month prospective clinical follow-up study

AO Trauma: Manual of fracture management

Pronator quadratus muscle flap: a preliminary cadaveric study

Luiz Roberto Vialle (ed): AO spine masters series—Volume 10 spinal infections