Determination of malignancy of cartilaginous tumors (1) . Clinical and histopathological evaluation of chondrosarcoma
Lin, C.P.; Higaki, S.; Takeyama, S.; Nakata, T.; Akai, M.; Tateishi, A.; Abe, M.
Nihon Seikeigeka Gakkai Zasshi 57(6): 607-616
1983
ISSN/ISBN: 0021-5325 PMID: 6619625 Document Number: 197220
The differential diagnosis between enchondroma and low grade malignant chondrosarcoma is sometimes difficult to determine by histologic examination, and in certain cases, it can be determined only by X-ray and clinical course. Sixty-six cases of chondrosarcoma, 40 males and 26 females were followed up from 1950-1980. The age distribution was from 1 mo. to 72 yr, the 3rd decade being the most common. The most prevalent sites were pelvis and long bones, especially the femur. The cumulative survival rate for the total number of cases (66), primary chondrosarcoma (54 cases), and secondary chondrosarcoma (12 cases) was, 57.1, 50.9 and 90.9% in 5 yr, and 46.6, 38.6 and 90.9% in 10 yr, respectively. The 54 cases which received a preliminary X-ray before treatment were classified into 2 types. The peripheral type (23 cases) showed a cumulative survival rate of 74.7% within the 5 yr span and 68.2% within the 10 yr span. The 2nd type, the central type (31 cases) showed a 5 yr cumulative survival rate of 39.3% and a 10 yr rate of 35.2%. Forty-one cases of chondrosarcoma were analyzed histologically and classified in accordance with O'Neal and Ackerman's classification and Mirra's definition. The cumulative survival rate in low grade malignancy, moderate grade malignancy, and high grade malignancy was 91.3, 76.6 and 38.5%, respectively, in the 5 yr survival rate and 91.3, 76.6 and 15.4% in the 10 yr survival rate. No significant difference in prognosis was found between low grade and moderate grade chondrosarcoma but a significant difference in prognosis was noted between low grade and high grade chondrosarcoma and between moderate grade and high grade chrondrosarcoma, respectively. Thirty specimens of chondrosarcoma were stained with special staining methods; especially with the Saframin-O stain, the color varied in intensity according to the grade of malignancy.