Author: Babe Westlake, DO


Chondrosarcoma is a cancer of cartilage cells. Although it is rare,  it is the most common primary bone cancer in adults. It is extremely rare in children and adolescents. Chondrosarcomas vary widely. Low-grade tumors are not very aggressive and present a low risk of spreading to other parts of the body. On the other end of the spectrum, high-grade chondrosarcomas and certain subtypes of chondrosarcoma are aggressive and present a significant risk of spread to other areas (Figure 1). If the cancer metastasizes, the most common places it will go in the body are the lungs and other bones (Figure 2). The primary treatment of chondrosarcoma is with surgery. Chemotherapy is rarely used except for certain subtypes such as mesenchymal chondrosarcoma. Radiation therapy is typically only used in situations where a tumor is deemed untreatable with surgery.  


Patients typically present with pain and swelling or a noticeable mass that can be seen or felt. The pain is often described as deep and aching. Pain can be constant or intermittent and occur at rest or with activity. Nighttime pain that can make it difficult to sleep is more common in larger and/or more aggressive tumors.


A mass can often be seen and felt.  Your physician will examine you for other masses and check for enlarged lymph nodes. Your physician will also examine your joints above and below the tumor, the overlying skin and soft tissues, and the nerves and blood vessels of the involved body part.


X-rays are the initial imaging test of choice. X-rays give clues to the type of tumor and how aggressive the tumor is. If chondrosarcoma is suspected, imaging is completed to see if the cancer has spread anywhere else and to precisely see the local extent of the disease. These tests include a magnetic resonance imaging (MRI) of the primary site (where the cancer started), computed tomography (CT) scan of the chest and a bone scan. In most cases, a biopsy to confirm the diagnosis will be performed with a needle.


Pelvis x-ray of a 41-year-old male diagnosed
with chondrosarcoma of the pelvis and a
pathologic fracture.


Risk of metastasis is highly dependent on the grade of the tumor. Grade 3 chondrosarcoma carries a greater than 60% risk of metastasis; grade 2 chondrosarcoma carries a risk of approximately 20%; and low-grade chondrosarcoma rarely metastasizes. Location of the tumor is also a variable that must be considered. Tumors in the pelvis often grow to larger sizes before they are detected and are more difficult to resect, thus, they have a higher risk of metastasis and local recurrence.

Due to the rare and complex nature of this disease, patients should seek out evaluation and treatment from an orthopaedic oncologist who specializes in treating this diagnosis. Often, there are discussions with other doctors on the team who can provide their expertise on chemotherapy and radiation.


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This is not intended as a substitute for professional medical advice and does not provide advice on treatments or conditions for individual patients. All health and treatment decisions must be made in consultation with your physician(s), utilizing your specific medical information. Inclusion in this is not a recommendation of any product, treatment, physician or hospital.