Study of Chondrosarcoma in Northwest Region of Libya
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2017, Vol 1, Issue 5
Abstract
Chondrosarcoma (CS) is a relatively rare malignant tumor of chondroblasts with pure hyaline cartilage differentiation. The neo-plastic cells do not synthesize osteoid, but areas of calcification, ossification and myxoid change may be seen. A total of 14 cases were obtained from two major hospitals in the northwest region of Libya over a period of 6 years. Clinico-pathological data were evaluated including age and gender. The result showed that (CS) was slightly more common in females than in males, male to female ratio was (1.7: 2) with a peak incidence in the second and third decades of life. It is concluded from this study that CS is generally a slightly more common in females than in males and more frequently affected patients in the second and third decades of life. There is no any previous published article regarding this aspect in the northwest region of Libya. Therefore, this paper may will bring forward data for further study of CS in future in Libya. Chondrosarcoma is a rare malignant tumor of chondroblasts with pure hyaline cartilage differentiation. The neo-plastic cells do not synthesize osteoid, but areas of calcification, ossification and myxoid change may be seen. Chondrosarcoma is the third most frequent primary malignant tumor of bone exceeded only by myeloma and osteosarcoma. It usually occurs in the trunk bones (pelvic girdle, shoulders, ribs) followed by the femur and humerus [1,2]. Chondrosarcomas may be divided in two major categories, central chondrosarcoma (primary or conventional), which arise in the medullary canal and then perforate the cortical plate and surface chondrosarcomas which arise on the bone surface and grow into the adjacent soft tissue, known as peripheral Chondrosarcomas either periosteal or juxtacortical Chondrosarcoma. In addition to central and surface Chondrosarcomas, some pathologists further subdivide Chondrosarcoma into primary which occur de novo and secondary Chondrosarcoma that occur in a preexisting lesions, as well as another three variants of Chondrosarcomas that have distinctive histological features, clear cell Chondrosarcoma, mesenchymal Chondrosarcoma and dedifferentiated Chondrosarcoma [3]. Central Chondrosarcoma may be high grade or low grade neoplasm that occurs in the medullary canal, then grow to perforate the cortex and present in the surrounding soft tissue. It has a wide age range but most frequently seen in fourth or fifth decade of life. Although, the majority of tumors occur in the pelvic bones, proximal humerus, femur, and tibia. Approximately 50% of cases arise in preexisting enchondromas [4-6]. Clinically, the pain is the most initial symptoms, which mostly indicate a growing lesion, although, radio graphically, central Chondrosarcomas usually appear as a poorly defined zone of stippled radio densities usually associated with cortical thickening [6]. Surface Chondrosarcomas, Almost all surface Chondrosarcomas are low-grade, slow-growing neo-plasma that arise on the bone surface and grow into the surrounding soft tissue. Juxtacortical Chondrosarcoma also called periosteal Chondrosarcoma, is a special surface variant [5,7]. Patients are usually between ages 20 and 40 and the neo-plasm present with pain and swelling, although most of the cases seen in the femur and pelvic bones. Radio graphically, the lesion shows lobulated masses of stippled and ring like calcification adjacent to the bone surface often accompanied by radiating bone spicules perpendicular to the bone surface and typical Codman’s triangle [7]. In general, the histological features of Chondrosarcomas, whether central or surface, can be grouped in three histologic grades. Grade 1 Chondrosarcoma, is slowgrowing, low-grade malignancy that almost never metastasize. The chondrocytes are present in lacuna and have small, dark nuclei in scanty cytoplasm. Binucleated cells are present but mitotic figures are absent, therefore, distinguishing a grade 1 Chondrosarcoma from enchondroma is extremely difficult. Grade 2 Chondrosarcoma is also slow-growing, low-grade malignancy, but more cellular than grade 1 with mild cellular Pleomorphism and few mitotic figures. By contrast, grade 3 Chondrosarcoma is high-grade neoplasm, in which the cytological criteria of malignancy is more obvious and mitotic figures count for 2 per 10 per high power fields [6,8-10].
Authors and Affiliations
Abdullatef Nureddin, Moftah Sherad
Keywords
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- EP ID EP569553
- DOI 10.26717/BJSTR.2017.01.000407
- Views 189
- Downloads 0
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