Cartilaginous Tumors: Fast Contrast-enhanced MR Imaging

Geirnaerdt, M. J. A.; Hogendoorn, Pancras C.W.; Bloem, J. L.; Taminiau, A. H. M.; Woude, H. J. van der

doi:10.1148/radiology.214.2.r00fe12539

Cited by 203 publications

(106 citation statements)

References 28 publications

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“…12,49 Low-grade chondrosarcomas are well differentiated, have a remarkably slow growth rate, and as in normal cartilage the supply of nutrients by blood vessels is limited. 50,51 Tumor cells must be able to survive this low state of energy and may do so by decreasing their DNA content, thereby decreasing nucleic acid and protein (histone and other nuclear protein) synthesis.…”

Section: Discussionmentioning

confidence: 99%

Near-Haploidy and Subsequent Polyploidization Characterize the Progression of Peripheral Chondrosarcoma

Bovée

Royen

Bardoel

et al. 2000

The American Journal of Pathology

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Chondrosarcomas are malignant cartilaginous tumors arising centrally in bone (central chondrosarcoma), or secondarily within the cartilaginous cap of osteochondroma (peripheral chondrosarcoma). We previously used DNA flow cytometry to demonstrate that near-haploidy is relatively frequent in peripheral chondrosarcomas. We performed fluorescence in situ hybridization (FISH) to interphase nuclei using centromeric probes, a genome wide loss of heterozygosity (LOH) analysis, and comparative genomic hybridization on five peripheral chondrosarcomas. We demonstrated near-haploidy in two low-grade tumors with only one copy and LOH of most chromosomes. Few chromosomes are disomic, with retention of heterozygosity and overrepresentation at comparative genomic hybridization. One tumor contains both a near-haploid clone with chromosomes in monosomic and disomic state, and an exactly duplicated clone. Two high-grade tumors clearly demonstrate polyploidization because most chromosomes show LOH and two copies at FISH, whereas few chromosomes have four copies with retention of heterozygosity. Using DNA from a relative, we demonstrate that chromosome loss is random regardless of parental origin. Using FISH on paraffin slides, we exclude near-haploidy to result from meiosis-like division in binucleated cells, characteristic for chondrosarcoma. In conclusion, our results indicate that near-haploidy characterizes the progression from osteochondroma toward low-grade chondrosarcoma. Moreover, further progression toward high-grade chondrosarcoma is characterized by polyploidization. Chondrosarcoma, the second most common primary malignant bone tumor after osteosarcoma, is a malignant cartilage-forming tumor occurring predominantly in adults. The majority of chondrosarcomas develops de novo and is located centrally within the medullary cavity (central chondrosarcoma). In contrast, ϳ15% arise within the cartilage cap of a long-standing osteochondroma (peripheral chondrosarcoma), mostly in patients suffering from the hereditary multiple exostoses syndrome. Hereditary multiple exostoses syndrome is a familial disorder with an autosomal dominant mode of inheritance.1-4 Malignant transformation is estimated to occur in 1 to 5% of osteochondromas.The development of peripheral chondrosarcoma results in genetic instability characterized by a high percentage of loss of heterozygosity (LOH) and a wide variation in DNA ploidy.5 LOH in peripheral chondrosarcoma most frequently involves the TP53 (80%), RB1 (71%), and EXT1 (65%) loci. 5 In contrast, peridiploidy and a low percentage of LOH in central tumors indicates that a different oncogenic molecular mechanism may be operative. 5 We have detected hypodiploidy, which is uncommon for human solid tumors, in 29% of peripheral chondrosarcomas and not in central chondrosarcomas.5 Others mention hypodiploidy in 8 to 31% of chondrosarcomas without further subclassification.6 -9 Near-haploidy, which is a very rare phenomenon in human solid tumors in general, is found especially in low-grade peripheral chon...

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Section: Discussionmentioning

confidence: 99%

Near-Haploidy and Subsequent Polyploidization Characterize the Progression of Peripheral Chondrosarcoma

Bovée

Royen

Bardoel

et al. 2000

The American Journal of Pathology

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“…Localization in the axial skeleton and size Ͼ5 cm have been shown to be reliable predictors for malignancy [8]. Dynamic contrast-enhanced magnetic resonance imaging (MRI) shows greater sensitivity [57,58], although an absolute distinction between benign and malignant cannot be made on radiological grounds alone [8,59,60]. Regarding the differential diagnosis of osteochondroma versus low-grade peripheral chondrosarcoma, the thickness and staining characteristics on (dynamic) MRI of the cartilaginous cap provide a rather reliable assessment of the likelihood of malignancy [57].…”

Section: Radiological Presentationmentioning

confidence: 99%

The Clinical Approach Towards Chondrosarcoma

et al. 2008

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After completing this course, the reader will be able to:1. Classify the chondrosarcoma subtypes.2. Engage in the diagnostic process of chondrosarcoma.3. Evaluate the treatment options for chondrosarcoma.Access and take the CME test online and receive 1 AMA PRA Category 1 Credit ™ at CME.TheOncologist.com CME CME ABSTRACTThis review provides an overview of the histopathology, classification, diagnostic procedures, and therapy of skeletal chondrosarcoma. Chondrosarcomas that arise de novo are primary chondrosarcomas, whereas chondrosarcomas developing superimposed on pre-existing benign cartilage neoplasms such as enchondromas or osteochondromas are referred to as secondary chondrosarcomas. Conventional chondrosarcomas can be categorized according to their location in bone into central, peripheral, and juxtacortical chondrosarcomas. Histological grading is related to prognosis; however, it is also subject to interobserver variability. Rare subtypes of chondrosarcoma, including dedifferentiated, mesenchymal, and clear cell chondrosarcoma, are discussed as well. Magnetic resonance imaging is necessary to delineate the extent of the intraosseous and soft tissue involvement preoperatively. Computed tomography is especially recommended in the pelvis and other flat bones where it may be difficult to discern the pattern of bone destruction and the presence of matrix mineralization. Wide, en-bloc excision is the preferred surgical treatment in intermediate-and high-grade chondrosarcoma. In low-grade chondrosarcoma confined to the bone, extensive intralesional curettage followed by local adjuvant treatment and filling the cavity with bone graft has promising long-term clinical results and satisfactory local control. Chondrosarcomas are relatively radiotherapy resistant; therefore, doses >60 Gy are needed in attempts to achieve local control after incomplete resection. Irradiation with protons or other charged particles seems beneficial in this curative situation. Chemotherapy is only possibly effective in mesenchymal chondrosarcoma, and is of uncertain value in dedifferentiated chondrosarcoma. Potential new systemic treatment targets are being discussed. The Oncologist 2008;13:320 -329

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“…Radiographic characteristics indicating a chondrosarcoma grade 1 are ill-defined margins, lobulated contours, and scalloping or cortical destruction [4]. Fast contrast-enhanced MR imaging may be useful in differentiating enchondroma from chondrosarcoma grade 1, since early and exponential enhancement is seen in chondrosarcoma and not in enchondroma [5].…”

Section: Introductionmentioning

confidence: 99%

Oncological and functional results of cryosurgical therapy of enchondromas and chondrosarcomas grade 1

Geest

Valk

Rooy

et al. 2008

Journal of Surgical Oncology

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Cartilaginous Tumors: Fast Contrast-enhanced MR Imaging

Abstract: Preliminary results show that in the adult population fast contrast-enhanced MR imaging may assist in differentiation between benign and malignant cartilaginous tumors.

Cited by 203 publications

References 28 publications

Near-Haploidy and Subsequent Polyploidization Characterize the Progression of Peripheral Chondrosarcoma

Near-Haploidy and Subsequent Polyploidization Characterize the Progression of Peripheral Chondrosarcoma

The Clinical Approach Towards Chondrosarcoma

Oncological and functional results of cryosurgical therapy of enchondromas and chondrosarcomas grade 1

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