Chondroid Tumors as Incidental Findings and Differential Diagnosis between Enchondromas and Low-grade Chondrosarcomas

Afonso, P. Diana; Isaac, Amanda; Martel, José

doi:10.1055/s-0038-1675550

Cited by 43 publications

(24 citation statements)

References 56 publications

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“…Cartilaginous tumors commonly have morphological heterogeneity and can have focal high-grade areas [ 21 ]. Consequently, there are risks of sampling failure of high-grade tumor tissue in a predominantly benign or low-grade lesion, and of under- or over-grading the tumors [ 22 , 23 ]. Compared with other types of bone tumors, high rates of discrepancies between biopsy findings and final diagnoses were reported in cartilaginous tumors [ 3 , 5 , 7 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

A Radiological Scoring System for Differentiation between Enchondroma and Chondrosarcoma

Miwa

Yamamoto

Hayashi

et al. 2021

Cancers

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Background: It is challenging to differentiate between enchondromas and atypical cartilaginous tumors (ACTs)/chondrosarcomas. In this study, correlations between radiological findings and final diagnosis were investigated in patients with central cartilaginous tumors. Methods: To evaluate the diagnostic usefulness of radiological findings, correlations between various radiological findings and final diagnoses were investigated in a cohort of 81 patients. Furthermore, a new radiological scoring system was developed by combining radiological findings. Results: Periosteal reaction on X-ray (p = 0.025), endosteal scalloping (p = 0.010) and cortical defect (p = 0.002) on CT, extraskeletal mass (p < 0.001), multilobular lesion (p < 0.001), abnormal signal in adjacent tissue (p = 0.004) on MRI, and increased uptake in bone scan (p = 0.002) and thallium scan (p = 0.027) was significantly correlated with final diagnoses. Based on the correlations between each radiological finding and postoperative histological diagnosis, a radiological scoring system combining these findings was developed. In another cohort of 17 patients, the sensitivity, specificity, and accuracy of the radiological score rates for differentiation between enchondromas and ACTs/chondrosarcomas were 88%, 89%, and 88%, respectively (p = 0.003). Conclusion: Radiological assessment with combined radiological findings is recommended to differentiate between enchondromas and ACT/chondrosarcomas.

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Section: Discussionmentioning

confidence: 99%

A Radiological Scoring System for Differentiation between Enchondroma and Chondrosarcoma

Miwa

Yamamoto

Hayashi

et al. 2021

Cancers

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“…The distinction of enchondroma from the borderline malignancy arising in the appendicular skeleton, the atypical cartilaginous tumor formerly known as grade 1 or low-grade central chondrosarcoma, 12 is problematic both on imaging and pathology. 8 13 14 15 16 Recent studies have highlighted the increased identification of CCTs attributed to the ever-increasing use of MRI particularly in the proximal humerus and around the knee. 17 18 Guidelines and imaging protocols for the management and follow-up have been proposed in an attempt to reduce costly and in many instances diagnostically low-yield follow-up imaging studies.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Enchondromas of the Proximal Femur in Adults as an Incidental Finding on MRI of the Pelvis

Davies

Patel

Azzopardi

et al. 2021

Indian J Radiol Imaging

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Objective To determine the prevalence of enchondroma in adults as an incidental finding in the proximal femur on magnetic resonance imaging (MRI). Materials and Methods A retrospective review of the MRI scans of the pelvis in a series of adult patients was conducted. All presented with nononcological musculoskeletal complaints. The site, size, and appearances of the enchondromas were identified according to criteria from previous studies. Results A total of 1,209 proximal femora in 610 patients were reviewed and a total of 9 enchondromas were identified. These ranged from 0.6 to 2.5 cm in length (mean 1.3 cm). None showed aggressive features suggestive of malignancy. Three cases (33%) underwent follow-up MRI scans which showed no change in size or morphology. Conclusion The prevalence on MRI of incidental enchondromas arising in the proximal femur is 0.7%. This is three to four times less common than seen in the proximal humerus and around the knee.

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“…Meanwhile, if there were signs of invasion (i.e., cortical bone invasion, periosteal reaction, bone expansion, periostitis, and extraosseous soft tissue), it is very likely that these cartilaginous lesions are chondrosarcomas [2]. In addition, CT scans of other parts of the body, especially the chest, are crucial for conducting a comprehensive staging of patients with chondrosarcoma [1,2]. Promising pooled sensitivity (94%) and specificity (89%) of 18 F-FDG PET/CT for diagnosing chondrosarcoma were revealed in the current study; meanwhile, the relatively narrower 95% confidence intervals (0.86-0.97 and 0.82-0.93, respectively) and smaller heterogeneity (I 2 = 15.69% and 0%, respectively) in comparison with those of 18 F-FDG PET indicated that these results were stable and persuasive.…”

Section: Discussionmentioning

confidence: 99%

“…Chondrosarcoma is the second most common primary malignant bone sarcoma characterized by the production of atypical cartilage matrix and invasive growth inside the pre-existing cortical and medullary bone tissue [1]. This malignant disorder could be further subcategorized to lowgrade (G1), intermediate-grade (G2), high-grade (G3), and dedifferentiated chondrosarcoma, which manifest diverse histological features and clinical behaviors [2].…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, unlike thin-section dedicated CT, the CT section integrated with PET behaves poorly in presenting fine details such as depth of scalloping [14]. For the aim of getting a definitive diagnosis of a cartilaginous neoplasm, all available information such as patient age, clinical manifestation, lesion location, and the tumor growth rate must be taken into consideration [1,2]. Creating a score that comprehensively summarizes these data as well as imaging and nuclear medicine findings will shed new light on the noninvasive diagnosis of cartilaginous neoplasms.…”

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confidence: 99%

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The utility of 18F-FDG PET and PET/CT in the diagnosis and staging of chondrosarcoma: a meta-analysis

Zhang

Liu

et al. 2020

J Orthop Surg Res

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Objective: Chondrosarcoma is the second most common primary bone sarcoma; however, unlike other tumors, the biopsy cannot easily make a definite diagnosis or predict the histological grade. This meta-analysis was performed to evaluate the utility of 18 F-FDG PET and PET/CT to differentiate chondrosarcoma from benign cartilaginous lesions and to predict the histopathological grade of chondrosarcoma. Material and methods: A comprehensive search was performed in three electronic databases including Medline/ PubMed, the Cochrane Library and Embase to retrieve diagnostic studies evaluating the role of 18 F-FDG PET or PET/ CT for appraising the status of chondrosarcoma. Reference lists of related articles were also scrutinized manually. Useful data were extracted to calculate the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), the summary receiver operating characteristic curve (sROC), and the area under the curve (AUC) of 18 F-FDG PET or PET/CT in diagnosing chondrosarcoma, and pooled weighted mean differences (WMD) of maximum standardized uptake value (SUVmax) between different entities of cartilaginous neoplasms by using Stata 19.0. Results: A total of twelve studies provided sufficient data for the quantitative analysis. For the diagnosis of chondrosarcoma, the pooled sensitivity, specificity, and DOR of 18 F-FDG PET were 0.84 (95% confidence interval [CI] 0.46 to 0.97), 0.82 (95% CI 0.55 to 0.94), and 24.244 (95% CI 1.985 to 96.148), respectively while those of 18 F-FDG PET/CT were 0.94 (95% CI 0.86 to 0.97), 0.89 (95% CI 0.82 to 0.93), and 112.999 (95% CI 41.341 to 308.866), respectively. The pooled WMD of SUVmax were − 0.89 (95% CI −1.67 to −0.10) between benign cartilaginous lesions and grade 1 (G1) chondrosarcoma, −1.94 (95% CI −2.76 to −1.12) between G1 and grade 2 (G2) chondrosarcoma, and − 2.37 (95% CI −5.79 to 1.05) between G2 and grade 3 (G3) chondrosarcoma. Conclusions: In a word, 18 F-FDG PET/CT revealed excellent accuracy in the diagnosis of chondrosarcoma and might assist in clinical decision-making. Meanwhile, although SUVmax alone showed restricted ability to differentiate benign cartilaginous lesions and G1 chondrosarcoma, as well as between G2 and G3 chondrosarcoma, it can identify intermediate/high-grade chondrosarcoma from low-grade ones.

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Chondroid Tumors as Incidental Findings and Differential Diagnosis between Enchondromas and Low-grade Chondrosarcomas

Cited by 43 publications

References 56 publications

A Radiological Scoring System for Differentiation between Enchondroma and Chondrosarcoma

A Radiological Scoring System for Differentiation between Enchondroma and Chondrosarcoma

Prevalence of Enchondromas of the Proximal Femur in Adults as an Incidental Finding on MRI of the Pelvis

The utility of 18F-FDG PET and PET/CT in the diagnosis and staging of chondrosarcoma: a meta-analysis

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