Enneking type III resection of pubic chondrosarcoma: A case report

Abstract

Chondrosarcomas are rare malignant cartilaginous tumor affecting adult and elderly patient. Pelvic and long bones are the most common location. We differentiate conventional chondrosarcoma which arises do novo from preexisting normal bone (primary chondrosarcoma) or within a preexisting lesion such as enchondromas or osteochondromas (secondary chondrosarcoma), Other rare subtypes of chondrosarcoma include clear cell chondrosarcoma, dedifferentiated chondrosarcoma, and mesenchymal chondrosarcoma, which will be considered separately. Although there are diverse clinical presentations depending on the anatomic extend, radiographic features of chondrosarcoma are very characteristic comprising frequently a combination of bone expansion and heterogeneous calcifications. We report a case of a 56-year-old male suffering from fixed mass adhering to the right pubic bone. MRI views showed a lytic lesion of right superior pubic rami, surgical biopsy was in favor of chondrosarcomas, then an en bloc resection was performed following a Pfannenstiel approach without any recurrence after three years of follow-up.

Grade III chondrosarcoma of the left iliopubic branch: A case report

“…In high-grade chondrosarcomas, as in this case, wide surgical excision offers the best prognosis for cure and local control [ 7 ]. The histological grade plays a crucial role in predicting local recurrence and metastasis [ 4,13 ]. Certainly, the prognosis of patients afflicted with pelvis-based chondrosarcoma hinges on various prognostic factors, including tumor size, location, histological grade, and the quality of surgical intervention, particularly in terms of achieving clear surgical margins [ 2 , 7,13 ].…”

“…Chondrosarcomas encompasses neoplasms derived from mesenchymal lineage cells and are characterized by the production of a cartilaginous matrix that may arise de novo or develop as a sequel to pre-existing benign cartilaginous neoplasms [ 1 , 2 ]. While its prevalence is eclipsed by myeloma and osteosarcoma, it ranks as the third most common primary malignant bone tumor [ [2] , [3] , [4] ]. Its incidence is notably variable, with European rates approximating 1–4 cases per 100,000 individuals [ 3 ].…”

“…Its incidence is notably variable, with European rates approximating 1–4 cases per 100,000 individuals [ 3 ]. The male gender exhibits a predilection, with a reported sex ratio of 2:1 [ 3 , 4 ]. Chondrosarcoma predominantly afflicts the adult and elderly population, with a typical onset occurring between the ages of 40 and 70 years [ 5 , 6 ].…”

“…Chondrosarcomas are typically asymptomatic until they reach large dimensions. When often encountered nocturnal pain, frequently of prolonged duration [ 4 ] is the cardinal symptom. In the context of pelvic chondrosarcomas due to their intricate anatomical localization and proximity to critical structures such as the bladder, rectum, and neurovascular bundles, when they reach large proportions clinical manifestations can include a palpable mass, pathological fractures, or symptoms attributed to a mass effect, including neural compression [ 1 , 4 , 8 ].…”

“…The therapeutic cornerstone for chondrosarcomas is surgical resection, a modality of choice due to the inherent resistance of these tumors to conventional radiotherapy and chemotherapy [ 1 , 2 , 4 , 6 , 8 ]. This requires comprehensive surgical procedures, including hindquarter amputation or internal hemipelvectomy, aimed at ensuring complete extirpation with wide surgical margins, thereby mitigating the risk of recurrence [ 4 ]. The surgical intervention mandates a delicate equilibrium between achieving radical resection and minimizing postoperative morbidity.…”