BACKGROUND: The diagnosis of a chondrosarcoma of the hand can be difficult for the surgeon as well as for the pathologist. The histological criteria for differentiation between chondrosarcoma and chondroma are not well-defined. Nevertheless, distinguishing the two entities is clinically relevant, as chondrosarcomas of the hand, despite their low tendency for metastatic spread, require a prompt and more radical treatment than chondromas. METHOD AND MATERIAL: From 1996 to 2003, we treated four patients with a histologically diagnosed chondrosarcoma of the metacarpal bones and phalanges. Two patients were female and two male with a mean age of 42 years. The duration between the first clinical symptoms and first surgery ranged from two months to 30 years. Three out of four patients underwent primary treatment in other institutions, always under the histologic diagnosis of a chondroma. The mean follow-up ranged from nine months to seven years. RESULTS: The histological diagnosis of chondrosarcoma was followed by ray resection in three cases. Two tumors were grade 1 and two tumors grade 2. During follow-up, the patients showed no local recurrence and no metastatic spread. CONCLUSION: Since the differentiation between chondroma and chondrosarcoma is difficult, a good cooperation between surgeon, radiologist and pathologist is required. Despite the low metastatic potential of chondrosarcomas of the hand in comparison with other sites, ray resection or digital amputation is recommended to avoid local recurrence. In cases with only local excision, close follow-up is recommended.
BACKGROUND: The diagnosis of a chondrosarcoma of the hand can be difficult for the surgeon as well as for the pathologist. The histological criteria for differentiation between chondrosarcoma and chondroma are not well-defined. Nevertheless, distinguishing the two entities is clinically relevant, as chondrosarcomas of the hand, despite their low tendency for metastatic spread, require a prompt and more radical treatment than chondromas. METHOD AND MATERIAL: From 1996 to 2003, we treated four patients with a histologically diagnosed chondrosarcoma of the metacarpal bones and phalanges. Two patients were female and two male with a mean age of 42 years. The duration between the first clinical symptoms and first surgery ranged from two months to 30 years. Three out of four patients underwent primary treatment in other institutions, always under the histologic diagnosis of a chondroma. The mean follow-up ranged from nine months to seven years. RESULTS: The histological diagnosis of chondrosarcoma was followed by ray resection in three cases. Two tumors were grade 1 and two tumors grade 2. During follow-up, the patients showed no local recurrence and no metastatic spread. CONCLUSION: Since the differentiation between chondroma and chondrosarcoma is difficult, a good cooperation between surgeon, radiologist and pathologist is required. Despite the low metastatic potential of chondrosarcomas of the hand in comparison with other sites, ray resection or digital amputation is recommended to avoid local recurrence. In cases with only local excision, close follow-up is recommended.
Authors: L F I J Oudenhoven; E Dhondt; S Kahn; A Nieborg; H M J Kroon; P C W Hogendoorn; J L Gielen; J L Bloem; A De Schepper Journal: Skeletal Radiol Date: 2005-10-25 Impact factor: 2.199