Chondrosarcoma in the young. A clinicopathologic analysis of 79 patients younger than 21 years of age.

We have studied 79 patients with chondrosarcoma who were younger than 21 years of age; this number represents 16% of all patients with chondrosarcoma diagnosed and treated in this hospital during half a century. The appendicular skeleton (53%), the humerus (13%), and the femur (23%) were most frequently affected. The pelvic bones were also common locations (20%). Pain, the presence of a mass, and tenderness were the most common presenting complaints. Two-thirds of the sarcomas were central lesions; the rest were mostly of the peripheral type. In 22 patients (28%), the chondrosarcomas were secondary to pre-existing benign solitary or multiple cartilaginous lesions. Histologically, the chondrosarcomas were subdivided into conventional, myxoid, "mesenchymal," and spindle cell (dedifferentiated) variants. Microscopically, the chondrosarcomas were graded according to their increasing grade of malignancy (grade I: 24 patients; grade II: 23 patients; grade III: 32 patients). Detailed survival analysis was performed and survival comparisons were made between the various age groups, the time of treatment, the sex of the patients, various skeletal sites, and the histologic grade of malignancy of the chondrosarcoma. It appears that chondrosarcoma affecting younger individuals is, in general, a more ominous tumor as compared with adults; i.e., relatively more high-grade chondrosarcomas affect young people than adults. Another notable difference was the dissimilarity in the skeletal distribution pattern of the malignant cartilage lesions between adults and the young.