Malignant Tumors of the Foot - 3

Chondrosarcoma

Chondrosarcoma may be as frequent as osteosarcoma in the foot, and in some series it is named as the most common bone malignancy in this site. Chondrosarcoma is more likely to present as a low- or intermediate-grade tumor. As a concequence the symptoms of the tumor may have been present for a long period prior to diagnosis. Generally there is the presence of a gradually increasing mass. Patients may have a history of enchondromatosis (Ollier's syndrome). These patients may or may not have been aware of the presence of an enchondroma of the foot.

Plain radiographs show a lucent area with bone lysis and variable amounts of cortical thinning or destruction. Close examination may be required in order to detect the matrix calcifications that aid in the diagnosis of cartilage lesions.

CT and MRI demonstrate the lesion well and aid in operative planning. On MR, the lesion has a nodular outline or interior architecture, and the tissue has signal characteristics similar to or identical to that of water in all sequences. The MRI signal characteristics may be highly characteristic and almost diagnostic.

High grade chondrosarcomas have a less characteristic appearance both on radiographs and MRI's and have the general features of an aggressive sarcoma. Secondary lesions may have areas that appear to be typical benign enchondroma juxtaposed with highly aggressive, lytic areas.

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