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Secondary chondrosarcoma

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Complete Information on this Tumor
Special and Unusual Features: 
The risk of malignant transformation to chondrosarcoma in hereditary multiple osteochondromatosis is unknown, but may be 25-30% compared to approximately 1% for a solitary osteochondromas. The risk of malignant degeneration increases as the number and size of the osteochondromas increases. In general, a sessile lesion is more likely to degenerate into sarcoma than an exostosis. Cancer risk assessment should be performed by an orthopedic oncologist. The authors of this site pay particular attention to the large deep osteochondromas, often located on the pelvis or the spine, where malignant transformation may be more likely and much more difficult to treat. To mitigate the risk of secondary chondrosarcoma in HMOCE, surgical removal of troublesome lesions or lesions which appear to possess malignant potential is recommended. Significant angular deformities of the lower limb can be reduced or eliminated with re-alignment procedures, which should improve function and reduce pain. Early surgical corrections of deformities of the forearm has been advocated to improve function. However, the actual functional improvement has been questioned, and surgery may be safely delayed until after skeletal maturity. Complications occur in approximately 10-12% of cases following elective excision of osteochondromas, including nerve injury, arterial laceration, and fracture. For this reason, the lesions should not be removed just because they exist. Indications for surgical removal include persistant pain, functional impairment, joint subluxation, neuropraxia, and others.