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Chondrosarcoma Arising from Benign Bone Tumor due to Malignant Transformation

양성 골종양의 악성변화에 의한 연골육종

  • Cho, Wan-Hyeong (Department of Orthopedic Surgery, Korea Cancer Center Hospital) ;
  • Song, Won-Seok (Department of Orthopedic Surgery, Korea Cancer Center Hospital) ;
  • Kong, Chang-Bae (Department of Orthopedic Surgery, Korea Cancer Center Hospital) ;
  • Hong, Yun-Suk (Department of Orthopedic Surgery, Korea Cancer Center Hospital) ;
  • Lee, Jung-Dong (Department of Orthopedic Surgery, Korea Cancer Center Hospital) ;
  • Jeon, Dae-Geun (Department of Orthopedic Surgery, Korea Cancer Center Hospital)
  • Received : 2011.02.28
  • Accepted : 2011.05.30
  • Published : 2011.06.30

Abstract

Purpose: We analyzed the oncological outcome and prognostic factor of the chondrosarcoma arising from benign bone tumor due to malignant transformation. Materials and Methods: From April 1986 to April 2009, 18 cases were considered eligible. We analyzed retrospectively the patient's characteristics and prognostic factors that affect to the local recurrence and distant metastasis. Results: As classified by primary benign bone tumor, 4 cases were solitary osteochondroma, 11 cases were multiple osteochondromatosis and 3 cases were multiple enchondromatosis. The mean follow-up period was 85 months. The 5-year disease free survival rate of 18 patients was 85.9%. Their overall MSTS score was 25.2 (84%). There were local recurrence in 3 cases and no distant metastasis. We found that tumor location and surgical margin affected to the prognosis significantly. Conclusion: In secondary chondrosarcoma patients, the prognosis was good relatively and tumor location and surgical margin are important prognosis factor.

목적: 저자들은 양성 골종양의 이차적 악성 변화로 인한 속발성 연골육종 환자의 특성 및 종양학적 결과에 대해 알아보고자 하였다. 대상 및 방법: 1986년 4월부터 2009년 4월까지 본원에서 치료받은 183명의 연골육종 환자 중 양성 골종양의 악성 변화로 생긴 속발성 연골육종 환자 18명을 대상으로 후향적 분석을 시행하여 환자의 특성 및 국소재발, 원격전이에 대해 살펴보았다. 결과: 속발성 연골육종 환자 18명을 원발성 병변에 따라 분류하였을 때, 골연골종 4명, 다발성 골연골종 11명, 다발성 내연골종 3명이었다. 추시 기간은 평균 85개월(21-166)이었다. 최종 추시상 5년 무병 생존율은 $85.9{\pm}9.3%$였으며 평균 기능적 점수는 25.2점(84%)으로 비교적 양호하였다. 추시 기간 중 3명의 환자에서 국소 재발이 발생하였으며 원격 전이는 없었다. 질병으로 인하여 사망한 환자는 없었다. 결론: 양성 골종양에서 발생한 속발성 연골 육종의 예후는 비교적 양호하였으며 해부학적 위치와 수술적 절제연이 중요한 예후 인자인 것으로 판단된다.

Keywords

References

  1. Gelderblom H, Hogendoorn PC, Dijkstra SD, et al. The clinical approach towards chondrosarcoma. Oncologist. 2008;13:320-9. https://doi.org/10.1634/theoncologist.2007-0237
  2. Ahmed AR, Tan TS, Unni KK, Collins MS, Wenger DE, Sim FH. Secondary chondrosarcoma in osteochondroma: report of 107 patients. Clin Orthop Relat Res. 2003;411:193-206. https://doi.org/10.1097/01.blo.0000069888.31220.2b
  3. Lin PP, Moussallem CD, Deavers MT. Secondary chondrosarcoma. J Am Acad Orthop Surg. 2010;18:608-15. https://doi.org/10.5435/00124635-201010000-00004
  4. Altay M, Bayrakci K, Yildiz Y, Erekul S, Saglik Y. Secondary chondrosarcoma in cartilage bone tumors: report of 32 patients. J Orthop Sci. 2007;12:415-23. https://doi.org/10.1007/s00776-007-1152-z
  5. Bieling P, Rehan N, Winkler P, et al. Tumor size and prognosis in aggressively treated osteosarcoma. J Clin Oncol. 1996;14:848-58. https://doi.org/10.1200/JCO.1996.14.3.848
  6. Gobel V, Jurgens H, Etspuler G, et al. Prognostic significance of tumor volume in localized Ewing's sarcoma of bone in children and adolescents. J Cancer Res Clin Oncol. 1987;113:187-91. https://doi.org/10.1007/BF00391442
  7. Dahlin DC, Henderson ED. Chondrosarcoma, a surgical and pathological problem; review of 212 cases. J Bone Joint Surg Am. 1956;38-A:1025-38.
  8. Enneking WF, Spanier SS, Goodman MA. A system for the surgical staging of musculoskeletal sarcoma. Clin Orthop Relat Res. 1980;153:106-20.
  9. Enneking WF, Dunham W, Gebhardt MC, Malawer M, Pritchard DJ. A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system. Clin Orthop Relat Res. 1993; 286:241-6.
  10. Murphey MD, Choi JJ, Kransdorf MJ, Flemming DJ, Gannon FH. Imaging of osteochondroma: variants and complications with radiologic-pathologic correlation. Radiographics. 2000;20:1407-34. https://doi.org/10.1148/radiographics.20.5.g00se171407
  11. Coley BL, Higinbotham NL. Secondary chondrosarcoma. Ann Surg. 1954;139:547-59. https://doi.org/10.1097/00000658-195405000-00003
  12. Garrison RC, Unni KK, McLeod RA, Pritchard DJ, Dahlin DC. Chondrosarcoma arising in osteochondroma. Cancer. 1982;49:1890-7. https://doi.org/10.1002/1097-0142(19820501)49:9<1890::AID-CNCR2820490923>3.0.CO;2-U
  13. Merchan EC, Sanchez-Herrera S, Gonzalez JM. Secondary chondrosarcoma. Four cases and review of the literature. Acta Orthop Belg. 1993;59:76-80.
  14. Schaison F, Anract P, Coste F, De Pinieux G, Forest M, Tomeno B. Chondrosarcoma secondary to multiple cartilage diseases. Study of 29 clinical cases and review of the literature. Rev Chir Orthop Reparatrice Appar Mot. 1999;85:834-45.
  15. Wuisman PI, Jutte PC, Ozaki T. Secondary chondrosarcoma in osteochondromas. Medullary extension in 15 of 45 cases. Acta Orthop Scand. 1997;68:396-400. https://doi.org/10.3109/17453679708996185
  16. Evans HL, Ayala AG, Romsdahl MM. Prognostic factors in chondrosarcoma of bone: a clinicopathologic analysis with emphasis on histologic grading. Cancer. 1977;40:818-31. https://doi.org/10.1002/1097-0142(197708)40:2<818::AID-CNCR2820400234>3.0.CO;2-B
  17. Flemming DJ, Murphey MD. Enchondroma and chondrosarcoma. Semin Musculoskelet Radiol. 2000;4:59-71. https://doi.org/10.1055/s-2000-6855
  18. Marcove RC, Mike V, Hutter RV, et al. Chondrosarcoma of the pelvis and upper end of the femur. An analysis of factors influencing survival time in one hundred and thirteen cases. J Bone Joint Surg Am. 1972;54:561-72. https://doi.org/10.2106/00004623-197254030-00009
  19. Lee FY, Mankin HJ, Fondren G, et al. Chondrosarcoma of bone: an assessment of outcome. J Bone Joint Surg Am. 1999;81:326-38. https://doi.org/10.2106/00004623-199903000-00004
  20. Gitelis S, Bertoni F, Picci P, Campanacci M. Chondrosarcoma of bone. The experience at the Istituto Ortopedico Rizzoli. J Bone Joint Surg Am. 1981;63:1248-57. https://doi.org/10.2106/00004623-198163080-00006
  21. Pierz KA, Womer RB, Dormans JP. Pediatric bone tumors: osteosarcoma ewing's sarcoma, and chondrosarcoma associated with multiple hereditary osteochondromatosis. J Pediatr Orthop. 2001;21:412-8.