Chondrosarcoma

Chondrosarcoma is a type of cancer that typically develops in the cartilage that coats the ends of bones and forms joints. It also can occur inside the bone or on the surface of the bone.

Chondrosarcoma occurs primarily in adults, is rarely encountered during the adolescent years, and almost never affects young children. It most commonly occurs in cartilage found in the femur (the large bone in the leg), humerus (upper arm bone), shoulder, ribs, and pelvis, but can also occur in the head or neck. This tumor can be a rapidly growing and invasive or it can develop slowly, causing less severe symptoms and sometimes never spreading.

Several factors, including Ollier’s disease (multiple benign tumors within a bone) and a rare genetic condition called Maffucci syndrome, may contribute to disease risk. Chondrosarcomas can be rapidly invasive or slow-growing and cause fewer symptoms and seldom spread to other organs and tissues.

Typical symptoms may include:

• Pain (sharp or dull) at the tumor site
• Swelling and/or redness at the tumor site
• Enlargement of pre-existing exotoses (bone growths)
• Increased pain with activity or lifting
• Limp
• Decreased movement of affect limb
• Urinary obstruction (with pelvic tumors)

The cause of chondrosarcoma is not known. Talk to your child's doctor if your family has a history of genetic disorders as part of your child's treatment plan.

A physician may order a number of different tests to diagnose a possible chondrosarcoma. In addition to a medical history and physical exam, these may include:

• Physical exam and neurologic function tests
• Magnetic resonance imaging (MRI)
• Magnetic resonance spectroscopy (MRS)
• Computerized tomography scan (also called a CT or CAT scan)
• Biopsy
• Lumbar puncture (spinal tap)

Chondrosarcoma treatment for children may include surgery to form a complete diagnosis of the tumor type and providing information on the stage of the disease. The type of surgery will depend on the size and location of the tumor and whether the cancer has spread. At Dana-Farber/Boston Children's Cancer and Blood Disorders Center, these procedures are performed in the hospital's new state-of-the-art pediatric MR-OR. It allows specialists to take an MRI scan immediately following surgery to ensure the tumor is completely removed and decreases the need for additional surgery.

If your child’s leg or arm is affected, your child may receive:

• Limb-salvage surgery
• Rotationplasty
• Amputation surgery
• Head or neck surgery

In addition to surgery, your child may receive radiation therapy, which can help stop the growth of abnormal cells in specific areas of the body. Radiation therapy uses high-energy rays from a specialized machine to damage or kill abnormal cells. Our doctors use precisely targeted and dosed radiation to kill cancer cells left behind after your child's surgery.

Your child may also receive chemotherapy. These medicines can help stop the growth of abnormal cells throughout the body. Chemotherapy is systemic treatment, meaning it is introduced to the bloodstream and travels throughout the body to kill or slow the growth of targeted cells. Different groups of chemotherapy drugs work in different ways and can be taken in a variety of ways including orally or intravenously.

Prognosis for children with chondrosarcoma greatly depends on:

• The extent of the disease
• The size and location of the tumor
• Presence or absence of metastasis
• The tumor's response to therapy
• The age and overall health of your child
• Your child's tolerance of specific medications, procedures, or therapies
• New developments in treatment

Every child is unique and treatment and prognosis is structured around your child's needs. Prompt medical attention and aggressive therapy are important for the best prognosis.

Survivorship care

Children treated for chondrosarcomas should visit a cancer survivorship clinic every year to:

• Manage disease complications
• Screen for early recurrence of cancer
• Manage late effects of treatment

A typical follow-up visit may include some or all of the following:

• A physical exam
• Laboratory testing
• Imaging scans

Through our David B. Perini Jr. Quality of Life Clinic, childhood cancer survivors receive a comprehensive follow-up evaluation from their cancer care team. In addition to meeting with your pediatric oncologists, your child may see one of our endocrinologists, cardiologists, neurologists, neuropsychologists, or alternative/complementary therapy specialists.

Children with chondrosarcoma are treated at Dana-Farber/Boston Children's Cancer and Blood Disorders Center through our Bone and Soft Tissue Tumors program. Our integrated pediatric oncology program offers the combined expertise of a leading cancer center and a world-renowned children’s hospital.

We provide the full set of options that can be used to treat bone and soft tissue tumors, and our solid tumor treatment team can help you determine which option is best for your child. Our pediatric oncologists have access to (and often lead) some of the most innovative clinical trials for soft tissue sarcomas, including fibrosarcoma. The surgeons of the Bone and Soft Tissue Tumors program have specialized expertise in complex surgeries, and our radiation oncologists have access to the newest radiation therapy techniques that may also be used in the care of a child with fibrosarcoma.