Dr. Randall on the Diagnosis of Mesenchymal Chondrosarcoma

R. Lor Randall, MD, FACS, the David Linn Endowed Chair for Orthopedic Surgery, chair of the Department of Orthopedic Surgery, professor, UC Davis Comprehensive Cancer Center, discusses, the importance of correctly diagnosing mesenchymal chondrosarcoma.

Mesenchymal chondrosarcoma is an unusual tumor that accounts for less than 10% of all chondrosarcomas, Randall begins. Although chondrosarcomas are the most common form of bone cancer diagnosed in adults, mesenchymal chondrosarcomas will sometimes present outside the bone in soft tissue, Randall continues. Because of the rarity of these tumors, even major cancer centers and sarcoma programs do not encounter mesenchymal chondrosarcoma very often, Randall notes. Given the rarity of mesenchymal chondrosarcoma, it is important to raise awareness and talk about potential therapeutic avenues for patients who are diagnosed with this malignancy, Randall emphasizes.

Mesenchymal chondrosarcoma typically presents in younger adults, and the malignancy tends to occur in a multifocal manner, with a primary tumor and other sites of disease appearing on imaging, Randall continues. This multifocal nature makes mesenchymal chondrosarcoma more aggressive than other chondrosarcomas, which typically present as isolated disease, Randall adds. Although these are typical signs of mesenchymal chondrosarcoma, there are still not much data available for these rare tumors, Randall cautions.

When treating mesenchymal chondrosarcoma, it is important for medical oncologists to be aggressive in doing staging studies to look for noncontiguous disease, Randall says. Moreover, having an orthopedic or a similar type of oncologist available to treat isolated disease is important, Randall says. Since these tumors are rare, mesenchymal chondrosarcomas are not diagnosed readily by pathologists who do not encounter them very often, Randall adds. For example, if a surgical or medical oncologist is treating patient with mesenchymal chondrosarcoma, the biopsy specimen would likely need to go to a major tumor center that has a high-volume pathologist who can assist in making the correct diagnosis, Randall concludes.