Dr Randall on the Presentation and Symptoms of Mesenchymal Chondrosarcoma

R. Lor Randall, MD, FACS, The David Linn Endowed Chair for Orthopedic Surgery, professor and chair, Department of Orthopedic Surgery, University of California Davis Health, discusses the potential symptoms and presentation of mesenchymal chondrosarcoma, as well as highlighted recent case studies that he consulted on for patients with mesenchymal chondrosarcoma.

Mesenchymal chondrosarcoma represents less than 10% of all chondrosarcomas, and although chondrosarcomas are the most common form of bone cancer diagnosed in adults, mesenchymal chondrosarcomas will sometimes present in soft tissue. Randall notes that many cancer centers and sarcoma programs do not encounter mesenchymal chondrosarcoma very often due to its rarity.

However, if a patient does present with mesenchymal chondrosarcoma, it will typically be accompanied pain if the disease develops in the bone, Randall begins. When mesenchymal chondrosarcoma does present in the bone, it typically appears in the appendicular skeleton; however, a recent case report of mesenchymal chondrosarcoma reviewed by Randall involved the lumbar spine, which he explains is unusual. This particular case also involved a 47-year-old patient, which is older than the typical age for patients diagnosed with mesenchymal chondrosarcoma, Randall notes.

When a patient presents with pain, a radiograph can display some of the structure of the bone, which will lead to an MRI, Randall says.

However, mesenchymal chondrosarcoma can also present as a soft-tissue mass. Randall recently provided a second opinion for patient with mesenchymal chondrosarcoma who was located outside of the United States. Although this patient was in their 20s and otherwise healthy and athletic, they presented with a large shoulder mass, Randall says. A biopsy and molecular tests confirmed the diagnosis, and the patient is now undergoing resection, Randall concludes.