Posters— Surgical Treatment of Sarcomas

PERIOSTEAL CHONDROSARCOMA: EXPERIENCE OF THE ISTITUTO ORTOPEDICO RIZZOLI

Fabbri N., De Paolis M., Vanel D., Mercuri M., Picci P. Department of Musculoskeletal Oncology, Istituto Ortopedico Rizzoli – Bologna, Italy

Periosteal chondrosarcoma is a rare primary malignant tumor of the bone surface. Due to its rarity, the differential diagnosis with other primary tumor of the bone surface can be difficult and the potential for metastasis remains unclear. Studies reporting series of patients homogeneously managed at the same Institution are scant in the literature. From 24855 bone tumors filed at our Institution, 26 cases of periosteal chondrosarcoma were identified; 2 cases were excluded for incomplete imaging studies. A retrospective study of the remaining 24 cases was undertaken. Clinico-pathologic features were reviewed and analyzed along with follow-up in order to define diagnostic criteria and understand prognosis of this condition.

There were 18 males and 6 females, average age was 33 years (17-65). A palpable mass and dull pain averaging more than 18 months of duration were the most common symptoms at presentation.

Tumor location was the femur in 14 cases (12 distal, 2 proximal), humerus in 7 cases (5 proximal, 2 shaft), tibia in 2 cases (2 proximal) and iliac wing in one case. Imaging studies showed a frequently lobulated juxtacortical mass, usually suggestive of cartilaginous matrix on both plain X-rays and CT or MRI scan. Although abnormalities of the cortex were present in all the cases, medullary involvement could be detected and histologically confirmed only in 2 cases.

Information regarding the surgical margin and a minimum follow-up longer than 3 years were available in 18 patients (average 11 years, range 3-30). Surgical margin was adequate (wide) in 10 cases and inadequate (wide/contaminated or marginal) in the remaining 8 cases. All the patients were disease free; 3 local recurrences were managed with further surgery. None of the patients developed metastasis. There were no local recurrences when the surgical margin was adequate. In our experience prognosis is excellent after adequate surgical management and risk of metastasis is very low.