Chondrosarcoma classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Chondrosarcoma may be classified into six subtypes based on topographical location of tumor, histological characteristics, makeup of surrounding matrix material.

Classification

Chondrosarcoma is classified into six "subtypes" based on: (a) The topographical location of the tumor. (b) The histological characteristics of the cancerous cartilage cells. (c) The makeup of the surrounding matrix material associated with the tumor.

• Chondrosarcoma NOS ("Not Otherwise Specified")
• Juxtacortical chondrosarcoma
• Myxoid chondrosarcoma
• Mesenchymal chondrosarcoma
• Clear cell chondrosarcoma
• Dedifferentiated chondrosarcoma

Grading

Physicians grade chondrosarcoma using several criteria, but particularly on how abnormal the cancerous cells appear under the microscope and the growth rate of the tumors themselves, both of which are directly linked to the propensity of the cancer to invade locally, and to spread widely to distant organs and sites in the body (called metastasis).

Grade 1

• Chondrosarcoma grows relatively slowly, has cells whose histological appearance is quite similar to cells of normal cartilage.
• Mostly chondroid matrix, little if any myxoid.
• Mild-to-moderate increase of cellularity +/- binucleated cells.
• Have much less aggressive invasive and metastatic properties.

Grade 1 - Somewhat cellular cartilage with binucleation

Grade 2

• Intermediate grade chondrosarcoma.
• Little chondroid matrix, Necrosis and more common prominent myxoid.

Grade 2 - Very cellular cartilage with obvious hyperchromasia and nuclear atypia

Grades 3

• Grade 3 chondrosarcoma is increasingly faster-growing cancer, with more varied and abnormal-looking cells.
• Characterized by myxoid stroma, nuclear pleomorphism and mitoses.
• Absent chondroid matrix.
• These are much more likely to infiltrate surrounding tissues, lymph nodes, and organs.

Grade 3 - Even more cellular neoplastic cartilage with high grade nuclear atypia

Grade 4

• Some, but not all, authorities and medical facilities assign a "Grade 4" to the most anaplastic, undifferentiated cartilage-derived tumors.

References

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