Chondrosarcoma diagnostic study of choice

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Diagnostic Study of Choice

Study of choice

• Biopsy is the gold standard test for the diagnosis of chondrosarcoma.

Technique

• Open
• Closed

Open Technique

• The tumor is surgically exposed and biospy of the tumor is taken.

Incision

• Longitudinal incision in the extremities is taken.
• It should allow for extension of the incision for definitive management

Approach

• Never expose neurovascular structures.
• During the biopsy, all tissue exposed is considered contaminated with tumor.
• Meticulous hemostasis to be carried out.
• Post-surgery hematomas are considered contaminated with tumor.
• Always deflate the tourniquet prior to wound closure.

Biopsy

• Perform through the involved compartment of the tumor.
• For bone lesions with a soft tissue mass, perform the biopsy using the soft tissue mass.

'Closure

• If drain is kept, remove the drain out of the skin in line with surgical incision.
• This helps in excising the drain site with definitive surgical extensile incision.

Closed Technique

Diagnostic results

The following finding(s) on performing [investigation name] is(are) confirmatory for [disease name]:

• [Finding 1]
• [Finding 2]

Sequence of Diagnostic Studies

The various investigations must be performed in the following order:

• X-ray
• MRI
• Biopsy

Enneking (MSTS) Staging System

• The Enneking surgical staging system (also known as the MSTS system) for malignant musculoskeletal tumors based on histological and radiographic characteristics of the tumor host margin.
• It is widely accepted and routinely used staging system.

Stages	Grade	Site	Metastasis
IA	G1: Low grade	T1: Intracompartmental	M0: No metastasis
IB	G1: Low grade	T2: Extracompartmental	M0: No metastasis
IIA	G2: High grade	T1: Intracompartmental	M0: No metastasis
IIB	G2: High grade	T2: Extracompartmental	M0: No metastasis
III	G1 or G2	T1 or T2	M1: Regional or distant metastasis