Diseases of the bone are considered today as one of the common lesions of the human skeleton. And their diversity is due to the place of localization and the course of the disease.
However, among them should be allocated chondrosarcoma, which in recent decades is one of the main places in the treatment of diseases of this nature. What is this disease and what are the features of its manifestations?
What is chondrosarcoma and its statistics
As a serious and life-threatening disease, chondrosarcoma is, according to medical statistics, the most common diseases of the skeleton.
Photo of chondrosarcoma of bone
Having a malignant course, it can arise in the humeral and pelvic girdle, developing in the cartilaginous tissue. There are also cases of its appearance and bones tubular nature. The incidence of the disease is about 7-12% of the total number of malignant tumors.
Options for the development of this condition:
- appearance on healthy bones of the skeleton;
- degeneration of an existing tumor with a benign course.
By age, this disease is not classified: its occurrence is possible in any age group, but this condition is more often diagnosed at a more mature age.
There is also no pronounced pattern on the basis of gender, however, men suffer more than women - in 1.5 times chondrosarcoma is diagnosed in the male half of the population.
Varieties
The process of classification of chondrosarcoma is performed depending on the degree of its development. The limitation period for the emergence can be divided into primary and secondary forms, with each having further division.
Primary
This type of neoplasm usually occurs on the surface of intact bones. Inside the disease also has a classification:
- central - tumor development occurs inside the cavity of the affected bone;
- is periosteal, or peripheral - growing outside the bone, along its surface.
Primary form of is diagnosed more often - in 90% of cases of the appearance of chondrosarcoma.
Secondary
This species is more often found in older people, whose age has crossed the 40-year boundary. They can arise from the chondromas, with pronounced dischondroplasia, from the cartilaginous tissue of the joints.
The appearance of this type of lesion can be triggered by the following conditions:
- with bone-cartilaginous exostoses;
- with chondromatosis of bones, or diseases of the Ollie-Maffuchi;
- for chondroblastomas;
- with chondromixoid fibroids.
Secondary form of the disease manifests itself significantly less often than the primary one - its detection occurs in 10% of cases of chondrosarcoma.
Classification by type of structure
The different type of structure of such malignant tumors determines the classification of the following type:
- anaplastic type of disease;
- typical view;
- a clear cell chondrosarcoma;
- is an undifferentiated species.
This disease may also vary depending on the degree of malignancy.
Classification by type of malignancy
If a suspected development of this disease is necessary, a histological analysis of part of the bone tissue is carried out, and based on the results of such a study, the presence of the disease and the features of tumor development are determined.
The classification process is based on the degree of penetration of the tumor process into the bone:
- , the first degree of is characterized by the fact that the intercellular substance predominantly consists of chondroid-like tissue, in which chondrocytes having small and dense nuclei can be observed. There are no mitotic figures, nor are there multi-nuclear cells;
- the second degree of development of malignancy is manifested already in the change in the nature of the intercellular fluid - it contains more cells, the composition is myxoid. The cells accumulate mainly in the peripheral part of the lobes. There are figures of mitosis, the cell nuclei have enlarged sizes. Start to appear areas of damage and destruction - the process of necrosis is monitored;
- the third degree of - the whole intercellular fluid has a mixoidal character, the location of the cells in it - by strands or single groups, the figures of mitosis are more common, and the areas of necrosis( tissue lesions) become more extensive.
Depending on the degree of malignancy of the disease, the higher the probability of relapse after treatment( surgical intervention), as well as the development of metastasis in the course of the disease.
This means that the first degree of malignancy is more easily treatable and less prone to metastasis. The third degree is more malignant - the metastases are more pronounced and have a deeper penetration into neighboring tissues.
Tumor localization
The bone of any part of the human skeleton can become a place of occurrence of this disease. However, most often a tumor of this nature occurs in the following areas:
- bone of the pelvis - the hip can be affected by this type of malignant tumor most often. In this case, there are long and dull pain in the pelvic region, which begin when the sciatic nerve grows with a tumor;
- bone of the sacrum - there is also pronounced soreness, the pain can have a sharp or dull, pulling character;
- thighs - the manifestation of the disease here is also acute pain, long-lasting. Possible restrictions on movement in this area;
- shoulders of are also often affected by chondrosarcoma, the most pronounced in this area is the primary form of the disease;
- less often the disease is diagnosed by in the bones of the hands and fingers .
Causes of development of
Today, the study continues on the causes that may be the cause of chondrosarcoma. However, the following are the general stimulating factors of this process:
- incorrectly selected treatment of some diseases - for example, the implementation of economical resection, prescribed for the development of bone chondroma;
- are some of the predisposing diseases that have been listed above.
Symptoms of
The initial stage of the development of the disease usually does not cause severe soreness. However, as the growth grows, it penetrates into neighboring tissues, which causes pain.
Symptoms of chondrosarcoma are swelling, tenderness increases with palpation, and it is also possible to change the color of external tissues to cyanotic.
Features of metastasis
In the course of the development of the disease, an increase in the number of metastases is accelerating, which have some peculiarities of their development. Most often they appear in the lungs, brain tissue. This occurs with a low differentiated form of the disease.
Periostal chondrosarcomas can metastasize in a different way. When the pathological tissue of the reactivity region grows, "jumping metastases" arise which do not have a pronounced connection with the underlying tumor and can be observed in any tissues. Usually, such metastases are formed in the reactive region or not far from it, with a healthy tibia.
Diagnostic Methods
Methods for diagnosing this disease are divided into the following:
- X-ray - with its use it is possible to detect central chondrosarcoma;
- biopsy allows to determine the degree of malignancy of the neoplasm;
- MRI is performed in the area of the affected bone;
- computed tomography is the most modern method of diagnosing a disease.
Treatment of
The most effective methods of treatment of chondrosarcoma include operative intervention, which allows you to remove pathological tissue. Radiation therapy is also effective, but it is shown at an early stage.
Chemotherapy is used for chemical-sensitive forms of the disease, such as highly differentiated and mesenchymal chondrosarcoma.
Can also be used for complex treatment.
Amputation of the limb is prescribed for serious neglect of the disease.
Prognosis
Survival after treatment with chondrosarcoma is high at an early stage, the prognosis is favorable at the start of treatment of a non-neglected form of the disease and is about 20-35% for a five-year period of .