Chondrosarcoma: Classification

Chondrosarcomas are classified as follows:

  • Primary chondrosarcoma (approximately two-thirds of cases).
    • Chondrosarcoma (conventional)
    • Dedifferentiated chondrosarcoma
    • Juxtacortical (periosteal) chondrosarcoma
    • Clear cell chondrosarcoma
    • Malignant chondroblastoma
    • Mesenchymal chondrosarcoma
  • Secondary chondrosarcoma (about one-third of cases).
    • Central chondrosarcoma as a secondary lesion in enchondroma (“cartilaginous tumor”) or multiple enchondromas (with/without Ollier’s disease)
    • Peripheral chondrosarcoma as a secondary lesion in solitary osteochondroma, ecchondromatosis, or periosteal chondroma

In addition, chondrosarcoma can also occur extraosseous (“outside the bone”) (trachea/trachea and larynx/larynx).

Furthermore, chondrosarcomas can be divided into three stages:

  • Stage I: highly differentiated chondrosarcoma (low-grade/grade 1).
  • Stage II: moderately- to de-differentiated chondrosarcoma (high-grade/grade 2-3) or mesenchymal chondrosarcoma.
  • Stage III: metastatic chondrosarcoma.

Lodwick classification

By means of the Lodwick classification, it is possible to assess whether the tumor is benign (benign) or malignant (malignant) on an X-ray. Furthermore, it is suitable for the assessment of progression in the case of aggressive behavior of the tumor.

An index for the growth rate of the bone tumor or an inflammatory process is the reaction visible on the X-ray, i.e. the bone structure is modified locally, regionally or diffusely by the tumor. The visible patterns of destruction are classified into the following main groups:

Grade Growth rate Bone destruction Dignity* Bone tumors
Grade I Purely geographic (circumscribed); boundary definable
  • A
 Very slow growing Sclerosis (pathological hardening of here: tissues) and sharp boundary benign Chondroblastoma, enchondroma, fibrous bone dysplasia, nonossifying fibroma, osteoid osteoma
  • B
 Slow growing (displacing) Bone distention > 1 cm and/or no sclerosis actively benign Giant cell tumor
  • C
 Mean growth rate(locally invasive) Total compact penetration (compacta = outer marginal layer of bone). aggressive benign chondro-, osteo-, fibrosarcomas
Grade II fast growing Geographic, with moth-eaten/permeated (without respect for anatomical boundaries) component predominantly malignant Chondrosarcoma, fibrosarcoma, malignant fibrous histiocytoma, metastases, osteosarcoma
Grade III very fast growing purely moth-eaten or permeative destruction malignant Ewing’s sarcoma

* biological behavior of tumors; that is, whether they are benign (benign) or malignant (malignant).

The classification is particularly appropriate for tumors of a long bone or small bone. However, it is neither sensitive nor specific, so further diagnostic measures are usually indispensable.