Cervical Chondrosarcoma: Discussion of Treatment Options and Recommendations

1. Radiation
2. Chemotherapy
3. Observation
4. En Bloc Resection with Reconstruction

Maffucci's syndrome is characterized by soft tissue angiomatosis and bony enchondromatosis. Furthermore, the potential for malignant degeneration of the angiomatosis to angiosarcoma, or the enchondroma to chondrosarcoma, is high, probably greater than 50%.

Despite the high incidence of malignant degeneration, the prevalence of Maffucci's is low. Primary chondrosarcoma is also a rare condition. Because of the rarity of this malignancy, few reports beyond case reports exist. In a review of patients at M.D. Anderson over a 43-year period, only 21 cases were identified. Furthermore, only 37 patients, who presented at the Mayo Clinic from 1916 to 1981, had chondrosarcomas located in the spine.

Radiographically, the typical chondrosarcoma has a malignant appearance consisting of poor margination, cortical destruction, and soft-tissue extension. Calcified matrix is present in about two-third of patients. The treatment advocated by both groups is en bloc resection, if possible. Local recurrence was found to be diminished with en bloc resection. Because surgical ablation is often difficult if sufficient margins are not obtainable, postoperative radiation has been advocated; however, the efficacy of radiation has been challenged. No chemotherapeutic agents have definitively proved to be of benefit in the treatment of chondrosarcoma.

Cervical Chondrosarcoma: Case Commentary Vincent Traynelis, MD