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J Am Acad Orthop Surg, Vol 8, No 5, September/October 2000, 292-304.
© 2000 the American Academy of Orthopaedic Surgeons

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Cartilage Tumors: Evaluation and Treatment

Rex A. W. Marco, MD, Steven Gitelis, MD, Gregory T. Brebach, MD and John H. Healey, MD

Dr. Marco is Assistant Professor of Surgery, M.D. Anderson Cancer Center, Houston. Dr. Gitelis is Professor of Orthopaedic Surgery, Rush Medical College, Chicago. Dr. Brebach is Instructor in Orthopaedic Surgery, Rush Medical College. Dr. Healey is Professor of Orthopaedic Surgery, Weill/Cornell University and Memorial Sloan-Kettering Cancer Center, New York.

Reprint Requests: Dr. Gitelis, Suite 440, 1725 W. Harrison Street, Chicago, IL 60612.

The proper treatment of cartilaginous tumors is dependent on the clinicopathologic and radiologic findings. Enchondroma is a benign tumor that is usually asymptomatic and thus should be treated nonoperatively. Symptomatic enchondromas are often treated by intralesional excision. Intramedullary low-grade chondrosarcoma is a malignant tumor that is usually painful. The treatment of low-grade chondrosarcoma may range from intralesional excision with or without adjuvant therapy to wide excision. Although intralesional excisions have a higher bone and joint preservation rate than wide excisions, they may be associated with a higher local recurrence rate. Intermediate- and high-grade chondrosarcomas are treated with wide excisions. The treatment of these cartilaginous lesions should involve a multidisciplinary team including a musculoskeletal surgeon, a radiologist, and a pathologist.




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