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Dedifferentiated chondrosarcoma of the appendicular skeleton: MRI-pathological correlation

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Abstract

Objective

To correlate the T2-weighted and STIR MRI appearances of dedifferentiated appendicular chondrosarcoma with gross and microscopic pathology.

Design and patients

Nine patients with a histologically confirmed diagnosis of dedifferentiated appendicular chondrosarcoma were identified from the Bone Tumour Registry. All patients underwent MRI, including T2-weighted and/or STIR sequences in at least one plane, prior to limb salvage surgery. Areas of reduced signal intensity (SI) compared with hyperintense chondral tumour on the T2-weighted or STIR images were correlated with the resection specimen, to determine the relationship of such out areas of reduced SI with regions of dedifferentiation.

Results and conclusions

Patients presented over a period of 7 years. There were five men and four women with mean age 68.2 years and age range 51–78 years. Tumours arose in the femur (6 cases), humerus (2 cases) and tibia (1 case). Three MRI patterns were identified: (1) type 1, a lesion with two distinct signal characteristics—hyperintense chondral and reduced SI dedifferentiated tumour (n=6); type 2, mainly reduced SI lesion—dedifferentiated tumour, with areas of signal void corresponding to matrix calcification (n=2); type 3, a heterogeneous lesion with no radiological evidence of underlying chondral tumour (n=1). T2-weighted or STIR MR sequences can identify areas of dedifferentiation, which should be the preferential site of pre-operative biopsy.

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Authors and Affiliations

  1. Department of Histopathology, The Royal National Orthopaedic Hospital NHS Trust, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK

    Fergus MacSweeney & Alan Darby

  2. The London Bone and Soft Tissue Tumour Unit, London, UK

    Fergus MacSweeney, Alan Darby & Asif Saifuddin

  3. Department of Radiology, The Royal National Orthopaedic Hospital NHS Trust, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK

    Asif Saifuddin

  4. Department of Diagnostic Imaging, The Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex, HA7 4LP, UK

    Asif Saifuddin

Authors
  1. Fergus MacSweeney
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  2. Alan Darby
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  3. Asif Saifuddin
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Correspondence to Asif Saifuddin.

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MacSweeney, F., Darby, A. & Saifuddin, A. Dedifferentiated chondrosarcoma of the appendicular skeleton: MRI-pathological correlation. Skeletal Radiol 32, 671–678 (2003). https://doi.org/10.1007/s00256-003-0706-1

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  • DOI: https://doi.org/10.1007/s00256-003-0706-1

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