Evaluation of predictive factors for malignancy in chondrogenic bone tumors

Objective: It is often difficult to distinguish radiologically and pathologically between enchondromas, atypical chondrogenic tumor (ACT) and chondrosarcoma. Pathology results may be insufficient to determine the treatment plan. In this study, the relationship between radiological findings and definitive diagnosis was investigated. Materials and methods: 127 patients who applied to our hospital between 2011-2021 and were diagnosed with chondrogenic tumors in the skeletal system after the examinations and pathological confirmation were included in the study. These patients were evaluated together with their demographic information and data obtained from radiological imaging methods. The first biopsy results of the cases and the pathology results of the last surgical procedure were compared. It was checked whether there was discordance among the results. To evaluate the diagnostic usefulness of radiological findings, correlations between various radiological findings and final diagnoses were examined. Results: The mean age of 34 patients with enchondroma was 30.2 years, and no discordance was found between the biopsy result and the final result in these patients. No patient died due to the disease. The mean age of 51 patients diagnosed with atypical chondrogenic tumors was 44 years, and a discordance was found in 20 (39.2%) patients (ACT → grade 1 CS) between the biopsy result and the final result. No patient died due to the disease. The mean age of 54 patients with chondrosarcoma was 47 years, and 20 of these patients were diagnosed as a result of the final surgery of ACT patients. There were 34 patients diagnosed with CS in both initial biopsy and final surgical pathology results. When the pathology results of these patients were examined, discordance was found in 5 (14.7%) patients. In patients with a diagnosis of chondrosarcoma, 6 (11.1%) patients died due to the disease. All of these patients are in the grade 3 CS group. Conclusion: In the light of the findings obtained by imaging methods in bone tumors of cartilage origin, cases thought to have atypical chondrogenic tumors can be followed closely without biopsy. Even if the biopsy result is low-grade chondrosarcoma in tumors with aggressive findings in imaging methods, it is recommended to plan appropriate surgery for high-grade chondrosarcoma. Keywords; Atypical, enchondroma, cartilage, chondrosarcoma, tumor