Diagnostic and Management Challenges in Chondrosarcoma: A Case-Based Expert Review Publisher



Saberi S ; Valinejadqanati A ; Khabiri SS
Source: Journal of Orthopedic and Spine Trauma Published:2026

Abstract

This case-based expert review from ORTHOBIT 2025 Congress (Tehran, Iran) highlights the practical challenge of distinguishing between enchondroma/atypical cartilaginous tumor (ACT) (low-grade) and higher-grade chondrosarcoma (CS). A 57-year-old woman presented with 4 months of shoulder pain. Magnetic resonance imaging (MRI) revealed a proximal humeral metaphyseal intramedullary cartilaginous lesion with a focal cortical breach and a small extraosseous component. The core needle biopsy (CNB) suggested enchondroma, and the patient underwent extended curettage, cementation, and plate fixation. Final pathology upgraded the lesion to central CS, grade 2, prompting resection and reconstruction using a proximal humeral megaprosthesis. At 3 years, she was pain-free, recurrence-free, The Musculoskeletal Tumor Society Score (MSTS) 26/30, with moderate range of motion (ROM) limitation, and radiographic superior prosthetic migration without major complications. This case emphasizes the importance of radiology-pathology correlation and planning for possible diagnostic upgrading in borderline cartilaginous tumors. ht © 2026 Tehran University of Medical Sciences. Published by Tehran University of Medical Sciences.