As of today two types of cartilage tumors remain a challenge even for the orthopedic oncologist: enchondroma (E), a benign tumor, and chondrosarcoma (LGC), a malignant and low aggressiveness tumor. A prospective study of 133 patients with a cartilaginous tumor of low aggressiveness in the long bones of the appendicular skeleton was done to prove this difficult differential diagnosis. Parameters including medical history and radiological and nuclear imaging were collected and compared to the result of the biopsy. A scale of aggressiveness was applied to each patient according to the number of aggressiveness episodes present. A comparison of the results of the biopsy with the initial diagnosis made by the orthopedic oncologist based solely on clinical data and imaging tests was also made. Finally, a management algorithm for these cases was proposed. A statistical significance for LGC resulted from the parameter as follows: pain on palpation, involvement of cortical in either the CT or MRI, and Tc99 bone scan uptake equal or superior to anterosuperior iliac crest. In our series, a tumor scoring 5 points or higher in the scale of aggressiveness can have 50% more chance of being LGC. When compared with the gold standard (the biopsy), surgeon’s initial judgement showed a sensitivity of 73.5% and a specificity of 94.1%.
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机译：截至目前，甚至对整形肿瘤学家仍然是挑战的两种类型的软骨肿瘤：Enchondroma（E），良性肿瘤和软骨菌瘤（LGC），恶性和低侵袭性肿瘤。对133例患有阑尾骨骼长骨骼低侵袭性的软骨肿瘤患者进行了前瞻性研究，以证明这种难以鉴别诊断。收集包括病史和放射学和核影像的参数，并与活组织检查结果进行比较。根据存在的侵袭性发作的数量，对每位患者的侵袭性规模应用于每个患者。还制造了对整形外科肿瘤学家的初步诊断的活检结果的比较，仅基于临床数据和成像测试。最后，提出了一种用于这些情况的管理算法。 LGC的统计学意义由参数产生如下：触诊疼痛，皮质在CT或MRI中的涉及，以及TC99骨扫描摄取等于或优于Anterosuperior in iliac Crest。在我们的系列中，肿瘤评分5点或更高的侵略性规模可能有50％的LGC的机会。与黄金标准（活检）相比，外科医生的初始判断显示敏感性为73.5％，特异性为94.1％。
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