Treatment of benign and low-grade malignant intramedullary chondroid tumours with curettage and cryosurgery

To shed light on the controversy surrounding the methods of evaluating, staging and final treatment of intramedullary chondroid lesions. Controversy particularly exists for enchondroma and low-grade chondrosarcoma located in the extremities, because their accurate distinction is hampered by their ra...

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Bibliographic Details
Published in:European journal of surgical oncology 1998-04, Vol.24 (2), p.120-126
Main Authors: Bart Schreuder, H.W., Pruszczynski, Maciej, Veth, René P.H., Lemmens, J. Albert M.
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Bone Neoplasms - diagnostic imaging
Bone Neoplasms - surgery
bone tumours
Chondroblastoma - diagnostic imaging
Chondroblastoma - surgery
Chondroma - diagnostic imaging
Chondroma - surgery
Chondrosarcoma - diagnostic imaging
Chondrosarcoma - surgery
cryosurgery
Cryosurgery - methods
curettage
Curettage - methods
Diseases of the osteoarticular system
Female
Femoral Neoplasms - surgery
Follow-Up Studies
Humans
Humerus - surgery
Magnetic Resonance Imaging
Male
Medical sciences
Middle Aged
Radiography
Treatment Outcome
Tumors of striated muscle and skeleton
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Summary:To shed light on the controversy surrounding the methods of evaluating, staging and final treatment of intramedullary chondroid lesions. Controversy particularly exists for enchondroma and low-grade chondrosarcoma located in the extremities, because their accurate distinction is hampered by their radiographical and histological similarity. Since 1991 we have treated 22 patients (mean age: 39.6 years) with 26 lesions (three chondroblastomas, 14 enchondromas and nine grade 1 chondrosarcomas) with curettage, cryosurgery and bone grafting. After a mean follow-up of 26 months no recurrences were observed. Complications consisted of two postoperative fractures, one wound infection and one intraoperative venous gas embolism. All bone grafts incorporated, resulting in full weight-bearing capacity and excellent functional results. The usefulness of a combination of curettage and cryosurgery as adjuvant therapy is considered to be equal to marginal resection according to orthopaedic oncological principles. The pre-operative assessment of these lesions and cryosurgical technique is described in detail.
ISSN:0748-7983
1532-2157
DOI:10.1016/S0748-7983(98)91459-7