MRI appearances of atypical cartilaginous tumour/grade I chondrosarcoma after treatment by curettage, phenolisation and allografting

S. H. M. Verdegaal*, C. S. van Rijswijk, H. F. C. Brouwers, P. D. S. Dijkstra, M. A. J. van de Sand, P. C. W. Hogendoorn, A. H. M. Taminiau

*Corresponding author for this work

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    Abstract

    Aims

    The purpose of this retrospective study was to differentiate between the MRI features of normal post-operative change and those of residual or recurrent disease after intralesional treatment of an atypical cartilage tumour (ACT)/grade I chondrosarcoma.

    Patients and Methods

    We reviewed the case notes, radiology and histology of 75 patients, who had been treated for an ACT/grade I chondrosarcoma by curettage, phenolisation and bone allografting between 1994 and 2005. The first post-operative Gd-enhanced MRI scan was carried out within one year of surgery. Patients had a minimum of two scans and a mean follow-up of 72 months (13 to 169). Further surgery was undertaken in cases of suspected recurrence.

    Results

    In 14 patients (18.6%) a second procedure was undertaken after a mean period of 59 months (8 to 114). Radio frequency ablation (RFA) was used in lesions of <10 mm and curettage, phenolisation and bone grafting for those >= 10 mm. Only six of these (8% of total) had a histologically-proven recurrence. No increase in tumour grade was seen at time of recurrence.

    Conclusion

    Based on this study, we have been able to classify the post-operative MRI appearances into four groups. These groups differ in follow-up, and have a different risk of recurrence of the lesion. Follow-up and treatment vary for the patients in each group. We present a flow diagram for the appropriate and safe follow-up for this specific group of patients.

    Original languageEnglish
    Pages (from-to)1674-1681
    Number of pages8
    JournalBone & joint journal
    Volume98B
    Issue number12
    DOIs
    Publication statusPublished - 1-Dec-2016

    Keywords

    • TUMORS
    • ETHANOL
    • PHENOL

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