J Korean Bone Joint Tumor Soc.  2014 Dec;20(2):89-93. 10.5292/jkbjts.2014.20.2.89.

Clear Cell Chondrosarcoma of the Tibia Diaphysis: A Case Report

• Kang CM
• Han CS
• Jung GY
• Jeong HY
• Kim YJ

• KMID: 1799899
• DOI: http://doi.org/10.5292/jkbjts.2014.20.2.89

Abstract

Clear cell chondrosarcoma is a very rare malignant bone tumor that shows a strong predilection for the epiphysis or metaphysis of long bones. Many studies have reported that the proximal end of the femur is the most commonly affected site, followed by the proximal end of the humerus. Histopathologically, tumor cells of this type have centrally located round nucleoli with clear cytoplasm and a distinct cytoplasmic membrane. Generally, clear cell chondrosarcomas is not confused with conventional chondrosarcomas. However, when it involves the diaphysis in long bones, diagnosis can be hindered, as only three reports of this exist in the literature. We report herein an unusual case of clear cell chondrosarcoma of the tibial diaphysis in a 42-year-old male.

Keyword

tibia; diaphysis; clear cell chondrosarcoma

MeSH Terms

Adult
Cell Membrane
Chondrosarcoma*
Cytoplasm
Diagnosis
Diaphyses*
Epiphyses
Femur
Humans
Humerus
Male
Tibia*

Figure

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  Figure 1. (A, B) The radiographs showed an intramedullary ovalshaped radiolucent lesion of the right tibia diaphysis. A distinct sclerotic border was identified, but the posterior endosteal portion of the lesion showed an ill-defined margin with a slightly infiltrative pattern. There was no periosteal reaction. (C) T1-weighted coronal images showed a well-marginated lesion with intermediate signal intensity in the medullary cavity of the tibia shaft. (D) T2-weighted sagittal images showed intermediate to high signal intensity with a relatively homogeneous appearance without soft tissue expansion. (E) A bone scan revealed highly increased uptake in the middle shaft of the tibia, and showed no other abnormalities elsewhere.

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  Figure 2. (A, B) CT showed an intramedullary lesion with permeative endosteal bone destruction. Complete cortical disruption was not noted. (C−E) MRI repeated after surgical biopsy showed a similar appearance with enhancement.

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  Figure 3. (A−F) Resection of the tibia shaft including the tumor was performed and structural allogenic bone was transplanted into the empty space. The allo-bone was fixed with an intramedullary nail and plate.

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  Figure 4. Histopathologic appearance. The cells had pale, clear cytoplasm with a distinct cytoplasmic membrane and centrally located large, round nuclei, which are typical features of CCCS (H&E, ×160, ×250).

Reference

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