chondrosarcoma, clear cell chondrosarcoma, diagnosis clear cell chondrosarcoma, radiology clear cell chondrosarcoma, pathology clear cell chondrosarcoma, surgery clear cell chondrosarcoma, prognosis clear cell chondrosarcoma, epiphyseal tumor, cartilage cancer, bone cancer, bone sarcoma, low grade bone sarcoma, sarcoma

For an appointment call:
833-292-BONE (2663)

 

dr james c wittig, orthopedic oncologist, new york, new jersey
About Dr. Wittig
Clear Cell Chondrosarcoma
Clear Cell Chondrosarcoma

General Information

  • Malignant tumor
  • Comprised of neoplastic chondrocytes
  • With abundany, clear cytosplasm
  • Little interveining matrix
  • Foci of conventional chondrosarcoma may be present

Clinical Presentation

Signs/Symptoms:

  • Pain and swelling
  • There may be interference with motion
  • Often of long duration
Prevalence:
  • ~2% of all chondrosarcomas
  • 2 to 1 male predilection
Age:
  • Adolescence to old age
  • Most common in third and fourth decades
Sites:
  • Epiphyses of long bones
  • Most commonly proximal femur, proximal humerus, distal femur, proximal tibia

Radiographic Presentation

  • Usually osteolytic, expansile lesion
  • May be focally calcified
  • Often a sharp interface between tumor and surrounding bone
  • Sclerotic rim is uncommon
  • Overlying cortex is usually thin, but intact
Roll over the images for more information
Geographic, epiphyseal lesion, skeletally mature, no sclerotic rim AP pelvis
T1-weighted MRI proximal femur: clear cell chondrosarcoma MRI T2 Weighted Image
bone scan: increased uptake in region of proximal femur, clear cell chondrosarcoma Left proximal femur: clear cell chondrosarcoma
Plain X-ray of clear cell chondrosarcoma of proximal femur Plain X-ray: Proximal femur clear cell chondrosarcoma
Proximal humerus clear cell chondrosarcoma

Gross Pathology

  • Cut surface
  • Typically lacks appearance of conventional chondrosarcoma
  • Usually red, soft and granular
  • Possibly multiple cysts
  • Small areas of gray or white cartilage may be irregularly interspersed

Microscopic Pathology

  • May have inconspicuous lobular pattern
  • Sometimes microlobules are separated by delicate fibrovascular stroma
  • Dominant cell is chondrocyte
  • Variably clear cytoplasm
  • Condensation of powdery cytoplasm near membrane or nucleus
  • Sharply defined cell borders
  • Nuclei are enlarged and rarely binuclear
  • Matrix formation is sparse
  • Small deposits of chondroid material between clear cells
  • May be focally calcified
  • More abundant m,atrix may be found in areas of conventional chondrosarcoma
  • These areas found in about half of clear cell variants


Roll over the images for more information
gross specimen histology: clear cell chondrosarcoma
pathology pathology
pathology pathology

Biological Behavior

  • Slightly aggressive
  • Destructive cortical penetration is rare, but possible
  • Recurrence rare
  • Metastasis somewhat common

Treatment and Prognosis

  • En bloc resection with wide margin of normal bone and soft tissue
  • Procedure of choice
  • Recurrence rare
  • Simple excision or curettage
  • 80% risk of local recurrence
  • Amputation always a possible back up
  • Metastasis
  • No microscopic or clinical differences from original lesion
  • Somewhat common
  • Even if treated with amputation
  • Death rate low to moderate

Office Locations

Morristown Medical Center
Carol G. Simon Cancer Center
100 Madison Avenue
2nd Floor
Morristown, NJ 07960
Phone:  833-292-BONE (2663)
Fax:  973-898-1636
Email:  drjameswittig@gmail.com

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Services & Specialties

Pediatric and Adult Bone Sarcomas
Soft Tissue Sarcomas
Benign Bone Tumors
Benign Soft Tissue Tumors
Childhood Sarcomas
Shoulder Tumors
Cryosurgery
Radiofrequency Ablation
Special Surgeries
Diagnosis and Treatment



Ask The Doctor

Testimonials
"Thank you from the bottom of my heart for your excellent care...I wish you a very long and productive professional life so that more people can benefit from your expertise, so that more people can get a second chance to live their lives to the fullest."

Irina B.
"I am writing to you to thank you for everything you and your team have done for me. I cannot tell you how fortunate I feel that I am in your care. It gives me the peace of mind that I have you as my doctor.  Your knowledge and expertise is greatly appreciated. You truly are the best!  Thank you!"

-Sincerely,
JG
Dear Dr. Wittig,
I am writing at a loss to find adequate words to thank you for all that you have done for me.  You were so generous to give up your time on a weekend to operate on my femur.  I believe that this made a vast difference in my life.  Your skills as a diagnostician and surgeon have given me an opportunity to have a better life.  At a time like this, it is comforting to be treated with kindness and skill.  Thank you for sharing your gifts with me.
Dear Dr. Wittig,
I'm so thrilled with your diagnosis, and thankful too!  If you're ever in S. Orange and would like to visit "The Gate" for a pint, I'd be happy to personally escort you.  You'll get the VIP treatment.  Thank you so very much for your attention and professionalism.
Dear Dr. Wittig,
I can't thank you, and your team enough for making our son, who recently underwent surgery (removing a tumor on his pelvis), feel so comfortable and at ease.  As did you, with my family, addressing all our questions, and concerns.  We knew he as in the best possible hands.  You are a wonderful, compassionate Doctor....We are so grateful to have such a gifted Dr. taking care of him.
Sincerely,
Sandy
Dear Dr. Wittig,

Thank-you so very much for being my surgeon for that chondrosarcoma, for saving my life!  And I have learned over the months (from other doctors...) that I was very fortunate to have you as a surgeon.

I think that I should have been more cheerful and clear upon receiving the good news from you during the visit on Wednesday.--I was just that I've been so anxious, worried, tense, confused from 6 months of various treatments -- prostate 45 day radiation, gall stone passing, kidney stone matters that have been happening these past months.

In driving home after the news today, I've begun feeling increasingly released, cheerful...able at long last to get on fully with my life.

You, your staff, that hospital...have set the bar for health care so much higher than I could have imagined.

With Deepest Gratitude!

Robert
Good evening Dr. Wittig,

I hope you are doing well this evening and hope you have a restful weekend with your family.  It was a pleasure meeting you in person. After meeting you, I can understand why you and Sheeraz are close friends and colleagues, especially how highly Sheeraz spoke of you!  You are kind and down to earth.  Also, you and Sheeraz are not only amazing and talented doctors, but you are compassionate and empathetic to the needs of your patients and families, which often lacks in the world of medicine.  I wanted to be a doctor, but I really can't deal with the sight of blood, like I mentioned to Sheeraz.  Both of you are great role models how family centered care should be and how I strive  and want to be with my little patients at Sloan. 

I appreciate everything you have done for my Uncle. I am grateful to Sheeraz for recommending you! I hope you and your family are always happy and healthy, so you can continue to great things to impact the quality of life of others...

Thanks so much again for everything NYU familia! 

Kind Regards,
Mariyam 
On May 10th I had the pleasure of meeting Dr. Wittig for the first time.  This was an extremely stressful time for me since I had received several reports regarding my cancer diagnosis.  Upon meeting Dr, Wittig I immediately knew I was in good hands.  His calm demeanor & straightforward manner were very comforting to me.  He laid out how he was going to proceed with the operation, how long it would take, & followup.  He has been a source of comfort to me thru out this ordeal & I know I could not be in a better place with him.  His support staff of nurses, is top notch.  Their attention to detail, answering questions we may have, are always done in a timely manner.  Without the ease of working with Dr. James Wittig, I can tell you. I would not feel as confident with my situation as I do.  He is truly a very special human being.   Sincerely,   Karolyn
"Thank you for helping me through the toughest time in my life!"

- Eric P.
"I can't thank you enough for everything you've done for me!"

- Kyle B.
"Unbelievable! Thank you!"

-Amanda S.
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