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

 

dr james c wittig, orthopedic oncologist, new york, new jersey
About Dr. Wittig
Juxtacortical (Periosteal) Chondrosarcoma

General Information

Juxtacortical/Periosteal
  • Similar to juxtacortical chondroma
  • Periosteal lesion - cortical erosion
  • Chondroid matrix calcification
  • Similar to periosteal ogs (no hair on end periosteal reaction)
  • Larger soft tissue mass/size (>3-4cm)
  • Intramedullary canal spared
Juxtacortical Chondrosarcoma

Definition:

  • A malignant, subperiosteal cartilaginous tumor that lacks osteoid production and erodes the underlying cortical bone (periosteal chondrosarcoma)
  • <2% of chondrosarcomas

Age:

  • 15-63 (80% are >20 years old vs periosteal osteosarcoma and periosteal chondroma)
  • No sex predilection

Clinical:

  • Painless, mass or swelling; 1/3 of patients have pain (pain rarely exceeds swelling)
  • Most Common Locations:
    • Femur
    • Humerus
    • Pelvis
    • Rib or foot

Radiographic Presentation

Radiology:

  • Metaphyseal
  • Cortical erosion with sclerotic underlying cortex (saucer shaped defect)
  • Matrix calcification
  • Triangular sclerotic spur at margin of tumor
  • >5cm in diameter; average size: 11 cm (vs periosteal chondroma that is usually <5cm)
  • No hair on end periosteal reaction (vs. chondroblastic osteosarcoma)
  • Intramedullary canal is spared
Roll over the images for more information
Cortical Thickening at Periphery of Lesion, Erosion of Outer Cortex Juxtacortical Chondrosarcoma

Differential Diagnosis

  • Periosteal Chondroma
  • Periosteal Osteosarcoma

Gross Pathology

  • Grossly lobulated, gray-white, translucent
  • Calcification is common
  • Underlying cortex eroded with irregular sclerotic reaction

Microscopic Pathology

  • Lobulated
  • Well differentiated, low grade, hyaline cartilage
  • Focally myxoid stroma
  • No osteoid production
  • Almost always grade 1 or 2
  • Rarely grade 3

Juxtacortical Chondrosarcoma

Prognosis
  • Low rate of Mets
    • Metastisizes most commonly to the lungs
      • Most are low to intermediate grade tumors
    • 80-90% long term survival

Treatment

  • Wide Limb Sparing Resection whenever feasible
    • Amputation may be indicated for very large, unresectable or recurrent tumors
  • Chemotherapy and radiation are generally not used in treatment of periosteal chondrosarcoma
    • Chemotherapy may be considered for Grade 3 tumors
    • Postoperative radiation may be considered for large tumors that can not be removed with a wide margin

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

Get Directions >>

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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