Primary pulmonary chondrosarcomas: a clinicopathologic study of 4 cases.

Malignant cartilaginous tumors of the lung are unusual, and although their occurrence has been reported in the literature in some cases, their separation from other benign cartilaginous tumors of the lung can be very difficult. Four cases of primary chondrosarcomas of the lung are presented. The patients are 2 men and 2 women between the ages of 51 and 69 years. Clinically, the most common symptoms were chest pain, dyspnea, and cough. Two tumors were centrally located, whereas 2 tumors were peripheral. Complete surgical resection was accomplished in all the patients. Histologically, 2 tumors were low grade of the hyaline type, whereas 2 tumors were predominantly myxoid chondrosarcomas. In the 2 myxoid chondrosarcomas immunohistochemical studies for keratin, desmin, smooth muscle actin, and CD31 were negative, whereas S-100 protein shows focal positive staining in both cases. Follow-up showed that one patient with low-grade tumor was alive and well at 36 months, whereas one patient with myxoid chondrosarcoma died 45 days after diagnosis because of surgical complications. Two additional patients were lost to follow-up. Our study highlights the ubiquitous distribution of chondrosarcomas and the histopathologic spectrum that these tumors may show when occurring in the lung.