Mesenchymal chondrosarcoma: a report of 17 cases.

Mesenchymal chondrosarcoma is a rare, almost uniformally lethal variant of chondrosarcoma which has been regarded as resistant to chemotherapy and radiotherapy. Seventeen cases are reported; 14 are dead of tumor or still alive with disease; eight of the 14 died less than one year after treatment, predominately of distant metastatic disease. This confirms previous reports of the highly aggressive nature of mesenchymal chondrosarcoma. Although surgery is regarded as the major method of treating the primary disease, it has limitations because many tumors cannot be adequately removed owing to location or extension to unresectable sites. It was found that such tumors respond to irradiation and that a combination of chemotherapy and radiotherapy should be used in unresectable tumors or those resected with inadequate margins. Adjuvant chemotherapy is advised in all cases treated with radical surgical excision. Unfavorable prognostic factors in mesenchymal chondrosarcoma are pain as a presenting symptom and a central rather than a peripheral limb location.