After a biopsy, surgery is done to remove the tumor. Again, it is important that the biopsy be done by the same surgeon who will remove the tumor. For a low-grade chondrosarcoma in an arm or leg, curettage with cryotherapy is an option. (Details about curettage can be found in the “Surgery for bone cancer” section) If the tumor is high-grade, limb-sparing surgery will be done if possible. Sometimes amputation is needed to remove all of the cancer. If the chondrosarcoma has spread to the lung, the lung tumors may be removed if there are only a few.
If the tumor is in a place where it can’t be removed (for example, the skull) it might sometimes be treated with curettage and cryosurgery (a treatment that uses freezing to kill cancer cells) or with high-dose radiation therapy. Proton-beam radiation works well for these tumors.
Some of the special types of chondrosarcoma are treated with chemotherapy (chemo).
Malignant fibrous histiocytomas (MFH)
MFH is treated the same way as osteosarcoma (see our document Osteosarcoma for more details). The usual treatment plan starts with chemo. This shrinks the tumor and makes it easier to remove. Next, surgery may be done to take out the tumor and nearby bone. After that, the bone may be rebuilt with a bone graft or metal rod. Amputation is rarely needed. In some cases, chemo is given after surgery.
Surgery is the main treatment for this kind of bone cancer. If all of the tumor cannot be removed, radiation treatment may be used instead of or along with surgery. Radiation is also used if the cancer comes back after surgery.
Giant cell tumors of bone
These tumors are most often treated with surgery. The extent of surgery can vary, and depends on where the tumor is found and how big it is. One option is to remove the part of the bone affected by the tumor and replace it with a bone graft or prosthesis (such as a metal rod). Another option is curettage, sometimes followed by using extreme hot or cold temperatures to kill any remaining cancer cells. (More about curettage can be found in the “Surgery for bone cancer” section.) Radiation is not often used to treat giant cell tumors because if the tumor is not killed completely it may increase the chance that it comes back as a cancer (in the malignant form). Amputation is rarely needed to treat a giant cell tumor.
If there are only a few metastatic tumors in the lungs, it may be possible to remove them with surgery. Metastases can also be treated with radiation.
This tumor is most often found in the base of the skull and bones of the spine. Removing all of the cancer is best, but it might not be possible. If some of the tumor is left after surgery, radiation may be used, but it must be aimed carefully. Long-term follow-up is important because these tumors can come back, even 10 or more years after treatment.
The targeted therapy drug imatinib (Gleevec) may be used if a chordoma has spread widely.
Last Revised: 01/24/2013