Chondrogene Knochentumoren

Zusammenfassung

Chondrogene Tumoren sind unter den Tumoren des Skeletts eine der häufigsten Vertreter – insgesamt aber relativ selten. Die Mehrzahl ist gutartig oder niedrig maligne. Einige Chondrosarkome weisen jedoch ein hoch aggressives Verhalten auf. Für die Diagnosestellung ist die Synopse aus Klinik, Radiologie und Histologie unerlässlich. Periphere gutartige Knorpeltumoren ohne klinische Symptomatik bedürfen meist keiner Therapie. Bei der Behandlung von Chondrosarkomen steht die chirurgische Kontrolle des Lokalrezidivs im Vordergrund. Daneben gibt es unter kurativer Intention bisher keine zufrieden stellenden auf Chemotherapeutika oder Strahlenapplikation basierenden Therapieoptionen. Momentan gilt es, die Ergebnisse von Studien mit neuen Chemotherapeutika und monoklonalen Antikörpern abzuwarten. Neue Therapieansätze mit Bisphosphonaten weisen in vitro vielversprechende Ergebnisse auf, haben jedoch aus den Laboratorien in die klinische Anwendung noch einen langen Weg vor sich. Zur Beschleunigung der Diagnosestellung und Optimierung der Therapie sollten die Diagnostik und die Behandlung chondrogener Tumoren in einem Zentrum für Knochentumoren mit interdisziplinärem Setting erfolgen.

Summary

Cartilagenous tumours of the skeleton are generally very unusual. Compared to other bone tumours they are one of the most common. Most of them are benign or of low-grade malignancy. However some subtypes of chondrosarcomas show a highly aggressive behaviour. It is important that good clinical, radiological and histological correlations are provided to make an accurate diagnosis in a cartilagenous tumour. Benign cartilaginous tumours without clinical appearance usually need no special treatment. Surgical management of a local recurrence is in the main focus of treatment. Until now there are no appropriate alternatives for therapy based on X-rays or conventional chemotherapeutics. Investigators are currently awaiting results of therapies with new chemotherapeutics and monoclonal antibodies. Novel therapies with bisphosphonates show in vitro hopeful results. However it will be a long way from the laboratories to clinical application. Finally, patients should be evaluated and managed in the context of a multidisciplinary setting to promote timeliness of care and optimize treatment.

Schlüsselwörter

Knorpeltumoren - Chondrosarkome

Keywords

Cartilagenous tumours - chondrosarcomas

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