The Benign – Malignant Continuum
When we think of cancer versus benign tumors, we tend to think of completely different entities. However, all sorts of tumors, generally referred to as neoplasia, should be thought of on a continuum.
Cartilage tumors of bone exemplify this principle. These tumors run the gamut from very benign and non-progressive to rapidly enlarging, highly malignant cancerous tumors. They can also be anything in between.
Benign cartilage tumors in the bone are called enchondromas. Cancerous cartilage tumors are called chondrosarcoma.
We attempt to estimate the biologic potential for continued growth by establishing the grade of the tumor based on microscopic findings. This grading affects your treatment.
The lowest grade chondrosarcomas can be managed in the same fashion as benign enchondromas, by a straightforward removal of the tumor, called curettage, from the inside out, followed by bone grafting.
However, the higher-grade chondrosarcomas are treated with a radical excision similar to other bone sarcomas.
In short, each tumor has a personality that is determined by its own genetics, which are somehow deviant from those of the person in whom it grows.