대한흉부영상의학회 Weekly Chest Cases

Case No : 296 Date 2003-06-28

Courtesy of Yeon Joo Jeong, M.D., Kyung Soo Lee, M.D. / Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Age/Sex 67 / F
Chief ComplaintPalpable mass on anterior chest wall

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Diagnosis With Brief Discussion

Diagnosis: Chondrosarcoma, low grade(Grade I-II), Sternum
Radiologic Findings: Pre- (Fig.1a) and post-contrast enhanced (Fig.1b) chest CT scans show relatively well circumscribed, lobulated, partially calcified mass with peripheral rim enhancement and sternal destruction.This mass shows intermediate or low SI on T1WI (Fig.2a), high SI on T2WI (Fig.2b), and peripheral rimlike or septal enhancement on Gd-enhanced sagittal T1WI (Fig.2c).
Brief Review: Chondrosarcomas are the most common malignant tumors of the sternum and are usually seen in patients in the third and fourth decades of life (1). Usual or conventional chondrosarcoma may be histologically graded as 1 to 3, with grade 1 lesions having the best prognosis (2). Chondrosarcoma frequently appears as a large, lobulated, excrescent mass with scattered flocculent calcifications characteristic of its cartilaginous matrix, regardless of pathologic types. This tumor usually exhibits intermediate signal intensity similar to that of adjacent muscle on T1WI and high signal intensity on T2WI (2). Althogh analysis of signal intensity noted on routine MR images does not predict the histologic type or grade of chondrosarcoma, low grade chondrosarcoma usually shows septal and peripheral rimlike enhancement on Gd-enhanced T1WI, corresponding to fibrovascular septation between lobules of hyaline cartilage (2,3).
References: 1. Jeung MY, Gangi A, Gasser B, et al. Imaing of chest wall disorders. Radiographics 1999; 19:617-637.
2. Varma DG, Ayala AG, Carrasco CH, Guo SQ, Kumar R, Edeiken J. Chondrosarcoma: MR imaging with pathologic correlation. Radiographics 1992; 12:687-704.
3. Geirnaerdt MJ, Bloem JL, Eulderink F, Hogendoorn PC, Taminiau AH. Cartilaginous tumors: correlation of gadolinium-enhanced MR imaging and histopathologic findings. Radiology 1993; 186:813-817.
Keywords: Sternum, Malignant tumor,

No. of Applicants : 20

▶ Correct Answer : 15/20, 75.0%

- Annecy Hospital, France Gilles Genin
- Armed Forces Seoul Hospital, Korea Chang Min Park
- CHU Nancy-Brabois, France Denis Regent
- Chungju Hospital Konkuk University, Korea Chang Hee Lee
- CIM Saint Dizier, France JC Leclerc
- Ewha Women's University Hospital, Korea Sung Shine Shim
- Hangang Sacred Heart Hospital, Korea Eil Seong Lee
- Homs National Hospital, Homs, Syria Rami Abou Zalaf
- Incheon Sarang Hospital, Korea Jung Hee Kim
- Jecheon Public Health Center, Korea Seung Hun Ryu
- Kangbuk Samsung Hospital, Korea Semin Chong
- Maimonides Medical Center, N.Y., USA Naomi Twersky
- Ondokuz Mayis University, Samsun, Turkey Cetin Celenk
- Ospedale di Jesi, Italy Giancarlo Passarini
- Social Security Hospital, Ankara, Turkey Meric Tuzun

▶ Semi-Correct Answer : 1/20, 5.0%

- Chung Li Ten-Chen Hospital,Taiwan Gui-Lin Zheng

대한흉부영상의학회 Korean Society of Thoracic Radiology

Archive of Old Cases

Case No : 296 Date 2003-06-28

Discussion

No. of Applicants : 20