Abstract
Background Chondrogenic tumors are the most frequent primary bone tumors. Malignant chondrogenic
tumors represent about one quarter of malignant bone tumors. Benign chondrogenic bone
tumors are frequent incidental findings at imaging. Radiological parameters may be
helpful for identification, characterization, and differential diagnosis.
Methods Systematic PubMed literature research. Identification and review of studies analyzing
and describing imaging characteristics of chondrogenic bone tumors.
Results and conclusions The 2020 World Health Organization (WHO) classification system differentiates between
benign, intermediate (locally aggressive or rarely metastasizing), and malignant chondrogenic
tumors. On imaging, typical findings of differentiated chondrogenic tumors are lobulated
patterns with a high signal on T2-weighted magnetic resonance imaging (MRI) and ring-
and arc-like calcifications on conventional radiography and computed tomography (CT).
Depending on the entity, the prevalence of this chondrogenic pattern differs. While
high grade tumors may be identified due to aggressive imaging patterns, the differentiation
between benign and intermediate grade chondrogenic tumors is challenging, even in
an interdisciplinary approach.
Key Points:
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The WHO defines benign, intermediate, and malignant chondrogenic bone tumors
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Frequent benign tumors: osteochondroma and enchondroma; Frequent malignant tumor:
conventional chondrosarcoma
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Differentiation between enchondroma versus low-grade chondrosarcoma is challenging
for radiologists and pathologists
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Pain, deep scalloping, cortical destruction, bone expansion, soft tissue component:
favor chondrosarcoma
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Potential malignant transformation of osteochondroma: progression after skeletal maturity,
cartilage cap thickness (> 2 cm adult; > 3 cm child)
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Potentially helpful advanced imaging methods: Dynamic MRI, texture analysis, FDG-PET/CT
Citation Format
Key words
cartilage - neoplasms - chondroma - osteochondroma - chondrosarcoma - diagnostic imaging
