-Case Reports-

Solitary Chondrosarcoma of the Right Ring Finger: A Case Report

Yuji Tomori¹, Norio Motoda², Ryu Tsunoda¹, Ryuji Ohashi³, Yasuyuki Kitagawa¹ and Tokifumi Majima¹

¹Department of Orthopaedic Surgery, Nippon Medical School Hospital, Tokyo, Japan
²Department of Diagnostic Pathology, Nippon Medical School Musashikosugi Hospital, Kanagawa, Japan
³Department of Diagnostic Pathology, Nippon Medical School Hospital, Tokyo, Japan

We present a case of solitary chondrosarcoma arising from the proximal phalanx of the ring finger in an elderly man. The chondrosarcoma developed over a period of 14 years, during which the phalanx became progressively more deformed. Several radiographic investigations were carried out, but the patient declined further suggested diagnostic examinations (computed tomography, magnetic resonance imaging, biopsy). Eventually, the lesion became significantly enlarged, and radiographs showed osteolytic lesions in the phalangeal bone. Ray amputation of the finger was required to establish a wide resection of the chondrosarcoma. Most osteochondral tumors arising from the phalanges are benign tumors such as enchondromas, but primary chondrogenic malignant bone tumors (chondrosarcomas) occasionally occur. Chondrosarcoma of the phalanx is difficult to distinguish from enchondroma of the phalanx, because histological investigations of the two neoplasms often produce similar findings. Even with a combination of clinical, biopsy, and imaging findings, differentiating these neoplasms is still challenging, because the characteristic clinical and radiological features of chondrosarcoma do not appear until it becomes aggressive and starts to cause destructive changes. Once that happens, radical expanded resection of the tumor is essential. Therefore, longstanding enchondroma-like lesions should be actively treated in elderly patients, even if a definite diagnosis of chondrosarcoma cannot be made.

J Nippon Med Sch 2022; 89: 599-605

Keywords
solitary chondrosarcoma, malignant tumor, finger, hand, sarcoma

Correspondence to
Yuji Tomori, MD, PhD, Department of Orthopaedic Surgery, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8602, Japan
s4064@nms.ac.jp

Received, May 1, 2021
Accepted, August 4, 2021