Fine needle aspiration biopsy diagnosis of primary clear cell chondrosarcoma: A case report

Abstract

Clear cell chondrosarcoma is a rare chondrosarcoma variant often involving the long bone epiphyses of young to middle aged adults. We report herein a case involving the left femoral head in a 25-year-old female with a 3-month history of worsening left hip pain. Radiographs revealed a complex, multifocal and lytic lesion centered in the left proximal femoral epiphysis with involvement of the femoral neck. Computed tomography-guided fine needle aspiration biopsy with concomitant core needle biopsy was performed, and a diagnosis of clear cell chondrosarcoma was rendered. Cytologic smears revealed aggregates of matrix material accompanied by a population of mostly uniform spindled to epithelioid and histiocytoid cells, rarely accompanied by osteoclast-type giant cells. The patient underwent surgical resection with -total hip replacement, and subsequent pathologic examination confirmed the initial needle biopsy diagnosis. There has been no evidence of local recurrence or distant metastases with 3-years follow-up. To our knowledge, this is the first reported example of a primary clear cell chondrosarcoma initially evaluated by fine needle aspiration biopsy.

Clear‐cell chondrosarcomas: Fine‐needle aspiration cytology, radiological findings, and patient demographics of a rare entity

“…A chondroid background matrix was seen in all cases indicating a cartilage‐forming tumor. This is in line with previously described cytology of CCCS 7,8 …”

“…CCCS commonly have peripheral and intermingling bone trabeculae and adjacent areas with conventional chondrosarcoma. Occasionally osteoclastic giant cells can be identified 4,7,8 . Due to its rarity, cytological descriptions of CCCS are few and limited to small groups and single cases, and the cytomorphological features have not been reviewed in series.…”

“…Occasionally osteoclastic giant cells can be identified. 4,7,8 Due to its rarity, cytological descriptions of The most common radiological differential diagnosis is chondroblastoma, which may have a similar radiologic presentation. 5,[9][10][11] While chondroblastomas can be removed with local resection, CCCS, like low-grade chondrosarcomas, should preferably be resected en bloc.…”

Clear Cell Chondrosarcoma: Clinical Characteristics and Outcomes in 15 Patients

“…Core needle biopsy is the diagnostic method of choice in most cases. Cytologic analysis via fine-needle aspiration can also be employed, although findings are typically not specific to CCC, and no definitive cytogenetic link has been 2 Sarcoma identified [21][22][23]. CCC is characterized by cells with distinct borders, central nuclei, and abundant clear vacuolated cytoplasm, surrounded by a cartilaginous matrix (Figure 5) [1,2,5,20].…”