Clinicopathological Conference: The Classic and Tragic Tale of a Cartilaginous Tumour by Dr Khong Kok Sun

Date:

09 May 2019

Event:

Clinicopathological Conference: The Classic and Tragic Tale of a Cartilaginous Tumour

Speaker:

Dr Khong Kok Sun

“A young Indonesian male presented with a hard bump over the greater trochanter of the right hip. He had noticed it for the past 15 years but realised progressive enlargement in the past 6-9 months. It was not painful but he could not lie on that side. He also noticed similar bony hard bumps in the upper arms and above the knees. There is also a family history of one of his sons and another nephew having similar bumps in their extremities. All three were shorter than their siblings at the same ages.

Just prior to his presentation, he underwent a “small” open biopsy by another Singapore orthopaedic surgeon not dealing with musculoskeletal oncology who then referred the patient to the presenter. Histopathology revealed a low-grade chondroid malignancy. Staging studies such as PET-CT and contrast MRI showed a good chance of limb salvage with megaprosthetic replacement.

The patient agreed to the complex surgery and returned for pre-op review a day before the operation. Re-examination of the patient revealed extensive ecchymosis from the 5cm biopsy site which strongly suggested widespread soft tissue contamination by tumour cells far beyond the confines of the original tumour. The patient and family were devastated when told of the recommended option.”