Chondrosarcoma of the Scapula - Erler Zimmer 3D anatomy Series MP2114

This dissection model highlighting a Chondrosarcoma of the scapula is part of the exclusive Monash 3D anatomy series, a comprehensive series of human dissections reproduced with ultra-high resolution color 3D printing.

Clinical History.

A 60-year-old woman presented with a 12-month history of recurrent pain and increased swelling in her right shoulder. On examination, there was a palpable mass over the superior aspect of her right scapula. There was limitation of abduction and external rotation of the shoulder joint. There was no palpable lymphadenopathy. Radiography of her shoulder showed a mass involving the upper scapula above the spine. The mass was biopsied and the scapula was completely excised.

Pathology

The specimen is the patient's excised right scapula. An irregular lobulated tumor with a maximum diameter of 11 cm arises from the spine of the scapula and extends to involve the acromion and coracoid process. The tumor is mottled pale yellow-brown with patchy superficial hemorrhage. There is adherent muscle and fibrous tissue. The mass has infiltrated and replaced normal bone. Histologically, the tumor consisted of rounded, spindle-shaped pleomorphic cells with numerous mitotic figures and cartilage formation. This is chondrosarcoma of the scapula.

Additional Information.

Chondrosarcomas are malignant bone tumors that produce cartilage. These are the third most common primary bone neoplasm after myeloma and osteosarcoma. Conventional tumors are the most common subtype of chondrosarcoma; accounting for 90% of cases. Less frequently diagnosed subtypes include clear cell, dedifferentiated, and mesenchymal chondrosarcomas.
Some chondrosarcomas arise from preexisting benign lesions, such as enchondroma or osteochondroma. Common mutations in chondrosarcomas are point mutations in the IDH1 and IDH2 genes and silencing of the oncosuppressor gene CDKN2A. Chondrosarcomas occurring in multiple osteochondroma syndrome have mutations in the EXT oncosuppressor genes. Men are twice as likely to develop chondrosarcoma as women. The axial skeleton is more frequently affected than the appendicular skeleton. About 5% affect the scapula. These are largely slow-growing tumors. They usually present as painful, gradually expanding masses. At diagnosis, most are low-grade tumors that rarely metastasize. The lungs are the most common site of distant spread. Grade 1 tumors have a 5-year survival rate of nearly 90%, while with grade 3 chondrosarcomas,

CT is the optimal radiological investigation for diagnosis even with MRI frequently used. Biopsies can be taken to aid diagnosis. Treatment depends on the grade and location of the tumor. Complete surgical resection is the standard treatment. Generally, chondrosarcomas do not respond to chemotherapy or radiation therapy because they are very slow-growing tumors.

What advantages does the Monash University anatomical dissection collection offer over plastic models or plastinated human specimens?

• Each body replica has been carefully created from selected patient X-ray data or human cadaver specimens selected by a highly trained team of anatomists at the Monash University Center for Human Anatomy Education to illustrate a range of clinically important areas of anatomy with a quality and fidelity that cannot be achieved with conventional anatomical models-this is real anatomy, not stylized anatomy.
• Each body replica has been rigorously checked by a team of highly trained anatomists at the Center for Human Anatomy Education, Monash University, to ensure the anatomical accuracy of the final product.
• The body replicas are not real human tissue and therefore not subject to any barriers of transportation, import, or use in educational facilities that do not hold an anatomy license. The Monash 3D Anatomy dissection series avoids these and other ethical issues that are raised when dealing with plastinated human remains.