Efficacy of Combined Neo-Adjuvant Chemotherapy and Radical Resection for a Giant Chondrosarcoma of the Gluteal Region

Chondrosarcoma is a malignant tumor characterized by the proliferation of chondroblasts producing no bone , which can sometimes developed by metaplasia inside a connective tissue and present a rapid growth of both cartilaginous and connective tissues. Chondrosarcoma is a very rare tumor, two times less frequent than osteosarcoma. It may represent 11-20% of all malignant bone tumors as reported by Unni [1]. It has been found more in males than in female [2]. Some authors have reported a high incidence in young adults [3,4]. Dahlin et al. and Campanacci et al. have reproted it in 4% only of patients below 20 years, 40-47% of patients are above 40 years [1,2]. The most likely diagnosis below 20 years is chondroblastic osteosarcoma. Current management of chondrosarcoma by chemotherapy has been associated with a high rate of failure [5,6], chondrosarcoma tumor’s cells highly expressed the multidrug resistance-1 (mdr-1) responsible of the inefficacy of the chemotherapy. Undifferentiated chondrosarcoma and mesenchymal chondrosarcoma are less resistant to chemotherapy and show some sensitivity [7]. Very large tumors are very difficult to be removed enbloc, with a high rate of local recurrence of 30% compared to 15% for smaller tumors. This recurrence is more with high grade tumors [3]. We are reporting herein the first case of neo-adjuvant chemotherapy associated with external application of camphor based essential oil, followed by radical surgery indicated for a giant chondrosarcoma of the left coxo-femoral and gluteal regions.