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3D Printed Chondrosarcoma
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3D Printed Chondrosarcoma
Clinical History
A 57-year old male attends complaining of recurrent pain in his right thigh. On
examination there is no palpable abnormality in the thigh. An x-ray of the limb showed bony absorption associated
with expansion and periosteal reaction at the proximal right femur. A CT of the limb showed a mass in the proximal
right femur. A biopsy was taken of the lesion. Subsequently he had excision of the right upper femur followed by
insertion of a prosthesis.
Pathology
The specimen comprises the head, neck and upper third of the shaft of the right femur,
sawn longitudinally to display the cut surface. In the medullary cavity of the upper portion of the shaft is an
ovoid tumour that is 6.5 cm in maximum diameter. The tumour is not encapsulated and has a haemorrhagic cut surface
with pale hyaline and cystic areas. Histologically, this is a low grade chondrosarcoma.
Further Information
Chondrosarcomas are malignant bone tumours that produce cartilage. These are
the third most common primary bone malignancy after myeloma and osteosarcoma. Conventional tumours are the most
common subtype of chondrosarcoma, making up 90% of cases. Less frequently diagnosed subtypes include clear cell,
dedifferentiated and mesenchymal chondrosarcomas.
Some chondrosarcomas arise from pre-existing benign lesions,
such as enchondroma or osteochondroma. Common mutations in chondrosarcomas are point mutations in the IDH1 and IDH2
genes as well as silencing of CDKN2A tumour suppressor gene. Chondrosarcomas that occur in multiple osteochondroma
syndrome have mutations in the tumour suppressor EXT genes.
Men are twice as likely to develop chondrosarcoma
than women. The axial skeleton is more frequently affected than the appendicular skeleton. Around 20% affect the
femur. These are largely slow growing tumours. They usually present with painful and gradually enlarging masses. At
the time of diagnosis, most are low grade tumours that rarely metastasize. The lungs are the most common site for
distant spread. Grade 1 tumours have an almost 90% 5-year survival rate, whereas with grade 3 chondrosarcoma the
5-year survival rate drops to 43%.
CT scan is the optimal radiological investigation for diagnosis with MRI also frequently used. Biopsies may be taken to assist diagnosis. Treatment depends on the grade and the location of the tumour. Complete surgical resection is the standard treatment. Generally, chondrosarcomas do not respond to chemotherapy or radiotherapy given they very slow growing tumours.
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The models are very detailed and delicate. With normal production machines you cannot realize such details like shown in these models.
The printer used is a color-plastic printer. This is the most suitable printer for these models.
The plastic material is already the best and most suitable material for these prints. (The other option would be a kind of gypsum, but this is way more fragile. You even cannot get them out of the printer without breaking them).The huge advantage of the prints is that they are very realistic as the data is coming from real human specimen. Nothing is shaped or stylized.
The users have to handle these prints with utmost care. They are not made for touching or bending any thin nerves, arteries, vessels etc. The 3D printed models should sit on a table and just rotated at the table.