Correct understanding of the biological behavior of atypical cartilaginous tumors in long bones to guide scientific clinical diagnosis and treatment
XU Ming
YU Xiu-chun
Abstract：Atypical cartilaginous tumor (ACT) of long bones is a borderline neoplasm characterized by locally aggressive behavior and minimal metastatic potential. Historically classified as low-grade chondrosarcoma, the 2020 WHO redefined ACT as an intermediate tumor (ICD-O 9222/1) for appendicular lesions, emphasizing its distinct biological behavior. Current guidelines recommend optimizing diagnostic and therapeutic strategies based on imaging evaluation and individualized risk assessment. Imaging advancements, such as MRI-based protocols (e.g., BACTIP) and radiomics aggressiveness scoring (RAS), enable non-invasive differentiation of ACT from higher-grade malignancies and guide decisions among observation, curettage with adjuvant therapy, and resection. Studies demonstrate that curettage achieves local control rates exceeding 95% while preserving limb function, with active surveillance feasible for stable lesions. Future directions involve integrating artificial intelligence and multimodal radiomics to refine risk stratification and treatment individualization. Clinicians must avoid overtreatment (e.g., unnecessary wide resection) and undertreatment (e.g., misdiagnosing high-grade tumors) through multidisciplinary collaboration and evidence-based protocols.
Keywords：ChondromaChondrosarcomaArtificial intelligenceCartilaginous tumoratypicalEditorial
Publication Date：2025-05-19
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：3( 385-387 )