Some adults or older adults have unintentional clinical findings of cartilage-like focal changes on the backbone, and some imaging diagnoses (CT, MRI or X-rays) are endogenous chondromas or chondromas or descriptive (cartilage-like calcified manifestations, fibrous lesions possible, benign possible, etc.). Most such descriptions are, probably, endogenous chondromas or benign disease. There are exceptions, however, where the imaging presentation is very much like an endogenous chondrosarcoma, but the final pathology diagnosis is chondrosarcoma, which is particularly important to note in older adults. This is because these are two completely different diseases with different prognoses, the former being benign and the latter being malignant. Clinically this differential diagnosis can sometimes be difficult. Therefore, if a similar description or disease is found, one needs to visit a tertiary hospital specializing in bone tumors and must find a bone tumor doctor with extensive experience. Most orthopedic surgeons in hospitals do not know enough about bone tumors, and this is a point that must be noted, otherwise, if there is a mistake in treatment and diagnosis, the consequences will be very serious.