Patient: My uncle is 48 years old, three years ago he fell on a motorcycle and had an operation on his right knee, at the beginning of this year, he felt some pain in his right knee, and when he went to Hunan Chenzhou Xiangya College Hospital, he was told that the bone on his right buttock was broken and he had to have an operation. Two months after he was discharged from the hospital, the place where the surgery was done suddenly grew a bag and was very painful, and in August, he came to Hunan Xiangya Second Hospital for a checkup, and the hospital said he needed another surgery. The surgical plan was to go to Beijing to have an artificial bone custom-made to replace the original bad bone. The surgery to replace the bone was not done immediately because my aunt insisted that the diagnosis be confirmed first and then the surgery be done. After a week of hospitalization, the doctor diagnosed the disease as “highly differentiated chondrosarcoma” through CT and biopsy, and the treatment plan was changed to one month of chemotherapy first, followed by bone replacement surgery. Considering that Hunan Cancer Hospital might be more specialized in treating tumors, uncle then came to Hunan Hospital for inpatient treatment. After reviewing uncle’s medical records at Xiangnan College Hospital and Hunan Xiangya Second Hospital, doctors at Hunan Cancer Hospital said uncle’s disease was serious and there were problems with his lungs, so there might not be a need for surgery, and said they might be able to see more clearly when their test results came out. Three days later, the CT results came out, and there were three small dots on the lungs the size of soybeans, and it was also said that there were problems with the liver, and the kind doctor advised us to “go back and take care of it. At that time, except for a lump on his buttocks and a little pain, uncle was no different from a good person, and no one believed that it was really hopeless. After my uncle came back, his right leg is now much smaller than before, and he has to walk with a cane, and the lump area is very painful. There is also some coughing. I would like to ask Dr. Guo, is there any hope for my uncle in this situation? Guo Yuewu, Department of Medical Oncology, Shanghai Sixth People’s Hospital: Highly differentiated chondrosarcoma is one of the malignant bone tumors, the treatment is mainly surgery, radiotherapy is not sensitive. According to the information you provided, the patient has recurrence after surgery and is accompanied by liver and lung metastases, so the possibility of surgical treatment is very small because all metastases cannot be removed by surgery. Suggestions: 1. Intravenous chemotherapy, with drugs such as adriamycin and isocyclophosphamide as the mainstay. 2. If the primary lesion increases significantly in the short term with pain, local palliative radiotherapy should be performed. 3, if possible, you can try molecular targeting therapy, that is, with chemotherapy using some vascular endothelial growth factor inhibitors. Patient: I came to Chenzhou because I did not know much about my uncle’s disease. Diagnosis of pathology at the Affiliated Hospital of Xiangnan College (25 April 08): “(right femur upper segment) hemangioma.” Pathological Diagnostic Graphic Analysis Report of Xiangya Second Hospital of Central South University (25 Aug 08): ” Pathological diagnosis: fragmented (right femur upper segment and hip), 4*4*2 cm large, microscopically consistent with highly differentiated chondrosarcoma.” Hunan Cancer Hospital pathology analysis report sheet (4/9/08): ” Consultation with Hunan University Xiangya Second Hospital pathology section opinion: (right femur) combined with medical history and imaging data, consider malignant tumor, tend to mucinous chondrosarcoma, not completely exclude mucinous chondrooid osteosarcoma.” Hunan Cancer Hospital ct examination report card (08.09.08): part: chest enhancement, mode: spiral scan; layer spacing: 10;(?) Agent: double North non-ionic contrast agent 75ml. See: multiple scattered distribution of small nodular shadows in both lungs, varying in size with clear borders. Several soft tissue density nodules were seen in the mediastinum, the largest of which was located under the bronchial bulge with a transverse diameter of about 1.3 cm. Bilateral lobes and segments of the bronchi were patent. The size and shape of each atrium of the heart were normal; there was no thickening of the pleura bilaterally. The bones of the thorax did not show any bone destruction. No fluid was found in the thoracic cavity. The liver was normal in size, the proportion of each lobe was within the normal range, the contour was regular, and several small scattered low-density nodules were seen in the liver parenchyma. Preliminary diagnosis: 1, multiple small nodules in both lungs, combined with clinical, consider metastases. 2, several small lymph nodes in the mediastinum. 3, several small nodules in the liver, the nature is to be determined, further examination is recommended. Diagnosis: chondrosarcoma of the upper right femur and double fee metastasis Prof. Guo: My uncle has been out of the hospital for more than two months, and his current physical condition is as follows: 1. My mental state is fine. I would like to ask you if you can consider removing the mass on the leg or amputating the whole right leg so that he can move around more easily. Guo Yuewu, Department of Medical Oncology, Shanghai Sixth People’s Hospital: I have seen some of your additional information, the patient’s diagnosis is still clear. If the local tumor proliferates too fast and the volume is too large, it is recommended to perform tumor reduction surgery, that is, to remove most of the tumor tissue to improve the patient’s quality of life. After surgery, local radiation therapy should be applied to the tumor bed to prevent rapid growth of tumor after surgery.