Central chondrosarcoma may present as osteolysis with vague borders, with or without interruption of cortical bone. Areas of x-ray opacity may be present within the tumor due to the tendency of the cartilage to calcify and ossify, and calcification often occurs around cartilage lobules without certain structure. It is characterized by irregular foggy granules, nodules or rings that are impervious to X-rays. Central chondrosarcoma is a chondrosarcoma of intraosseous origin, ranking 4th among primary malignant bone tumors, after plasmacytoma, osteosarcoma and Ewing’s sarcoma. There are distinct sites of predilection, in order of predilection, for the femur (especially proximal), pelvis, proximal humerus, scapula, and proximal tibia. The disease is mainly seen in adults between 30 and 70 years of age, rare before 20 years of age, and rare before puberty. It is more common in men, with a male to female ratio of 1.5 to 2:1. It occurs in the femur, pelvis, humerus, scapula, and proximal tibia. It is less common in the trunk bone, radius, ulna, foot, and hand (chondromas are common in the hand and less common in the trunk bone). Central chondrosarcoma in the long bones often originates at one end of the diaphysis or epiphysis, usually in adults who have lost their growth cartilage, and the tumor often invades the epiphysis and may also invade the joint; central chondrosarcoma in the middle part of the diaphysis is rare, and by the time of diagnosis, the tumor has invaded 1/3, 1/2, or more of the entire long bone; central chondrosarcoma of the pelvis occurs in the periacetabular region (iliac bone, sit bones, or pubic bone); Central chondrosarcoma of the scapula is more likely to occur in the rostral process-articular pelvis region. Chondrosarcoma of the pelvis and scapula can also invade large portions of the bone. The disease is mild, slow to develop, and has a long history, sometimes presenting as a recurrent “chondrosarcoma-like” tumor after local surgery. The clinical picture is one of deep pain, which is not severe and is not persistent. Because the tumor has not yet expanded into the soft tissues, the extraosseous mass cannot be palpated and there is only slight bone enlargement; in the progressive stage of the tumor, a large spherical extraosseous mass may form. If the central chondrosarcoma is located in the vertebrae, sacrum, ribs or pelvic area, it can compress the nerve trunk and cause severe pain with radiating pain. Some tumors are rapidly growing and aggressive, and can destroy the bone cortex and invade the soft tissues to form larger soft tissue masses at an early stage. In some cases, it can invade the joint from epiphysis and cause joint symptoms. Pathological fracture is rare. Sometimes, postoperative recurrent central chondrosarcoma is more aggressive than the original tumor.