Transarticular High-Grade Conventional Chondrosarcoma of the Hip Mimicking a Cystic Intra-Articular Lesion: Diagnostic Challenge in Determining Osseous Origin

Author(s):   Amara Ahmed, Diego A L Garcia

High-grade conventional chondrosarcoma usually demonstrates chondroid matrix and solid enhancement, but atypical variants may resemble benign intra-articular cystic lesions. A 45-year-old man presented with acute hip pain and was found to have destructive lytic lesions of the femoral head and acetabulum with a large minimally enhancing intra-articular mass. Cystic morphology obscured the tumor’s origin, raising concern for synovial pathology. Biopsy confirmed high-grade chondrosarcoma with permeative medullary invasion. This case illustrates that aggressive osseous changes warrant biopsy even when imaging features appear deceptively benign.