PATHOPHYSIOLOGY OF MESENCHYMAL CHONDROSARCOMA

MODIFIABLE FACTORS NON MODIFIABLE FACTORS

Lifestyle DNA mutation

Diet Age
Environment Gender (Male)

Action of carcinogenic agent in normal

cells

DNA Damage

Failure of DNA to repair DNA repair (through DNA

repair genes)

Mutagenic alterations in genome A

 A

Activation of growth Inactivation of tumor Alterations in genes that Mutations of genes

promoting oncogenes suppressor genes control apoptisis controlling signaling pathway

Promote cell growth in the Removal of the genetic signal Mutation in proto-oncogene
absence of normal growth that normally inhibits controlling tyrosine kinase
promoting signal. proliferations. activity.

Uncontrolled growth factor

receptor to their nuclear
target.

Unregulated cell differentiation and

growth

Growth of malignant tumor

B
 B

Creation of new vascular Compression of spinal cord Normal vessels that supplies Stretching of the periosteum
pathway to abnormal certain bone tissues are of the involved bone
tissue(cancer cells) impeded.

Pressure on peripheral nerves

and entrapment of central Decreased blood supply to
Diverting blood and
canal. area. pain
nutrients from normal Increased
tissues to cancer cells pressure to
Nerve entrapment in Power failure in cells nearby
vertebral body. ( L1-L5) structures.
Destruction of normal
bone cells

Oxygen tension in cells fall Oxidative

Bone structure weakens Pushing
C D metabolism ceases structures in
different
Cellular pH falls directions
intervertebral
Cell reverts to anaerobic Increased pressure disc
Destruction in cell metabolism to adjacent muscles
membranes and
intracellular structures Production of lactic acid. Causing muscular
Causing
injury
intervertebral
Accumulation of lactic acid disk herniation
in cells
E
 C

Affects lumbosacral plexus

Entrapment of obturator Entrapment of femoral Entrapment of Entrapment of tibial Entrapment of common

nerves nerve great sciatic nerve nerve fibular nerve

Decreased medial thigh Decreased anterior PAIN Decreased posterior Decreased lateral thigh
muscle function thigh muscle function thigh muscle, anterior and legs, some foot muscle
& posterior leg function.
muscle and most foot
Decreased adduction Decreased extension ability muscle function.
ability of limbs of limbs

Decreased flexion
ability of limbs.

Musculoskeletal weakness, paralysis and

atrophy
 D

Decreased splanchnic nerve

stimulation

Decreased superior Decreased inferior Decreased hypogastric

mesenteric ganglion mesenteric ganglion ganglion stimulation
stimulation stimulation

Decreased peristalsis Decreased peristalsis and Decreased bladder

bladder stimulation stimulation

Impaction
Difficulty in urination
 E

Rapid vasodilation of venoules and

Activation of cell membrane phospholipids
arterioles to the injured muscle.

Release of arachidonic acid

Heat and redness to Increased in capillary blood flow.
area
INITIAL RELEASE FINAL RELEASEASE

Increased permeability with outpouring Lypoxegenase pathway Cyclooxygenase

protein rich fluid into extravascular pathway
spaces

Release of leukotrienes INITIAL RELEASE

Loss of protein
Release of
prostaglandin
Decreased capillary
s
osmotic pressure FINAL RELEASE

Thromboxan
Increased interstitial e release
osmotic pressure

Vasoconstriction
Outflow of fluid and and promoted
Swelling to area
accumulation in the tissue spaces. platelet function

Stagnation of flow and clotting of

blood occurs at site F
 F

Fibrotic regeneration of tissues (

chronic inflammation )

Tissue necrosis

LEGEND
DISEASE PROCESS
MANIFESTATIONS