Management of Atypical Cartilaginous Tumors (ACT) An Italian Sarcoma Group Consensus Document
BACKGROUND: Atypical cartilaginous tumors (ACT) are low-grade cartilaginous lesions of the appendicular skeleton with debated diagnostic and therapeutic management. METHODS: The Italian Sarcoma Group (ISG) conducted a multidisciplinary consensus process involving 61 experts from six specialties across 22 institutions. A narrative literature review informed key questions discussed during an in-person consensus meeting, and agreement was assessed through structured voting. RESULTS: Six consensus statements were developed: three on diagnosis, two on treatment, and one on active surveillance and follow-up. Biopsy was recommended selectively in the presence of aggressive or equivocal radiological features. Active surveillance was endorsed for selected patients, while intralesional curettage remains the preferred surgical option when treatment is indicated. Structured follow-up protocols were proposed. CONCLUSIONS: This consensus provides practical recommendations for the management of ACT, supporting imaging-driven decision-making and active surveillance in appropriate cases.
Authors
- Tiziana Robba
- Raimondo Piana (ORCID: https://orcid.org/0000-0002-7651-4599)
- Daniela Greto (ORCID: https://orcid.org/0000-0002-2667-0841)
- Giulia Trovarelli (ORCID: https://orcid.org/0000-0001-8655-2479)
- S Ruggeri (ORCID: https://orcid.org/0009-0002-6561-0523)
- Katia Scotlandi (ORCID: https://orcid.org/0000-0001-6114-9499)
- Domenico Andrea Campanacci (ORCID: https://orcid.org/0000-0002-3912-3943)
- Stefano Bastoni (ORCID: https://orcid.org/0009-0000-2557-8288)
- R. Biagini (ORCID: https://orcid.org/0000-0002-6819-2841)
- Virginia Ferraresi (ORCID: https://orcid.org/0000-0001-6419-1668)
- Roberto Luksch (ORCID: https://orcid.org/0000-0002-7203-4176)
- Roberto Scanferla (ORCID: https://orcid.org/0000-0002-4271-8278)
- Lorenzo D’Ambrosio (ORCID: https://orcid.org/0000-0003-3294-8819)
- Anna Maria Frezza (ORCID: https://orcid.org/0000-0003-2335-7224)
- Elena Fumagalli (ORCID: https://orcid.org/0000-0003-4814-7637)
- Silvia Stacchiotti (ORCID: https://orcid.org/0000-0002-1742-8666)
- Giuseppe Maria Milano (ORCID: https://orcid.org/0000-0002-0250-6043)
- Giacomo Giulio Baldi (ORCID: https://orcid.org/0000-0003-0798-7752)
- Guido Scoccianti (ORCID: https://orcid.org/0000-0003-0637-6896)
- Giuliana Roselli
- Davide Donati
- Toni Ibrahim
- Pietro Ruggieri
- Ferdinando Cananzi
- Pierina Navarria
- Giovanni Grignani
- Angelo Paolo Dei Tos
- Marco Gambarotti
- Alessandro Gronchi
- Alessandro Franchi
- Carmine Zoccali
- Carlo Morosi
- Giuseppe Bianchi
- Maria Serena Bartoli
Institutions
- University of Pisa (IT)
- Humanitas University (IT)
- University of Padua (IT)
- Policlinico Umberto I (IT)
- Azienda Ospedaliera Citta' della Salute e della Scienza di Torino (IT)
- Istituto Ortopedico Gaetano Pini (IT)
- Azienda Ospedaliero-Universitaria Careggi (IT)
- Istituto Ortopedico Rizzoli (IT)
- Bambino Gesù Children's Hospital (IT)
- National Cancer Institute (MY)
- Candiolo Cancer Institute (IT)
- Fondazione Humanitas per la Ricerca (IT)
- Azienda Usl Toscana Centro (IT)
- Fondazione IRCCS Istituto Nazionale dei Tumori (IT)
- Orthopedic Institute (US)
- IRCCS Humanitas Research Hospital (IT)
- Ospedali Riuniti Umberto I (IT)
- Hospital of Prato (IT)
- University of Florence (IT)
- University of Bologna (IT)
Publication Details
- Journal
- Critical Reviews in Oncology/Hematology
- Published
- 2026-05-01
- DOI
- https://doi.org/10.1016/j.critrevonc.2026.105358
- Primary Topic
- Sarcoma Diagnosis and Treatment
- Type
- article
- Field-Weighted Citation Impact
- 0.00