http://www.orthobullets.com/pathology/8021/chondroblastoma?

expandLeftMenu=true

Chondroblastoma
Author: Ujash Sheth

Introduction
A rare, benign chondrogenic lesion (differs from giant cell tumor by its chondroid m
Epidemiology
demographics
M:F = 2:1
80% of patients under 25 years of age
body location
epiphyseal lesion in young patients (usually around 12 years of age)

common locations include distal femur and proximal tibia >>> proxima
femur, calcaneus, flat bones and apophysis or triradiate cartilage of the pelvis
typically epiphyseal but may occasionally cross the physis
Pathophysiology
thought to arise from cartilaginous epiphyseal plate
categorized as cartilage tumor due to its areas of chondroid matrix, but type
expressed by tumor cells
Genetics
mutations
may have genetic abnormalities on chromosome 5 and 8
Associated Conditions
medical conditions & comorbidities
< 1% develop benign pulmonary metastasis (similar to giant cell tumo
Prognosis
local recurrence rate is 10-15% after treatment
Presentation
Symptoms
progressive pain at tumor site
limping
Physical examination

inspection
muscle atrophy
tenderness over affected bone
motion
decreased ROM

Imaging
Radiographs
recommended views
AP, lateral, and oblique of involved area
findings
well-circumscribed epiphyseal lytic lesion with thin rim of sclerotic bon
demarcated from normal medullary cavity

lesions often cross physis into metaphysis

stippled calcifications within the lesion may or may not be present (25
cortical expansion may be present
soft tissue expansion rare
differential with radiographs
giant cell tumor
osteomyelitis
clear cell chondrosarcoma
CT
indications
not required
defines bony extent of lesion
MRI
findings
extensive edema surrounding lesion

Studies
Histology
findings
chondroblasts arranged in "cobblestone" or "chickenwire" pattern may

scattered multinucleated giant cells with focal areas of chondroid matr

occasional multinucleated giant cells may be present

mononuclear stromal cells are distinct, S100+ cells with large central n
nuclei have longitudinal groove resembling coffee bean

1/3 of chonroblastomas have areas of secondary ABC

Treatment
Operative
extended intralesional curettage and bone grafting

indications
standard of treatment in symptomatic individuals
technique
may do local adjuvant treatment with phenol or cryotherapy to d
recurrence
surgical resection
indications
pulmonary metastasis
Differential Groups
Chondroblastoma
Giant Cell Tumor
Aneurysmal bone cyst
Osteoblastoma
Chondromyoid fibroma
(CMF)

Epiphyseal
lesion

ASSUMPTIONS: (1) assuming no impending fracture

Benign lesion that may

metastasize to lung

Treatment is
g