Chondroblastoma of the Talus Mimicking an Aneurysmal Bone Cyst: A Case Report / 대한족부족관절학회지

Chondroblastoma is a rare benign tumor that produces giant cells and cartilage matrix. The tumor occurs in people between 10 and 25 years with slightly higher incidence in males. The condition occurs in the proximal epiphysis of the tibia and humerus, distal epiphysis of the femur, but its occurrence in the talus is relatively rare, accounting for 4% of the total number of chondroblastoma cases. Chondroblastoma is often misdiagnosed as a primary aneurysmal bone cyst, giant cell tumor, chondromyxoid, and lesion of a secondary aneurysmal bone cyst by fibrous dysplasia. The most commonly used surgical method for chondroblastoma is broad curettage with bone grafting. In general, an aneurysmal bone cyst is associated with a second degree chondroblastoma, which is approximately 20%. Chondroblastoma of the talus and secondary aneurysmal bone cysts can be misdiagnosed as primary aneurysmal bone cysts. This paper reports a case of a young male patient with chondroblastoma of the talus, which was initially misdiagnosed as an aneurysmal bone cyst with involvement of the talo-navicular joint.

The imaging manifestations and misdiagnosis analysis of chondroblastoma / 实用放射学杂志

Objective To investigate the X-ray,CT and MRI features of chondroblastoma (CB)and to improve diagnostic skills of this disease.Methods The X-ray,CT and MRI imaging of 27 cases with CB which were verified by histopathological examination and the misdiagnosed cases were analyzed retrospectively.Results Accurate diagnosis of preoperative images was made in 10 cases and all 10 cases were located in the epiphysis of long bone.X-ray and CT showed eccentric round and oval osteolytic bone destruction,with sclerotic rim and internal spotted calcification;MRI showed hypointensity on T1 WI and heterogeneous hypo-and hyperintensity on T2 WI,with peripheral regions of marrow edema and adjacent joint effusion.Seventeen cases were misdiagnosed preoperatively,including 8 cases in long bone epiphysis or apophysis,8 cases in short,flat and irregular bones and 1 case in metaphysis of long bone.Twelve cases showed expansive changes and 10 cases with associated aneurysmal bone cyst(ABC)showed fluid-fluid levels.Conclusion The CB shows sandy or stippled calcification,rim sclerosis,extensive surrounding bone marrow edema.CB in unusual sites usually shows expansive bone destruction,peripheral bone marrow edema,secondary aneurysmal bone cyst.Combined utilization of clinic,pathology and imaging features is helpful for the diagnosis.

The diagnosis and treatment of tibial intercondylar chondroblastoma

OBJECTIVES: To investigate the diagnosis and treatment of tibial intercondylar chondroblastoma. METHODS: We retrospectively analyzed the diagnosis and treatment of 12 patients with tibial intercondylar chondroblastoma admitted to the orthopedics department from May 2011 to February 2016; among them were 4 males and 3 females aged 10-19 years, with an average age of 15.7 years. Tibial intercondylar chondroblastoma was on the left and right side in 7 and 5 cases, respectively. The preoperative average Lysholm score of the knee joint was 68 (42-87). A posteromedial approach was applied in all cases. The incisions were approximately 5-8 cm in length. Complete curettage and inactivation were performed after fenestration, and allogeneic bone grafts were transplanted. Then, the posterior cruciate ligament insertion was fixed with 5.0 suture anchors. All patients were followed up with regularly to monitor for tumor recurrence, observe bone graft healing, and reassess the Lysholm score of the knee. RESULTS: Patients were followed for 7-55 months, and the median follow-up time was 19 months. One patient experienced tumor relapse 4 months after the operation. Incision, inactivation and cementation were performed. Then, the bone was fixed with anchors. In the other 11 patients, the bone graft healed over an average period of 6.2 months (4-10 months), with good functional recovery postoperatively. The average postoperative Lysholm score of the knee was 91 (81-95). CONCLUSION: Tibial intercondylar chondroblastoma has unique clinical and imaging characteristics and can effectively be treated by curettage followed by the inactivation, transplantation and fixation of allogeneic bone grafts with suture anchors through a posteromedial approach.

Chondroid Tenosynovial Giant Cell Tumor of the Temporomandibular Joint: A Rare Case Report

Abstract Tenosynovial giant cell tumor of diffuse type (TGCT-d) or pigmented villonodular synovitis (PVNS) is a locally aggressive lesion that mostly affects the joints of long bones. Chondroid tenosynovial giant cell tumor (CTGCT) or PVNS with chondroid metaplasia is a rare distinct subset of synovial tumors that has a predilection for the TMJ. We report a rare case of CTGCT in the TMJ, initially misdiagnosed as temporomandibular disorder (TMD). A 51-year-old woman was referred to the surgeon with the chief complaint of TMJ pain for 5 years and a past history of an unsuccessful TMD treatment. Extraoral examination revealed discrete preauricular swelling and restricted mandibular range of motion. Panoramic radiograph and computerized tomography showed destruction of the mandibular fossa and condyle. Histologically, the tumor was composed by large mononuclear cells with prominent eosinophilic cytoplasm and grooved nuclei, small histiocytoid cells, osteoclast-like multinucleated cells, brown pigmentation and areas of chondroid metaplasia. Morphological and immunohistochemical characteristics lead to the final diagnosis of CTGCT. The rarity of CTGCT could be attributed to the lack of recognition of this lesion, with cases diagnosed as chondroblastomas, synovial chodromatosis and chondrosarcoma. The patient received immediate reconstruction and recurrence was found 22 months after initial intervention. TGCT-d and CTGCT of the TMJ can present similar symptoms to TMD, but clinicians must distinguish both lesions by complete examination, imaging and, when necessary, histopathologic evaluation.

Resumo Tumor de células gigantes tenossinovial do tipo difuso (TCGT-d) ou sinovite vilonodular pigmentada (SVP) é uma lesão localmente agressiva que afeta principalmente as articulações dos ossos longos. Tumor de células gigantes tenossinovial condroide (TCGTC) ou SVP com metaplasia condroide é um tipo distinto e raro de tumor sinovial que tem a predileção pela articulação temporomandibular (ATM). Nós relatamos um caso raro de TCGTC da ATM, inicialmente diagnosticado, equivocadamente, como disfunção temporomandibular (DTM). Uma mulher de 51 anos foi encaminhada ao cirurgião com a queixa principal de dor na ATM por 5 anos, e uma história de tratamento de DTM sem sucesso. O exame extrabucal revelou discreto aumento de volume preauricular e movimentação mandibular restrita. A radiografia panorâmica e a tomografia computadorizada evidenciaram destruição da fossa mandibular e côndilo. Histologicamente, o tumor era composto por células mononucleares grandes, com amplo citoplasma eosinofílico e núcleo sulcado, pequenas células histiocitoides, células multinucleadas semelhantes a osteoclastos, pigmentação acastanhada e áreas de metaplasia condroide. As características morfológicas e imuno-histoquímicas levaram ao diagnóstico final de TCGTC. A raridade desta lesão pode estar associada ao seu não reconhecimento, sendo casos diagnosticados como condroblastoma, condromatose sinovial ou condrossarcoma. A paciente recebeu reconstrução imediata e recorrência foi observada 22 meses após a intervenção inicial. TCGT-d e TCGTC da ATM podem apresentar sintomas similares à DTM, mas os clínicos devem diferenciar ambas as lesões por meio do exame clínico completo, exames de imagem e, quando necessário, avaliação histopatológica.

The Clinical Characteristics, Treatments and Oncologic Outcomes of Chondroblastoma: Comparison with Giant Cell Tumor / 대한정형외과학회잡지

PURPOSE: The purpose of the study was to compare clinical, oncological outcomes between chondroblastoma and giant cell tumor. MATERIALS AND METHODS: This retrospective study reviewed 25 patients with histologically confirmed chondroblastoma of bone between 1998 and 2012. During the same period, 42 patients diagnosed as a giant cell tumor were also reviewed. We then analyzed clinical and oncological results of chondroblastoma compared with giant cell tumor. In chondroblastoma, 17 cases were male, and 8 cases were female, with a mean age of 20.6 years (range from 11 to 38 years). In giant cell tumor, 20 cases were male, and 22 cases were female, with a mean age of 39.26 years (from 17 to 75 years). All patients underwent surgical treatment that extended curettage with electrocauterization. After curettage, bony cavity was filled with autogenous bone, allogenic bone chip, bone cement, tricalcium phosphate, and so on. The results were compared in recurrence and metastatic rate. The minimum follow-up period was 1 year. RESULTS: In chondroblastoma, mean size was 2.18 cm (0.3 to 9.5 cm). Local recurrence and metastasis were absent. In giant cell tumors, mean size was 3.71 cm (0.3 to 11 cm). Local recurrence rate was 9.5% (4 of 42 cases) and there was one lung metastasis. CONCLUSION: Chondroblastoma is less invasive with better prognosis than giant cell tumor. Treatment of chondroblastoma and giant cell tumor is surgery. Electrocauterization as an adjuvant therapy showed good results.

Arthroscopic Burring of Exposed Cement Following Curettage and Cavity Filling Cementation for Chondroblastoma of the Proximal Tibia

Chondroblastoma of the proximal tibia is difficult to treat because of its epiphyseal predilection. This condition can be treated by curettage, which results in immediate restoration of stability and a reduced recurrence rate, followed by cement filling of the bone defect. Nevertheless, contact with cement can damage articular cartilage, potentially leading to severe knee osteoarthritis. Most previous reports regarding this complication described patients with giant cell tumors of the proximal tibia. We present here a patient who underwent arthroscopic treatment for cement exposure caused by articular cartilage loss of the tibial plateau, which occurred after initial curettage and cementation for chondroblastoma of the proximal tibia. To our knowledge, this is the first report on arthroscopic treatment of this condition.

Condroblastoma de la cabeza femoral y reconstrucción con aloinjerto osteocondral: Reporte de caso / Femoral head chondroblastoma and reconstruction with osteochondral allograft: Case report

El condroblastoma de la cabeza femoral es un tumor poco frecuente (aproximadamente 1 o 2% de los tumores benignos de hueso), se presenta con mayor frecuencia en pacientes jóvenes de sexo masculino. El condroblastoma es más frecuente en el húmero proximal, fémur proximal, fémur distal y tibia proximal. La cabeza femoral es el tercer sitio más frecuente, No existe un tratamiento específico para esta entidad; se han descrito desde osteotomías acetabulares, injertos osteocondrales, injertos vascularizados de peroné, etcétera, todos reportando buenos resultados. Pero es clínicamente impredecible si no recibe tratamiento. Se presenta un caso que se manejó con aloinjerto osteocondral y la evolución de tres años posterior al procedimiento quirúrgico...

Femoral head chondroblastoma is an infrequent tumor, accounting for approximately 1-2% of benign bone tumors. It occurs more frequently in young male patients. It's most frequent locations include the proximal humerus, proximal femur, distal femur and proximal tibia. The femoral head is the third most frequent site of this tumor. There is no specific treatment for this entity; reported treatments range from acetabular osteotomies and osteochondral grafts, to vascularized fibular grafts, all of them with good results. However, this tumor is clinically unpredictable if left untreated. We report a case managed with osteochondral graft and followed-up for three years after the surgical procedure...

Condroblastoma de presentación atípica en concomitancia a osteomielitis crónica operado con cirugía radical: caso clínico / Chondroblastoma of atypical presentation in conjunction with chronic osteomyelitis operated through radical surgery: clinical case

INTRODUCCIÓN: El condroblastoma es un tumor óseo benigno representando menos del 1 por ciento del total de tumores óseos; se presenta principalmente en jóvenes. De etiología controversial, se desarrolla habitualmente en centros secundarios de osificación en huesos largos. No hay casos que describan su existencia junto a osteomielitis ni su tratamiento quirúrgico. CASO CLÍNICO: Mujer de 15 años con antecedente de osteomielitis de inicio reciente, diagnosticada con cintigrafía y biopsia en escápula izquierda; a pesar de tratamiento médico antibiótico con cloxacilina persiste dolor, eritema, impotencia funcional y aumento de volumen progresivo. Cintigrafía de control confirma nula respuesta a tratamiento inicial. Tomografía computada (TC) informa probable proceso tumoral osteolítico cortical con reacción de partes blandas en casi la totalidad de la escápula incluyendo cavidad glenoidea. Biopsia quirúrgica informa condroblastoma sospecha de variante agresiva resolviéndose con escapulectomía total con resección de cabeza humeral y posterior pexia clavículo-humeral. Biopsia definitiva de pieza quirúrgica informa osteomielitis crónica y condroblastoma agresivo. Evolución favorable en controles posteriores sin signos de recidiva local ni a distancia. DISCUSIÓN: La nula respuesta clínica al tratamiento inicial y su progresión hizo sospechar un proceso tumoral no diagnosticado inicialmente debido a que la biopsia no incluyó focos del condroblastoma. El manejo clásico del condroblastoma consiste en curetaje y relleno con autoinjerto; pero debido a la localización atípica, posibilidad de malignización y coexistencia con proceso osteomielítico crónico se optó por cirugía innovadora que consistió en resección total y posterior pexiaclavículo-humeral

INTRODUCTION: A Chondroblastoma is a benign bone tumor, corresponding to less than 1 percent of all bone tumors, and affecting mainly young people. Commonly developing in secondary centers of ossification in large bones, there are no cases describing its existence along with osteomyelitis, nor its surgical treatment. CLINICAL CASE: Woman (15 Y/O) with a history of osteomyelitis onset caused by a recent fall is diagnosed through scintigraphy and biopsy in the left scapule. Despite treatment with cloxacillin, pain persisted, erythema developed, with a progressive increase of volume and functional impotence. Control scintigraphy confirms no response to initial treatment. Computed Tomography (CT) informs of a probable cortical osteolysis tumoral process with soft tissue reactions in almost the entire scapule including glenoid cavity. Surgical biopsy shows chondroblastoma and, suspecting an agressive variant, it is resolved to perform a total scapulectomy with resection of scapule head and subsequent humerus-claviclepexia. Definitive biopsy of surgical piece shows chronic osteomyelitis and agressive chondroblastoma. The evolution of the patient is normal on follow-up controls, not presenting any signs of local neither distant relapse. DISCUSSION: The non-existence of a response to the initial treatment and its progression made us suspect of a natural process that was not diagnosed initially because the biopsy didn't include chondroblastoma focus. The usual chondroblastoma treatment consists of curetting and autograft filling; but due to the atypical location, and the possibility of coexistence with malignant and chronic osteomyelitic process we chose to apply an innovative surgery that consisted of total resection and subsequent pexia.

Tratamiento y reconstrucción en tumores óseos del húmero con prótesis no convencional tipo RIMAG / Treatment and reconstruction of bone tumors of the with a rimag unconventional prosthesis

Introducción: La cirugía conservadora y de reconstrucción con prótesis no convencional en tumores del húmero sin compromiso neurovascular está indicada ayudando a conservar las funciones del hombro, del codo y la mano. El húmero es el tercer sitio más frecuentemente afectado por los tumores benignos, agresivos, malignos y metastásicos provocando limitación funcional o pérdida de la extremidad. Material: Pacientes con tumor óseo en el húmero sin invasión neurovascular, que cumplan con los criterios de selección. Prótesis no convencional tipo RIMAG, no cementada, con ajuste diafisario y bloqueo con pernos. Métodos: Entre Junio de 1995 y Diciembre de 2011, fueron tratados 39 pacientes con tumores intraarticulares tipo I según las clasificaciones de Malawer y Enneking, con resección tumoral y reconstrucción con prótesis no convencional y partes blandas. Resultados: Se estudiaron 18 mujeres y 21 hombres entre 12-72 años, con tumores como: tumores de células gigantes (14), osteosarcomas (7), metástasis (7), condrosarcomas (6), sarcomas de Ewing (2), condroblastoma (2), y quiste óseo aneurismático (1). Doce pacientes murieron por enfermedad sistémica, el resto de la serie sobreviven. Los márgenes quirúrgicos fueron amplios con resección humeral entre los 100 a 230 mm. Los resultados funcionales fueron evaluados de acuerdo a la Sociedad de Tumores Musculoesqueléticos; 13 excelentes, 16 buenos, 5 fallas, 5 pobres. Discusión: El nivel de la resección no restringe la colocación de esta prótesis que permite realizar revisiones a futuro. El resultado satisfactorio depende del tamaño de la resección y musculatura del hombro conservada y no es limitado por el tamaño de la resección mejorando la discapacidad del paciente.

Introduction: Conservative surgery and reconstruction with an unconventional prosthesis are indicated for tumors of the humerus without neurovascular compromise, as they help preserve shoulder, elbow and hand function. The humerus is the third most frequent site of benign, aggressive, malignant and metastatic tumors that cause functional limitation or limb loss. Material: Patients with a bone tumor of the humerus without neurovascular involvement that met the inclusion criteria. Unconventional, uncemented RIMAG prosthesis with diaphyseal fit and locking bolts. Methods: 39 patients with intraarticular type I tumors according to the Malawer and Enneking classification were treated with tumor resection and reconstruction with an unconventional prosthesis and soft tissues. Results: Patients enrolled included 18 females and 21 males ages 12-72 years with tumors such as: giant cell tumors (14), osteosarcomas (7), metastasis (7), chondrosarcomas (6), Ewing's sarcomas (2), chondroblastoma (2) and aneurysmatic bone cyst (1). Twelve patients died due to systemic disease and the remaining patients survived. Surgical margins were broad, with humeral resection between 100 and 230 mm. Functional results were assessed according to the Muscoloskeletal Tumor Society score as 13 excellent, 16 good, 5 failures and 5 poor. Discussion: The resection level does not restrict the placement of this prosthesis, which permits future revisions. An appropriate result depends on the resection size and the preserved shoulder musculature and it is not limited by the size of resection, thus improving patients' disability.

Secondary Aneurysmal Bone Cystic Change of the Chondroblastoma, Mistaken for a Primary Aneurysmal Bone Cyst in the Patella

A 29-year-old woman complained of a 3-month history of left knee pain without trauma history. X-ray showed a well-defined osteolytic lesion with a sclerotic margin in the patella and magnetic resonance imaging showed T1-low and T2-high signal intensity with different fluid level. Our impression was an aneurysmal bone cyst. At surgery, the lesion was a blood-filled cystic cavity, surrounded by a gray or brownish tissue. Hemorrhagic soft tissues with recognizable bone fragments were observed. Curettage and autogenous bone graft was done. Microscopically, sheets of tumor cells were intermingled with some areas of eosinophilic chondroid matrix. The tumor cells showed oval-shaped nuclei with moderate eosinophilic cytoplasm. Several multinucleated giant cells and blood filled cystic cavities were observed. The final diagnosis was a chondroblastoma with a secondary aneurysmal bone cyst. At the post-operative 1.5-year follow-up, grafted bones were well incorporated radiographically and there were no recurrent evidence or any other abnormal symptoms.

Epithelioid hemangioma of distal femoral epiphysis in a patientwith congenital talipes equinovarus

Epithelioid hemangioma (EH) is a rare benign vascular lesion of soft tissue and bone, characterized by endothelial cells with epithelioid or histiocytoid appearance. Though tubular bones, flat bones, vertebra and short bones are common sites for this lesion, the epiphyseal involvement is extremely rare. We present an unusual case of EH of the distal femur in a young boy. Case report: A 12-year-old boy who had congenital talipes equinovarus of the right foot presented with progressively increasing pain in the right lower thigh for six months. Physical examination revealed muscular atrophy of the right lower limb and a moderately tender swelling in the medial aspect of the right knee without restriction of knee movement. An X-ray revealed an osteolytic lesion, which appeared iso- and hypointense on T1W and hyperintense on T2W MRI images in the distal epiphysis and adjacent metaphysis of the right femur. A radiological diagnosis of chondroblastoma was entertained. The patient was treated with curettage and bone grafting. Histopathology showed a tumor composed of thin-walled arteriolar capillaries lined by large, polyhedral epithelioid endothelial cells with vesicular nuclei, finely distributed nuclear chromatin, and moderate amount of eosinophilic cytoplasm. The endothelial cells were strongly immunopositive for CD34. Mitotic activity was low and the Ki-67 proliferative rate was <2%. A diagnosis of EH was made. EH is a benign lesion and it should be differentiated from its histologically similar malignant counterparts such as epithelioid hemangioendothelioma and epithelioid angiosarcoma as the lesion can be successfully treated with curettage or resection.

A guise of osteosarcoma: Chondroblastoma-like.

Osteosarcoma (OS) is a rare tumor arising from immature bone forming cells or through neoplastic differentiation of other immature mesenchymal cells into osteoblasts. Chondroblastoma-like OS is one of the rare forms of OS to be seen in jaw bones. Aggressive clinical behavior, osteolytic areas in the radiograph and histological presentation of chondroblastoma such as cells with grooved nuclei, typical chicken-wire calcification along with areas of tumor osteoid, implied the diagnosis as chondroblastoma-like OS. Use of reticulin stain further confirmed the diagnosis. A case of chondroblastoma-like OS is reported, emphasizing the importance of early diagnosis of aggressive jaw lesions with the help of routine radiography, histopathology, and special stains.

Resultado do acompanhamento clínico-radiológico pós-cirúrgico do condroblastoma / Results from clinical and radiological follow-up, after surgical treatment of chondroblastoma

OBJETIVO: Avaliar o resultado clínico e radiológico, a longo prazo, de pacientes submetidos ao tratamento cirúrgico do condroblastoma, entre 2003 e 2009, pela mesma equipe cirúrgica e empregando a mesma técnica operatória. MÉTODOS: Foi realizado estudo retrospectivo de 12 pacientes com diagnóstico histológico de condroblastoma, atendidos entre 2003 e 2009, na Fundação Pio XII (Hospital de Câncer de Barretos - Barretos, SP) e submetidos ao tratamento cirúrgico com ressecção intralesional, adjuvância com eletrocauterização e substituição por metilmetacrilato (11 casos) ou enxerto ósseo autólogo de crista ilíaca (um caso). A avaliação pré-operatória incluía exame físico, radiografias simples do local, ressonância nuclear magnética ou tomografia axial computadorizada local, além de cintilografia óssea. Os pacientes foram avaliados clínica e radiologicamente, segundo protocolo predefinido, com radiografias seriadas e avaliação funcional, conforme o escore funcional de Enneking. RESULTADOS: A idade média do diagnóstico foi de 14A e 4M, sendo o local preferencial de acometimento a epífise distal do fêmur (75 por cento), seguido pela tíbia proximal (16,6 por cento) e calcâneo (8,4 por cento). Houve prevalência maior no sexo masculino em relação ao sexo feminino (3:1). Em três casos houve necessidade prévia de biópsia. Durante o seguimento, não evidenciamos recidiva local do tumor e todos os pacientes apresentaram excelente resultado funcional, com escore de Enneking entre 20 e 30, com a técnica cirúrgica empregada. CONCLUSÃO: O tratamento cirúrgico do condroblastoma, com ressecção intralesional, uso de adjuvância, com eletrocauterização e substituição por metilmetacrilato ou enxerto ósseo produz bons resultados.

OBJECTIVES: To evaluate the long-term clinical and radiological results from patients who underwent surgical treatment of chondroblastoma, between 2003 and 2009, by the same surgical team, using the same operative technique. METHODS: A retrospective study was conducted on 12 patients with histological diagnoses of chondroblastoma, who were attended between 2003 and 2009 at the Pius XII Foundation (Barretos Cancer Hospital, Barretos, State of São Paulo). These patients underwent surgical treatment with intralesional resection of the tumor, adjuvant electrocauterization and replacement with methyl methacrylate (11 cases) or an autologous graft from the iliac crest (one case). The preoperative evaluation included physical examination, plain radiographs of the site, magnetic resonance imaging, computed axial tomography and bone scintigraphy. The patients were assessed clinically and radiologically according to a predefined protocol, with a series of plain radiographs, and a functional assessment in accordance with the Enneking functional score. RESULTS: The average age at the time of diagnosis was 14 years and 4 months. The most frequent location affected was the distal femoral epiphysis (75 percent), followed by the proximal tibial epiphysis (16.6 percent) and the calcaneus (8.4 percent). There was higher prevalence among the female patients than among the male patients (3:1). In three cases, preoperative biopsy was necessary. During the follow-up, there was no evidence of local tumor recurrence, and all the patients presented an excellent functional result from the surgical technique used, with Enneking scores ranging from 20 to 30. CONCLUSION: Surgical treatment of chondroblastoma, using intralesional resection, adjuvant electrocauterization and replacement with methyl methacrylate or bone graft produced good results.

Chondroblastoma of the Lumbar Spine: A Case Report and Review of the Literature

We report a case of chondroblastoma arising in the lumbar spine in a 25-year-old man who presented with low back pain of 5 years duration. Plain radiography and computed tomography revealed a well-defined osteolytic mass surrounded by marginal sclerosis in the third lumbar vertebra. The mass encroached on the left neural foramen on magnetic resonance imaging. Histologically, the tumor consisted of round to oval cells with eosinophilic cytoplasm and randomly scattered osteoclastic type giant cells. There were characteristic chicken-wire calcification and aneurysmal bone cyst-like changes. Chondroblastomas of the lumbar spine are extremely rare, and only nine cases have been reported. Spinal chondroblastoma should be distinguished from other benign bone tumors, because it tends to show aggressive biological behavior with high recurrence and mortality rates.

Benign bone tumors subperiosteal on the talar neck resected anthroscopically: case reports / Tumores ósseos benignos subperiosteais do colo do tálus ressecados artroscopicamente: relatos de caso

Two cases of benign chondral tumors of the talar neck region (an osteoid osteoma and a chondroblastoma) were described. Because of their specific, unusual site they could be resected by arthroscopy. The imaging aspects, incidence in foot bones and possibilities of treatment were discussed, and a literature review is presented.

Dois casos de tumores condrais benignos na região do colo do tálus (um osteoma osteoide e um condroblastoma) foram descritos. Puderam ser resectados por artroscopia devido à localização específica e pouco comum. Discutiram-se os aspectos sobre exames de imagens, a incidência em ossos do pé e as possibilidades de tratamento, além de apresentar uma revisão da literatura.

Imaging findings of tarsal chondroblastoma / 中华放射学杂志

Objective To analysis the imaging features of the chondroblastoma in the tarsal bone. Methods The locations of 134 cases of pathologically confirmed chondroblastoma were retrospectively analyzed. Eleven of them were in tarsal bones and their X-ray and CT findings were analyzed. Results Of the 11 cases of tarsal chondroblastoma, 6 were in talus, 3 were in calcaneus and 2 cases were in navicular bones. They were examined by the X-ray and 5 cases had additional CT scans. The common locations were the posterior portion of the talus and calcaneus. The X-ray findings included expansive destruction (10/11), mild osteosclerosis (11/11), bone ridge (9/11), articular facet destruction (7/11) and spot or patching calcification(6/11). The imaging findings of CT included articular facets destruction (5/5), bone ridge (5/5) and spot or patching calcification (2/5). Conclusion The talus and the calcaneus are the frequently involved location of tarsal chondroblastoma. Its X-ray and CT findings are characteristic but not exclusive.

Diagnosis and treatment of chondroblastoma / 中国综合临床

Objective To summarize the keypoints of clinical diagnosis of chondroblastoma and the experience on the treatment Methods The clinical materials of 16 cases(11 males,aged from 12 to 26 years)from June 1992 to February 2003 of pathologically diagnosed chondroblastoma were analyzed retrospectively. The tumor located at distal femur in 6 cases,great trochanter in 1 case,proximal tibia in 6 cases,proximal humerus in 2 cases, talus in 1 case. The main symptoms were swelling and painful joint. All the 16 cases were treated with curettage and autologous bone graft from iliac crest. Results Twelve cases were followed up for 6 months to 5 years .averaging 3. S years. All the bone graft healed well. One case., recurred 2 years after the initial curettage and was treated with curettage again. No recurrence occurred at the last follow-up 6 months after the second curettage. The function of the involved joints was nearly normal in all cases except for one case with slight limitation of knee flexion. Conclusions Mastering the image and clinical characteristics of chondroblastoma can avoid misdiagnosis and mistreatment Curettage can control the tumor satisfactorily. Postoperative rehabilitation can improve the function of the involved limb.

Condroblastoma pélvico / Pelvic Chondroblastoma

Este artículo describe el caso de una mujer de 24 años de edad con un condroblastoma de localización pélvica, con una masa a la altura de la cresta iliaca derecha, de seis meses de evolución y crecimiento progresivo. Los rayos X mostraron una lesión osteolítica con densidad heterogénea y extensión hacia los tejidos blandos; el estudio histopatológico evidenció un condroblastoma. Los condroblastomas son tumores óseos benignos productores de cartílago que aparecen en las epífisis de los huesos largos de personas jóvenes. Alrededor del 75% de estos tumores afectan los huesos largos, principalmente el fémur, la tibia y el húmero; excepcionalmente se localizan en los huesos planos craneofaciales y en los huesos pélvicos. Los condroblastomas tienen características radiológicas e histopatológicas distintivas, y pese a su comportamiento biológico benigno, pueden causar una alta morbilidad para los pacientes, debido a su localización y a su tratamiento exclusivamente quirúrgico.

This article describes the case of a 24-year old woman with a pelvic chondroblastoma localized at the top of the right iliac crest, with six months of evolution and progressive growth. X-rays revealed an osteolytic lesion with heterogeneous density, extending toward soft tissue; the hisopathologic study provided evidence of chondroblastoma. Chondroblastomas are benign bone tumors producers of cartilage which appears in the long bone epiphysis of young people. Nearly 75% of such tumors affect the long bones, principally the femur, the tibia, and the humerus; exceptions include those in the flat craniofacial bones and the pelvis bones. Chondroblastomas have distinct radiological and histopathologic characteristics, and despite their benign biological behavior, can cause elevated morbidity among patients due to their localization and being treated exclusively with surgery.

MRI features of chondroblastoma / 中华放射学杂志

Objective To evaluate the MR imaging features of chondrnblastoma. Methods MRI examinations of 20 patients with histological proven chondroblastoma were reviewed retrospectively. The MRI findings of chondroblastoma including the signal intensity, the shape, the growth patterns, and the surrounding bone marrow edema and the adjacent soft tissue edema, the periosteal reaction, the adjacent joint effusion were analyzed . Results All 20 cases demonstrated heterogeneous MR signal intensity on T1WI and T2WI images and showed Iobular margins. Sixteen cases demonstrated expansive growth patterns. Surrounding bone marrow edema was found in 18 cases and adjacent soft tissue edema in 14 cases. Periosteal reaction was identified in 6 cases. In 7 cases the tumor extended to adjacent soft tissue. Adjacent joint effusion was visible on MRI in 6 cases. Conclusion Heterogeneous signal intensity, lobular margins and expansive growth pattern, adjacent bone marrow and soft tissue edema were the common features of chondroblastoma on MRI.

A Case of Spine Origin Chondroblastoma Metastasis to Lung / Journal of the Korean Cancer Association, 대한암학회지

Chondroblastoma is a rare benign cartilaginous neoplasm that accounts for approximately 1% of all bone tumors and characteristically arises in the epiphysis of a long bone, particularly the humerus, tibia, and femur. Chondroblastoma can affect people of all ages. It is, however, most common in children and young adults between the ages of 10 and 20 years. Although most chondroblastomas are cured by limited surgical procedures, occasional lesions behave more aggressively and may even metastasis. In this case a young man with pulmonary metastatic chondroblastoma on spine is presented. Unlike previously published examples of metastatic chondroblastoma, these metastasis developed before any operative manipulation of the primary tumor. And primary tumor site was also unusual. The histologic characteristics of the primary, metastatic tumors were those of a conventional chondroblastoma.