Chondroblastoma of bone a review of 25 cases

Chondroblastoma is an uncommon benign bone tumor with a tendency to reoccur after surgical treatment. Between 1994 and 2006, 25 cases diagnosed as chondroblastoma of bone were treated by the authors. The most common site in order of frequency was the distal femur [6 cases], followed by the proximal tibia [5 cases], the proximal humerus [4 cases] and the proximal femur [3 cases]. Other sites included the acetabulum, greater trochanter, lesser trochanter, talus, cuboid, distal humerus and scapula [one case in each]. Five cases had already a local recurrence at presentation. All lesions were curetted and the cavities filled by iliac crest bone graft in 14 cases, cement in 8 cases, bone graft substitutes in one case and nothing in 2 cases. The average follow-up period was 35.6 months [from 6 months and up to 147 months]. All except one patient, who had a double recurrence, had functional MSTS score over 25. Among the 25 patients, two patients had a local recurrence [8%]; one with a chondroblastoma of the pelvis and the other with a chondroblastoma of the proximal humerus. The use of a burr was a technically important step to achieve an adequate curettage in all cases. In conclusion, using cement may have reduced the incidence of local recurrence in comparison to the use of bone grafts. Recurrent cases can still be treated effectively by adequate curettage with low incidence of local recurrence

Functional and oncological outcome of total scapulectomy in the management of shoulder girdle malignant bone and soft tissue tumors

The aim of this study was to evaluate the functional and oncological outcome of total scapulectomy in the management of primary malignant bone and soft tissue tumors in and around the shoulder girdle. Eight patients [5 males, 3 females] with an age range of 7-48 years [average 25.5 years] had undergone total scapulectomy in our centre between 1999 and 2003. Five patients had stage IIB, two stage IB, and one stage III tumors according to Enneking's staging system. The follow- up period ranged from 6 to 48 months. The oncological outcome was assessed and the functional outcome was evaluated using the Musculoskeletal Tumor Society [MSTS] rating scale. Seven patients are still alive, one patient died of disease. Local recurrence was not detected in any of our patients while chest metastases occurred in two [one of them already had it at the time of presentation]. The mean functional score was 22.4. The shoulder function was significantly impaired in all cases especially abduction and flexion while the elbow and hand function were completely preserved. It was concluded that total scapulectomy remains a good limb-sparing technique that preserves a functionally useful extremity