604:. The prevalence of metastatic chondroblastoma, however, is quite low and is believed to be less than 0.5%. There is no relationship established between metastasis and previous surgery, non-surgical treatment, anatomical location, or patient age. Survival of patients with metastatic lesions is better when the metastases are surgically resectable, as chemotherapy has been shown to have little to no benefit. Prognosis is bleak for patients with malignant chondroblastomas that are resistant to surgery, radiation, and chemotherapy. However, patients with resectable metastases have survived for several years following diagnosis.
63:
32:
581:
lesion. The rate of recurrence is highly variable, ranging between 5% and 40%, as study results are generally inconclusive. However, local recurrence for long bone lesions is around 10%, with chondroblastoma in flat bones having higher recurrence and more complications. Recurrences are more common in cases involving an open epiphyseal plate where they can be attributed to inadequate curettage to avoid damage. Lesions of the proximal femur are particularly problematic because of difficulties accessing the
589:. Chondroblastoma may recur in the soft tissue surrounding the initial lesion, especially in the case of incomplete curettage. Recurrences have been shown to occur between 5 months and 7 years after initial treatment and are generally treated with repeat curettage and excision of affected soft-tissue. No histological differences have been seen between recurrent and non-recurrent chondroblastomas.
632:. This view was changed later by a comprehensive review completed by Jaffe and Lichtenstein in 1942 of similar tumors in other locations than the proximal humerus. They re-defined the tumor as a benign chondroblastoma of the bone that is separate from giant cell tumors. However, chondroblastoma of the proximal humerus is still sometimes referred to as Codman's Tumor.
619:, functional impairment, and malignant transformation. Complications are less common in patients presenting with chondroblastoma in accessible areas. Overall, patients with more classical chondroblastoma (appearing in long bones, typical presentation) have better prognoses than patients with atypical chondroblastoma (flat bones, skull, etc.).
114:. (The chances of having this condition are roughly one in a million.) It affects mostly children and young adults with most patients being less than 20 years of age. Chondroblastoma shows a predilection towards the male sex, with a ratio of male to female patients of 2:1. The most commonly affected site is the
580:
Although not specific to one mode of management, lesion size, patient sex, or follow-up, the recurrence rate for chondroblastoma is relatively high, and has been shown in select studies to be dependent upon the anatomical location, method of treatment, and biological aggressiveness of the initial
212:
Currently, the genetic or environmental factors that predispose an individual for chondroblastoma are not well known or understood. Chondroblastoma affects males more often than females at a ratio of 2:1 in most clinical reports. Furthermore, it is most often observed in young patients that are
466:
can share characteristics with chondroblastomas with regards to histologic and radiographic findings. However they more commonly originate from the metaphysis, lack calcification and have a different histologic organization pattern. Other differential diagnoses for chondroblastoma consist of
567:
has been used, but is typically most successful for small chondroblastoma lesions (approximately 1.5 cm). Treatment with radiofrequency ablation is highly dependent on size and location due to the increased risk of larger, weight-bearing lesions being at an increased risk for
376:. However, true metaphyseal chondroblastomas are rare and are typically the result of an extension from a neighboring epiphyseal legion. Most lesions are less than 4 cm. A mottled appearance on the radiograph is not atypical and indicates areas of
627:
Chondroblastoma was first described in 1927 as a cartilage-containing giant cell tumor by
Kolodny but later characterized by Codman in 1931. Codman believed chondroblastoma to be an "epiphyseal chondromatous giant cell tumor" in the proximal
213:
skeletally immature, with most cases diagnosed in the second decade of life. Approximately 92% of patients presenting with chondroblastoma are younger than 30 years. There is no indication of a racial predilection for chondroblastoma.
280:
The highly heterogeneous nature of the tumor makes classification particularly difficult especially considering the origins of chondroblastoma. There are two opposing views on the nature of chondroblastoma, one favoring an
354:
being the most common. Laboratory studies are not considered useful. Classical chondroblastoma (appearing on long bones) appears as a well-defined eccentric oval or round lytic lesion that usually involves the adjacent
367:
margin can be seen in some cases. For long bone chondroblastomas the tumor is typically contained to the epiphysis or apophysis but may extend through the epiphyseal plate. Chondroblastomas are usually located in the
511:
may be helpful to avoid destruction of the epiphyseal plate. In patients who are near the end of skeletal growth, complete curettage of the growth plate is an option. In addition to curettage, electric or chemical
1190:
264:
among the cells in the proliferating/pre-hypertrophic zone (cellular-rich area) versus the hypertrophic/calcifying zone (matrix-rich area). These findings suggest that chondroblastoma is derived from a
329:
have observed chondroblastoma neoplasms to be composed of mesenchymal cells that have completed normal chondrogenesis along with the production of osteoid and collagen I that could be the result of
244:
suggests a close relationship with growth plate cartilage. In chondroblastoma, growth signaling molecules may be present due to the pre-pubertal signaling network as well as cartilage growth.
248:
are thought to be linked to this process because of the spatial relationship of chondroblastoma with the growth plate and its typical occurrence before growth plate fusion. Both
204:
In a publication by
Turcotte et al. it was found that the average duration of symptoms for patients with chondroblastoma was about 20 months, ranging from 5 weeks to 16 years.
321:
of chondroblastoma being cartilaginous in nature but recognize that any definitive determinations regarding the origin of this neoplasm are not possible because of the
813:
Romeo, S; Bovée, JVMG; Jadnanansing, NAA; Taminiau, AHM; Hogendoorn, PCW (2003-11-27). "Expression of cartilage growth plate signalling molecules in chondroblastoma".
451:. There is no correlation between mitotic activity and location of the lesion. Furthermore, the presence of atypical cells is rare and is not associated with
411:, or biological activity of the chondroblastoma, respectively. MRI studies may show extensive oedema around the lesion and show variable T2 signal intensity.
1209:
447:
figures can be observed in chondroblastoma tissue but are not considered atypical in nature, and therefore, should not be viewed as a sign of a more serious
559:
are not commonly used. Radiotherapy has been implemented in chondroblastoma cases that are at increased risk of being more aggressive and are suspected of
1305:
150:
The most common symptom is mild to severe pain that is gradually progressive in the affected region and may be initially attributed to a minor injury or
1603:
763:
De Mattos, Camila B. R.; Angsanuntsukh, Chanika; Arkader, Alexandre; Dormans, John P. (2013). "Chondroblastoma and
Chondromyxoid Fibroma".
392:. In cases involving older patients or flat bones, typical radiographic presentation is not as common and may mimic aggressive processes.
293:
suggests that chondroblastoma should be reclassified as a bone-forming neoplasm versus a cartilaginous neoplasm due to the presence of
260:(FGF) signaling pathways, important for development of the epiphyseal growth plate, are active in chondroblastoma leading to greater
154:. Pain may be present for several weeks, months, or years. Other symptoms in order of most common to least commonly observed include
572:
and recurrence. Overall, the success and method of treatment is highly dependent upon the location and size of the chondroblastoma.
1298:
236:
has noted that chondroblastoma arising in long bones mainly affects the epiphyses, while in other locations it is close to
1089:
Turcotte, Robert E.; Kurt, Anne-Marie; Sim, Franklin H.; Krishnan Unni, K.; McLeod, Richard A. (1993). "Chondroblastoma".
253:
873:
Ramappa, A. J.; Lee, F. Y.; Tang, P.; Carlson, J. R.; Gebhardt, M. C.; Mankin, H. J. (2000). "Chondroblastoma of bone".
443:
that may surround individual cells. Although, calcification may not be present and is not a prerequisite for diagnosis.
1291:
1352:
325:
of mesenchymal cells when set into different microenvironments and static approaches used in literature. Romeo
169:
Physical findings include localized tenderness and a decreased range of motion in the involved bone and nearby
939:
Kurt, Anne-Marie; Krishnan Unni, K.; Sim, Franklin H.; McLeod, Richard A. (1989). "Chondroblastoma of bone".
380:
which is commonly associated with skeletally immature patients. Additionally, one-third of all cases involve
100:
1453:
612:
400:
385:
537:
503:. To prevent recurrence or complications it is important to excise the entire tumor following strict
274:
221:
The etiology of chondroblastoma is uncertain, as there is no specific characteristic abnormality or
62:
1549:
1217:
1125:
560:
440:
257:
1441:
564:
495:
Chondroblastoma has not been known to spontaneously heal and the standard treatment is surgical
1495:
1357:
476:
439:. A "chicken-wire" appearance is characteristic of chondroblastoma cells and is the result of
1477:
1458:
463:
381:
364:
330:
1034:
8:
1470:
1167:
607:
While recurrence is the most common complication of chondroblastoma other issues include
533:
529:
360:
286:
237:
182:
616:
261:
155:
84:
1487:
1228:
1147:
1106:
1102:
956:
952:
890:
882:
830:
780:
586:
552:
504:
468:
404:
51:
1268:
536:
bone grafts are the preferred filling materials. Other options include substituting
1436:
1335:
1271:
1137:
1098:
948:
822:
772:
525:
428:
369:
306:
266:
104:
31:
1391:
1319:
1222:
600:, with some cases also involving secondary bone sites, soft tissue, skin, or the
436:
322:
298:
163:
1283:
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569:
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appearance consists of a combination of oval mononuclear and multi-nucleated
377:
356:
249:
186:
185:
can be found, especially in cases involving the foot. In cases involving the
151:
1203:
1199:
776:
540:(PMMA) or fat implantation in place of the bone graft. The work of Ramappa
419:
Chondroid differentiation is a common feature of chondroblastoma. A typical
407:, which may be helpful in determining the anatomical boundaries, associated
1523:
1500:
1415:
1405:
1345:
894:
582:
556:
350:
A variety of imaging studies can be used to diagnose chondroblastoma, with
313:, was expressed in chondroblastoma, supporting the chondroid nature of the
241:
226:
198:
96:
76:
43:
1431:
1427:
544:
suggests that packing with PMMA may be a more optimal choice because the
521:
508:
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245:
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39:
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139:
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92:
88:
80:
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301:, and absence of true cartilage matrix (collagen II). However, Edel
1578:
427:. However this is not a prerequisite for diagnosis, as cells with
389:
314:
190:
56:
1401:
1035:"Chondroblastoma: Practice Essentials, Pathophysiology, Etiology"
629:
444:
396:
294:
119:
110:
Chondroblastoma is very uncommon, accounting less than 1% of all
1244:
1194:
517:
452:
812:
615:, pathological fractures, failure of bone grafts, pre-mature
601:
432:
408:
317:. The results of Romeo and colleagues favor the view of Edel
170:
123:
115:
1088:
597:
282:
159:
135:
79:, locally aggressive bone tumor that typically affects the
938:
507:. However, in skeletally immature patients intraoperative
771:(4). Ovid Technologies (Wolters Kluwer Health): 225–233.
91:. It is thought to arise from an outgrowth of immature
765:
Journal of the
American Academy of Orthopaedic Surgeons
548:
of the cement is thought to kill any remaining lesion.
875:
The
Journal of Bone and Joint Surgery. American Volume
240:. Additionally, rare prevalence of chondroblastoma in
872:
431:
characteristics have been observed in lesions of the
372:
portion of bones and can, in some cases, include the
229:
abnormalities being highly specific for some tumors.
1172:
528:. Depending on the size of the subsequent defect,
1313:
1124:Chen, Wenqian; DiFrancesco, Lisa M. (June 2017).
596:. The most common location for metastases is the
1595:
273:via active growth-plate signaling pathways (see
162:(when affected bone is in the lower extremity),
16:Benign cartilage tumor on the ends of long bones
1130:Archives of Pathology & Laboratory Medicine
1123:
384:which are thought to be the result of stress,
1299:
592:Rarely, more aggressive chondroblastomas can
177:, a palpable mass, soft tissue swelling, and
1084:
1082:
1080:
1078:
1076:
1074:
126:. Less commonly affected sites include the
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181:in the affected area. Less commonly,
145:
791:
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654:
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644:
1604:Osseous and chondromatous neoplasia
901:
254:parathyroid hormone-related protein
13:
345:
14:
1615:
1161:
641:
395:Other imaging techniques involve
225:breaking point observed, despite
1033:Damron, Timothy A (2022-10-14).
285:origin and the other favoring a
1353:Primitive neuroectodermal tumor
487:(this list is not exhaustive).
216:
207:
1117:
101:secondary ossification centers
1:
635:
242:intra-membranous ossification
1126:"Chondroblastoma: An Update"
1103:10.1016/0046-8177(93)90107-r
953:10.1016/0046-8177(89)90268-2
947:(10). Elsevier BV: 965–976.
575:
490:
340:
7:
1097:(9). Elsevier BV: 944–949.
425:osteoclast-type giant cells
289:origin. The work of Aigner
10:
1620:
1454:Mesenchymal chondrosarcoma
622:
613:degenerative joint disease
481:clear cell chondrosarcomas
401:magnetic resonance imaging
166:, and a soft tissue mass.
1562:
1540:
1522:
1513:
1486:
1414:
1382:
1373:
1326:
1254:
1176:
1168:Chondroblastoma- Medscape
1143:10.5858/arpa.2016-0281-RS
520:) can be used as well as
275:Endochondral ossification
50:
38:
29:
24:
1550:Giant-cell tumor of bone
815:The Journal of Pathology
561:malignant transformation
441:dystrophic calcification
333:of chondrocytes towards
258:fibroblast growth factor
1442:Extraskeletal chondroma
777:10.5435/jaaos-21-04-225
565:radiofrequency ablation
477:eosinophilic granulomas
107:or some remnant of it.
103:, originating from the
609:post-surgery infection
546:heat of polymerization
538:polymethylmethacrylate
464:Chondromyxoid fibromas
459:Differential diagnosis
309:, a marker for mature
183:pathological fractures
42:of a chondroblastoma.
1478:Chondromyxoid fibroma
1459:Myxoid chondrosarcoma
821:(1). Wiley: 113–120.
524:and wide or marginal
415:Histological findings
382:aneurysmal bone cysts
152:sports-related injury
331:transdifferentiation
238:ossification centers
201:have been reported.
1471:Osteochondromatosis
499:of the lesion with
397:computed tomography
1255:External resources
1039:Medscape Reference
617:epiphyseal closure
570:articular collapse
505:oncologic criteria
146:Signs and symptoms
118:, followed by the
1591:
1590:
1587:
1586:
1558:
1557:
1509:
1508:
1496:Ossifying fibroma
1281:
1280:
827:10.1002/path.1501
469:giant cell tumors
455:chondroblastoma.
70:
69:
19:Medical condition
1611:
1567:
1566:
1520:
1519:
1437:Enchondromatosis
1380:
1379:
1336:Multiple myeloma
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1086:
1049:
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1045:
1030:
965:
964:
936:
899:
898:
881:(8): 1140–1145.
870:
839:
838:
810:
789:
788:
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267:mesenchymal cell
256:(IHh/PtHrP) and
105:epiphyseal plate
66:
65:
34:
22:
21:
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1613:
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1594:
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1554:
1536:
1532:Chondroblastoma
1505:
1482:
1410:
1392:Osteoid osteoma
1369:
1322:
1312:
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1277:
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1091:Human Pathology
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968:
941:Human Pathology
937:
902:
871:
842:
811:
792:
761:
642:
638:
625:
578:
563:. Furthermore,
493:
461:
417:
348:
346:Imaging studies
343:
299:type I collagen
250:Indian Hedgehog
219:
210:
164:joint stiffness
148:
73:Chondroblastoma
60:
25:Chondroblastoma
20:
17:
12:
11:
5:
1617:
1607:
1606:
1589:
1588:
1585:
1584:
1582:
1581:
1575:
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1503:
1498:
1492:
1490:
1484:
1483:
1481:
1480:
1475:
1474:
1473:
1466:Osteochondroma
1463:
1462:
1461:
1456:
1449:Chondrosarcoma
1446:
1445:
1444:
1439:
1420:
1418:
1412:
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1399:
1394:
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1177:Classification
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1162:External links
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1136:(6): 867–871.
1116:
1050:
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295:osteoid matrix
271:chondrogenesis
218:
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179:joint effusion
175:muscle atrophy
147:
144:
68:
67:
54:
48:
47:
36:
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27:
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18:
15:
9:
6:
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1397:Osteoblastoma
1395:
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1363:Ewing sarcoma
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187:temporal bone
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97:chondroblasts
94:
90:
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58:
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53:
49:
45:
44:H&E stain
41:
37:
33:
28:
23:
1531:
1524:Chondroblast
1501:Fibrosarcoma
1416:Chondroblast
1406:osteosarcoma
1358:Ewing family
1346:Adamantinoma
1272:orthoped/469
1262:
1238:
1227:
1216:
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1133:
1129:
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764:
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583:femoral head
579:
557:chemotherapy
553:radiotherapy
550:
541:
494:
485:enchondromas
462:
437:facial bones
421:histological
418:
394:
363:reaction. A
349:
326:
318:
311:chondrocytes
302:
290:
279:
246:Sex hormones
233:
231:
220:
217:Pathogenesis
211:
208:Risk factors
203:
199:hearing loss
168:
149:
109:
72:
71:
1432:enchondroma
1428:ecchondroma
1314:Tumours of
594:metastasize
522:cryotherapy
509:fluoroscopy
429:epithelioid
403:(MRI), and
357:bone cortex
352:radiographs
335:osteoblasts
307:collagen II
305:found that
269:undergoing
227:cytogenetic
223:chromosomal
112:bone tumors
75:is a rare,
1384:Osteoblast
1375:Metaphysis
1229:DiseasesDB
1044:2024-06-22
636:References
473:bone cysts
405:bone scans
390:hemorrhage
374:metaphysis
361:periosteal
323:plasticity
140:flat bones
89:long bones
40:Micrograph
1571:Notochord
1515:Epiphysis
1424:Chondroma
1341:Epithelia
1328:Diaphysis
1320:cartilage
1269:radio/164
1264:eMedicine
1240:SNOMED CT
1152:0003-9985
1111:0046-8177
961:0046-8177
887:0021-9355
835:0022-3417
785:1067-151X
576:Prognosis
534:allograft
530:autograft
526:resection
497:curettage
491:Treatment
453:malignant
449:pathology
370:medullary
365:sclerotic
341:Diagnosis
195:dizziness
132:calcaneus
93:cartilage
85:apophyses
81:epiphyses
52:Specialty
1598:Category
1579:Chordoma
895:10954104
587:excision
359:without
315:neoplasm
191:tinnitus
156:swelling
57:Oncology
1542:Myeloid
1488:Fibrous
1402:Osteoma
1245:9001003
1223:D002804
630:humerus
623:History
445:Mitotic
283:osseous
134:of the
120:humerus
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95:cells (
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518:phenol
483:, and
399:(CT),
386:trauma
232:Romeo
197:, and
77:benign
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1563:Other
1234:31489
1210:ICD-O
602:liver
551:Both
542:et al
516:(via
433:skull
409:edema
327:et al
319:et al
303:et al
291:et al
234:et al
171:joint
128:talus
124:tibia
116:femur
1318:and
1316:bone
1218:MeSH
1148:ISSN
1107:ISSN
957:ISSN
891:PMID
883:ISSN
831:ISSN
781:ISSN
598:lung
555:and
435:and
160:limp
158:, a
138:and
136:foot
130:and
122:and
1204:C41
1200:C40
1191:ICD
1138:doi
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