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20110921

Chondroblastoma



Introduction
  • A benign chondrogenic lesion 
  • Age & location
    • epiphyseal lesion in young patients (usually around 12 years of age) 
      • common locations include distal femur, proximal tibia, proximal humerus, proximal femur, and apophysis or triradiate cartilage of the pelvis
      • typically epiphyseal but may occasionally cross the physis
  • Genetics
    • may have genetic abnormalities on chromosome 5 and 8
  • Prognosis
    • 2-5% of benign chondroblasts metastasize to the lungs (similar to giant cell tumor in this respect)
Symptoms
  • Presentation
    • pain referred to involved joint
  • Physical examination
    • exam may show mechanical symptoms with limitations of motion
Imaging
  • Radiograph
    • well-circumscribed epiphyseal lytic lesion with thin rim of sclerotic bone that is sharply demarcated from normal medullary cavity 
      • lesions often cross physis into metaphysis
      • mineralization within the lesion may or may not be present 
Histology
  • Classic characteristics are
    • chondroblasts arranged in "cobblestone" or "chickenwire" pattern may be present 
    • occasional multinucleated giant cells may be present 
    • loose myxoid tissue
Treatment
  • Operative
    • extended intralesional curettage and bone grafting 
      • may do local adjuvant treatment with phenol or cryotherapy

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