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.
Aneurysm ; Bone Cysts ; Bone Cysts, Aneurysmal ; Bone Transplantation ; Cartilage ; Chondroblastoma ; Curettage ; Epiphyses ; Femur ; Giant Cell Tumors ; Giant Cells ; Humans ; Humerus ; Incidence ; Joints ; Male ; Methods ; Talus ; Tibia

Unsintered hydroxyapatite (u-HA) and poly-L-lactide (PLLA) composites (u-HA/PLLA) are osteoconductive and biodegradable. Screw (Super-Fixsorb MX30) and plate (Super-Fixsorb MX40 Mesh) systems made of u-HA/PLLA are typically used in small bones in maxillofacial surgeries. After the resection of bone tumors in larger bones, reconstructions with β-tricalcium phosphate (β-TCP) implants of strong compression resistance have been reported. After a resection, when the cavity is hemispheric- or concave-shaped, stabilization of the implanted β-TCP block is necessary. In the current series, u-HA/PLLA were used to stabilize the mechanically strong implanted low-porous β-TCP blocks in six bone tumor cases, including three giant cell tumors of bone, and one case each of chondroblastoma, chondrosarcoma, and parosteal osteosarcoma. The mean age of patients at the time of surgery was 31.3 years (range, 19 to 48 years). The bones involved were two ilia (posterior), a femur (diaphysis to distal metaphysis), and three tibias (proximal epiphysis, proximal metaphysis to epiphysis, and distal metaphysis to epiphysis). Neither displacement of the implanted β-TCP block nor any u-HA/PLLA-related complications were observed. The radiolucent character of the u-HA/PLLA did not hinder radiological examinations for potential signs of tumor recurrence. The method of using u-HA/PLLA components for the stabilization of β-TCP blocks makes the procedure easy to perform and reliable. It can extend the application of β-TCP blocks in reconstruction surgery.
Bone Neoplasms ; Chondroblastoma ; Chondrosarcoma ; Durapatite* ; Epiphyses ; Femur ; Giant Cell Tumors ; Humans ; Hydroxyapatites ; Methods ; Osteosarcoma ; Reconstructive Surgical Procedures ; Recurrence ; Tibia

PURPOSE: Clear cell chondrosarcoma may have a benign appearance even on a magnetic resonance imaging (MRI). Hence, it can be confused with benign bone tumors, such as a giant cell tumor or chondroblastoma. The aim of our study was to document the doctorassociated diagnostic errors in patients with clear cell chondrosarcoma and oncologic outcomes of these lesions, which were misdiagnosed as benign bone tumors. MATERIALS AND METHODS: We identified 10 patients who were diagnosed with and treated for clear cell chondrosarcoma between January 1996 and December 2014. One patient was excluded due to insufficient clinical data. We then reviewed their data regarding age, gender, symptom onset, tumor location, initial imaging diagnosis, and associated previous treatment. We examined the errors of surgeons and pathologists with respect to patient and tumor characteristics. We also analyzed treatment delay, time to local recurrence, metastasis, follow-up duration, and the oncologic outcome. RESULTS: The initial presumptive diagnosis based on MRIs for all 9 patients was benign bone tumor. Among 8 patients who underwent inappropriate procedure, half of them were diagnosed as clear cell chondrosarcoma immediately after the curettage. As for the remaining 4 patients, the surgeon did not send any tissue samples to a pathologist for a definite diagnosis in three patients and a pathologist made an incorrect diagnosis in one patient. We performed an appropriate surgery on all patients with a wide surgical margin. The average treatment delay was 27 months (range, 0–127 months), and the average follow-up duration was 65 months (range, 13–164 months). One patient had local recurrence after 12 months. Metastatic disease developed in 2 patients with a median time to definitive treatment of 24 months (12–37 months). Ten-year overall survival of patients with clear cell chondrosarcoma was 78%, and two patients died due to disease progression. CONCLUSION: Misdiagnosis of clear cell chondrosacroma as a benign bone tumor is not uncommon, even for experienced orthopaedic oncologists, resulting in definite curative surgery without biopsy. An inappropriate primary treatment may increase the risk of local recurrence and metastasis. Therefore, a proper subsequent surgery is mandatory for patients with clear cell chondrosarcoma who received inadvertent curettage.
Biopsy ; Chondroblastoma ; Chondrosarcoma ; Curettage ; Diagnosis ; Diagnostic Errors ; Disease Progression ; Follow-Up Studies ; Giant Cell Tumors ; Humans ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Recurrence ; Surgeons

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.
Chondroblastoma* ; Curettage ; Female ; Follow-Up Studies ; Giant Cell Tumors* ; Giant Cells* ; Humans ; Lung ; Male ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Retrospective Studies

Adult ; Bone Cysts, Aneurysmal ; diagnosis ; surgery ; Bone Neoplasms ; diagnosis ; surgery ; Chondroblastoma ; diagnosis ; surgery ; Female ; Humans ; Male ; Talus ; surgery ; Young Adult

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.
Arthroscopy ; Cartilage, Articular ; Cementation ; Chondroblastoma ; Curettage ; Giant Cell Tumors ; Humans ; Osteoarthritis, Knee ; Polymethyl Methacrylate ; Recurrence ; Tibia

An osteolytic lesion with a small central area of mineralization and sclerotic borders was discovered incidentally in the clivus on the cone-beam computed tomography (CBCT) of a 27-year-old male patient. This benign appearance indicated a primary differential diagnosis of non-aggressive lesions such as fibro-osseous lesions and arrested pneumatization. Further, on magnetic resonance imaging (MRI), the lesion showed a homogenously low T1 signal intensity with mild internal enhancement after post-gadolinium and a heterogeneous T2 signal intensity. These signal characteristics might be attributed to the fibrous tissues, chondroid matrix, calcific material, or cystic component of the lesion; thus, chondroblastoma and chondromyxoid fibroma were added to the differential diagnosis. Although this report was limited by the lack of final diagnosis and the patient lost to follow-up, the incidental skull base finding would be important for interpreting the entire volume of CBCT by a qualified oral and maxillofacial radiologist.
Adult ; Chondroblastoma ; Cone-Beam Computed Tomography* ; Cranial Fossa, Posterior ; Diagnosis ; Diagnosis, Differential ; Fibroma ; Humans ; Incidental Findings ; Lost to Follow-Up ; Magnetic Resonance Imaging ; Male ; Skull Base ; Skull Base Neoplasms

Chondroblastoma ; pathology ; Chondroma ; pathology ; Chondrosarcoma ; metabolism ; pathology ; surgery ; Cricoid Cartilage ; Diagnosis, Differential ; Humans ; Laryngeal Neoplasms ; metabolism ; pathology ; surgery ; Laryngectomy ; Lymph Node Excision ; Male ; Middle Aged ; Osteoblastoma ; pathology ; Osteosarcoma ; pathology ; S100 Proteins ; metabolism ; Sarcoma, Clear Cell ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

Bone Neoplasms ; Chondroblastoma ; Humans ; Ribs ; pathology

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.
Adult ; Aneurysm ; Bone Cysts ; Chondroblastoma ; Curettage ; Cytoplasm ; Diagnosis ; Eosinophils ; Female ; Follow-Up Studies ; Giant Cells ; Humans ; Knee ; Magnetic Resonance Imaging ; Patella ; Transplants