Chondroblastoma
Original Editors - Drew Cecil & Chance Chadwick from Bellarmine University's Pathophysiology of Complex Patient Problems project.
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Definition/Description[edit | edit source]
Chondroblastoma refers to a benign bony tumor that is caused by the rapid division of chondroblast cells which are found in the epiphysis of long bones. They have been described as calcified chondromatous giant cell tumors1. The most frequently involved body regions are the hip, knee, and shoulder. Although usually benign, chondroblastoma metastasizes on rare occasions, with fatal results3.
Prevalence[edit | edit source]
Chondroblastoma is a relatively rare, benign cartilaginous tumor, accounting for approximately 1% of the benign tumors of bone. The peak incidence is in the second decade of life and is slightly more common in males than females. In addition to long bones, chondroblastoma also occurs in the acetabular region of the pelvis, scapula, spine, and ribs. It can also occur in the patella, tarsal bones, and occasionally in craniofacial bones.
Metaphyseal origin is rare but has been reported. Rare cases of multifocal chondroblastoma with synchronous involvement of several typical sites have also been documented. A small number of cases have reported chondroblastomas that are exclusively found in soft tissue2.
Recurrence of the tumor happens in about 20% of cases, and seems to depend on the location of the initial tumor and the surgical intervention selected to treat it6. Recurrence is most common in tumors of the hip and lumbar spine6.
Characteristics/Clinical Presentation[edit | edit source]
Clinically, patients present with the following signs and symptoms in early stages of tumor development4:
- Pain
- Swelling around the joint
- Limited range of motion secondary to pain
- Palpable mass at the sight of the lesion
- Antalgic gait patterns secondary to pain and decreased range of motion3
In later stages of tumor development the following signs and symptoms may become evident:
- Synovitis
- Joint effusion
- Periostitis
Histologically, the tumour is built up of round or polygonal chondroblasts surrounded by reticulin fibers. The matrix is pinkstained chondroid, with occasional focal calcification. Scattered osteoclast-type multi-nucleated cells are often present4. Dystrophic (chicken-wire) calcification is occasionally present but is not necessary for a diagnosis5.
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