Chondroblastoma

( Benign Chondroblastoma )
( Epiphyseal Chondroblastoma )

Ronny Sutanto
Bali, 24-04-2007
Definition
 Chondroblastoma is benign primary neoplasma
of bone composed of proliferating chondroblast
almost always occuring in secondary ossification
Epidemiology
 Chondroblastoma is Uncommon :
 < 1 % all bone tumors
 < 5 % all benign lesions
 Male ( 60-75% )
 Age : second decade ( 10-30 y )
 Localization : Epiphysis of long bone and apophysis
Metaphysis ( 2% )
 Frequent site : Proximal : Humeri
Tibia
Femur
Distal : Femur
Less common : Foot ( talus and calcaneus )
Pelvis ( Y ligament )
Symptom
 Pain ( progressive )
 Mass
 Effusion
 ROM decreased
 Muscular atrophy
Imaging Features
 Chondroblastoma appears on X-rays :
 Radiolucent
 Round or oval
 Smooth border
 Surounded thin sclerotic rim
 Physeal plate open
 Extension to metaphysial invsion ( 40-60 % )
 Mineralization ( 35-50 % )
 Periosteal bone formation (rare )
 Occasionally :
 Epiphyseal destruction, meta diaphyseal extension, soft
tissue invasion

 CT: intratumoral calcification

 MRI : synovial reaction

marrow edema
MRI
Pathology
 Macros :
 Soft
 Welldemilited
 Colour : Greyish – brown

 Histology :
 Proliferating chondroblastCoffe bean appearance
 Irregular multinucleated Giant Cell
 Chondroid matrix stain  pink
 Pericellular calcification chicken wire pattern
( 30 – 40 % )
 Immunostain  S 100 protein (+)
Diagnosis and stage
 Clinics – Radiology - Pathology

 Differntial diagnose :
 Giant Cell Tumors 
Chondroblastoma radiographic :
 Define border

 Intratumoral calcification

histologic :
 Irregular dist giant cell

 Rare mitosis

 Chondroid differentiation
ABC

GCT
  Pericellular calcification
 S 100 protein sensitivity

 Clear cell chondrosarcoma

 Radiography identical  histology

 Aneurysmal Bone Cyst

 Epiphyseal Brodies abcess
Treatment and Prognosis
 Surgical :
 Stage I or II or some stage III  incisional curretage
 Wide lesion with extensive bone or soft tissue invasion
 Wide Segmental Resection

 Effectiveness  large Bony Window :

 Saucerization
 High speed burr
 Local adjuvant

 Cavity filler :
 Bone graft ( homo/ auto)
 Osteochondral allograft
 Acrylic cement
 Local recurrance : 10 -15 %
 Lung metastase ( few case )