Condroblastoma

Chondroblastoma

Chondroblastoma is a rare benign neoplasm that accounts for approximately 1.8% of all bone tumors. This type of tumor prefers the epiphysis of long bones and generally manifests as a lesion of bone rarefaction, with foci of calcification. It is more common in male patients, typically occurring during the first and second decades of life, when the growth plate is still open.

First described by Codman in 1931, chondroblastoma was initially associated with the “calcified giant cell tumor” of the proximal humerus. However, subsequent studies showed that it was a tumor entity distinct from the gigantocellular tumor (GCT).

Due to its intra-articular location, chondroblastoma can present symptoms similar to arthritis. Furthermore, it can demonstrate local aggressiveness, causing erosion of the cortical bone, growth plate and joint invasion. Often, areas of aneurysmal bone cysts may be associated with radiographic manifestations of local aggressiveness.

Treatment of chondroblastoma generally involves intralesional curettage followed by local adjuvants, such as phenol, electrothermia or liquid nitrogen, in addition to the placement of an autologous bone graft or polymethyl methacrylate cement. In more advanced cases, segmental resection followed by reconstruction with a prosthesis or arthrodesis may be necessary in recurrent or very advanced cases.

The prognosis for chondroblastoma may be poor due to the risk of local recurrence and possible orthopedic complications, including joint degeneration and growth failure.

Although rarely, chondroblastoma can lead to lung metastases with histology similar to that of a benign tumor, without presenting atypia. The treatment for these metastases may be clinical and imaging monitoring and if observation indicates progress, surgical excision may be necessary.

In summary, chondroblastoma is a benign bone neoplasm that, although rare, requires careful attention due to its potential for local aggressiveness and possible long-term complications. Early diagnosis and appropriate treatment are essential to ensure the best possible prognosis for affected patients.

Author: Prof. Dr. Pedro Péricles Ribeiro Baptista

 Orthopedic Oncosurgery at the Dr. Arnaldo Vieira de Carvalho Cancer Institute

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