Bone: Chondroblastoma

Identity

Note	Chondroblastoma is a benign bone tumour typically affecting the epiphyses of long bones from individuals with an immature skeleton.
	Radiology of Chondroblastoma. FIG. 1,2,3: Typical radiological findings of a lytic eccentric lesion affecting the epyphysis of the humerus (1 RX, 2 NMR and 3 bone scan)

Clinics and Pathology

Epidemiology	Chondroblastoma is a rare neoplasm accounting for less than 1% of all bone tumors. Age of occurrence is usually between 10 and 25 years with a male predominance. Older age of presentation for skull lesions is reported.
Clinics	Usual symptom at presentation is mild localized pain. Radiologically it occurs more often as an eccentric lytic lesion, with sclerotic borders, involving epiphyses of the long bones.
Pathology	The tumour is composed of cellular and matrix rich areas. Cellular areas are made up of so called ³chondroblasts²: round-,or polygonal cells, with an oval to round nucleus and with well defined eosinophilic cytoplasm. Mainly in non-decalcified sections the chondroblasts appear focally delimited by a thin calcification rim, so called ³chicken wire². Matrix rich areas are composed of different types of matrix: chondroid, osteoid, fibrous and rarely mature hyaline cartilage. Mitoses, always typical, are quite frequent, especially in the cellular areas. Immunohistochemical stainings show reactivity of the neoplastic cells for S-100 protein and Vimentin; although several other antigens are reported to be expressed (i.e. Smooth muscle actin and Cytokeratin). Multinucleated giant cells, especially at the periphery of matrix-rich areas, are almost always found. An associated aneurysmal bone cyst occurs in about 1/3 of the cases.
	Histological features of chondroblastoma. Fig.4: The cellular areas are made up of polygonal cells with scattered multinucleated giants cells (Haematoxylin-Eosin stain). Fig.5: The polygonal cells are positive for S-100 immunostain.
Treatment	Simple curettage is the standard treatment.
Evolution	Rate of recurrence is between 14-18% mainly occurring within 2 years, and showing a higher occurrence rate in case of temporal bone location. Rare lung metastases in benign chondroblastomas, are documented. However they are not progressive, and therefore simple observation is sufficient, if necessary followed by simple surgical resection.
Prognosis	The prognosis is good. Rare and doubtful malignant progression are described, but no universal criteria for this event are currently available, and several authors consider this as cases of a misdiagnosis.

Cytogenetics

Cytogenetics Morphological

DNA flow cytometry studies show chondroblastoma mainly to be a low proliferative diploid neoplasm, however aneuploid near-diploid populations have been reported. Karyotypic results of 7 cases are available in the literature. No specific cytogenic abnormalities neither specific type of aberrations are reported sofar. However some chromosomes seem to be more often involved: 3 cases for chromosome 5, 2 for chromosome 8, 2 for chromosome 11 and 2 for chromosome 17.

Bibliography

Cytophotometric studies of the nuclear DNA content in cartilaginous tumors.

Cuvelier C, Roels HJ.

Cancer 1979; 44: 1363-1374.

PMID 80044542

Chondroblastoma: a clinical and radiological study of 104 cases.

Bloem JL, Mulder JD.

Skeletal Radiol 1985; 14(1): 1-9.

PMID 4023729

S-100 protein immunostaining in the differential diagnosis of chondroblastoma.

Monda L, Wick MR.

Hum Pathol 1985; 16(3): 287-293.

PMID 2579018

Chondroblastoma. A review of seventy cases.

Springfield DS, Capanna R, Gherlinzoni F, Picci P, Campanacci M.

J Bone Joint Surg Am 1985; 67(5): 748-755.

PMID 3997927

Histology and biology of metastatic chondroblastoma. Report of a case with a review of the literature.

Kunze E, Graewe T, Peitsch E.

Pathol Res Pract 1987; 182(1): 113-123.

PMID 3588400

Radiologic case study. Chondroblastoma.

Monticciolo DL, Brown NL.

Orthopedics 1987; 10(8): 1197, 1199-1201.

PMID 3628108

Chondroblastoma of the temporal bone.

Blaauw G, Prick JJ, Versteege C.

Neurosurgery 1988; 22: 1102-1107.

PMID 3047595

Chondroblastoma: an immunohistochemical study.

Brecher ME, Simon MA.

Hum Pathol 1988; 19(9): 1043-1047.

PMID 3417289

Immunohistochemical distribution of S-100 protein in tumors and tumor-like lesions of bone and cartilage.

Okajima K, Honda I, Kitagawa T.

Cancer 1988; 61: 792-799.

PMID 88109271

Chondroblastoma of bone.

Kurt AM, Turcotte RE, McLeod RA,  Unni KK, Sim FH.

Orthopedics 1990; 13(7): 787-790.

PMID 2197612

Cytokeratin expression in chondroblastoma.

Semmelink HJF, Pruszczynski M, Wiersma-van Tilburg AJM., Smedts F, Ramaekers FCS.

Histopathology 1990; 16: 257-263.

PMID 90236432

Epiphyseal chondroblastoma of bone. Long-term effects on skeletal growth and articular function in 15 cases treated surgically.

Caterini R, Manili M, Spinelli M, Santori FS, Ippolito E.

Arch Orthop Trauma Surg 1992; 111(6): 327-332.

PMID 1449941

Chondroblastoma of bone. A clinical, radiological, light and immunohistochemical study.

Edel G, Ueda Y, Nakanishi J, Brinker KH, Roessner A, Blasius S, Vestring T, Muller-Miny H, Erlemann R, Wuisman P.

Virchows Arch A Pathol Anat Histopathol 1992; 421(4): 355-366.

PMID 1384228

Human benign chondroblastoma with a pseudodiploid stemline characterized by a complex and balanced translocation.

Mark J, Wedell B, Dahlenfors R, Grepp C, Burian P.

Cancer Genet Cytogenet 1992; 58(1): 14-17.

PMID 1728944

Chondroblastoma of the temporal bone. Case report and literature review.

Varvares MA, Cheney ML, Goodman ML, Ceisler E, Montgomery WW.

Ann Otol Rhinol Laryngol 1992; 101(9): 763-769.

PMID 1514755

Biologic and clinical significance of cytogenetic and molecular cytogenetic abnormalities in benign and malignant cartilaginous lesions.

Bridge JA, Bhatia PS, Anderson JR, Neff JR.

Cancer Genet Cytogenet 1993; 69: 79-90.

PMID 94006162

Chondroblastoma.

Pflueger P,  Heinrich SD, Craver R.

Orthopedics 1993; 16(3): 339-342.

PMID 8464774

Chondroblastoma.

Turcotte RE, Kurt AM, Sim FH, Unni KK, McLeod RA.

Hum Pathol 1993; 24(9): 944-949.

PMID 8253461

Ultrastructural cytochemical demonstration of proteoglycans and calcium in the extracellular matrix of chondroblastomas.

Mii Y, Miyauchi Y, Morishita T, Miura S, Honoki K, Aoki M, Tamai S.

Hum Pathol 1994; 25(12): 1290-1294.

PMID 8001922

Chondroblastoma: classic and confusing appearance at MR imaging.

Weatherall PT, Maale GE, Mendelsohn DB, Sherry CS, Erdman WE, Pascoe HR.

Radiology 1994; 190(2): 467-474.

PMID 8284401

Benign cartilage tumors.

Scarborough MT, Moreau G.

Orthop Clin North Am 1996; 27(3): 583-589.

PMID 8649739

Benign and malignant cartilage tumors of bone and joint: their anatomic and theoretical basis with an emphasis on radiology, pathology and clinical biology. I. The intramedullary cartilage tumors.

Brien EW, Mirra JM, Kerr R.

Skeletal Radiol 1997; 26(6): 325-353.

PMID 9229417

Ring chromosome 4 as the sole cytogenetic anomaly in a chondroblastoma: a case report and review of the literature.

van Zelderen-Bhola SL, Bovee JV, Wessels HW, Mollevanger P, Nijhuis JV, van Eendenburg JD, Taminiau AH, Hogendoorn PC.

Cancer Genet Cytogenet 1998; 105(2): 109-112.

PMID 9723025

Cartilage-forming tumours of bone and soft tissue and their differential diagnosis.

Bovee JV, Hogendoorn PC.

Current Diagnostic Pathology 2002; 7[4]: 223-234.

Chondroblastoma. In: Fletcher CDM, Unni KK, Mertens F, eds. World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of Soft Tissue and Bone.

Kilpatrick SE, Parisien M, Bridge JA.

Lyon: IARC Press 2002; 241-242

Correlation between clinicopathological features and karyotype in 100 cartilaginous and chordoid tumours. A report from the Chromosomes and Morphology (CHAMP) Collaborative Study Group.

Tallini G, Dorfman H, Brys P, Dal Cin P, De Wever I, Fletcher CD, Jonson K, Mandahl N, Mertens F, Mitelman F, Rosai J, Rydholm A, Samson I, Sciot R, Van Den Berghe H, Vanni R, Willen H.

Journal of Pathology 2002; 196[2]: 194-203.

PMID 21653061

Cytogenetic findings in benign cartilaginous neoplasms.

Buddingh EP, Naumann S, Nelson M, Neffa JR, Birch N, Bridge JA.

Cancer Genet Cytogenet 2003; 141(2): 164-168.

PMID 12606137

Updates on the cytogenetics and molecular genetics of bone and soft tissue tumors: osteosarcoma and related tumors.

Sandberg AA, Bridge JA.

Cancer Genet Cytogenet 2003; 145(1): 1-30.

PMID 12885459

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Contributor(s)

Written	07-2003	Salvatore Romeo, Pancras CW Hogendoorn
		Leiden University Medical Center, P.O. box 9600, L1-Q, 2300 RC Leiden, The Netherlands

Citation

This paper should be referenced as such :

Romeo S, Hogendoorn PCW . Bone: Chondroblastoma. Atlas Genet Cytogenet Oncol Haematol. July 2003 . URL : http://AtlasGeneticsOncology.org/Tumors/ChondroblastomaID5148.html

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indexed on : Thu Apr 17 14:14:27 2008

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