Bone: Chondroblastoma

2017-11-01   Arjen Cleven , Judith Bovée 

1.Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands.
2.Leiden University Medical Center, P.O. box 9600, L1-Q, 2300 RC Leiden, The Netherlands
3.Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands.



Chondroblastoma is a locally aggressive, rarely metastasizing bone tumour typically affecting the epiphyses of long bones from individuals with an immature skeleton.
Atlas Image
Radiology of Chondroblastoma.
Figures 1, 2 and 3: Typical radiological findings of a lytic eccentric lesion affecting the epyphysis of the humerus (1 RX, 2 NMR and 3 bone scan)


Review on Chondroblastoma, with data on clinics, and the genes involved.

Clinics and Pathology


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.


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.


The tumour is composed of cellular and matrix rich areas. Cellular areas are made up of so called "chondroblasts": 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 "chicken wire". Matrix rich areas are composed of different types of matrix: chondroid, osteoid, fibrous and rarely mature hyaline cartilage. Mitoses, always typical, can be quite frequent, especially in the cellular areas.
Immunohistochemical stainings show reactivity of the neoplastic cells for S-100 DOG1 (focal) 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.
Atlas Image
Histological features of chondroblastoma.
Figure 4: The cellular areas are made up of polygonal cells with scattered multinucleated giants cells (Haematoxylin-Eosin stain).
Figure 5: The polygonal cells are positive for S-100 immunostain.

Figure 6: The polygonal lesional cells are focally positive for DOG1


Simple curettage is the standard treatment.


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.


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.



Recently a specific driver mutation in the histone 3 gene H3F3B (K36M), was identified in approximately 95% of chondroblastomas. H3F3B mutation detection can be used as a diagnostic tool for the distinction of chondroblastoma from other giant cell-containing tumors. The mutation can be detected using a mutation specific antibody for the K36M mutation.


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.


Pubmed IDLast YearTitleAuthors
268445332016The H3F3 K36M mutant antibody is a sensitive and specific marker for the diagnosis of chondroblastoma.Amary MF et al
241627392013Distinct H3F3A and H3F3B driver mutations define chondroblastoma and giant cell tumor of bone.Behjati S et al
30475951988Chondroblastoma of the temporal bone.Blaauw G et al
40237291985Chondroblastoma: a clinical and radiological study of 104 cases.Bloem JL et al
34172891988Chondroblastoma: an immunohistochemical study.Brecher ME et al
84025631993Biologic and clinical significance of cytogenetic and molecular cytogenetic abnormalities in benign and malignant cartilaginous lesions.Bridge JA et al
92294171997Benign 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 et al
126061372003Cytogenetic findings in benign cartilaginous neoplasms.Buddingh EP et al
14499411992Epiphyseal chondroblastoma of bone. Long-term effects on skeletal growth and articular function in 15 cases treated surgically.Caterini R et al
264023122016DOG1 expression in giant-cell-containing bone tumours.Cleven AH et al
264573572015Mutation Analysis of H3F3A and H3F3B as a Diagnostic Tool for Giant Cell Tumor of Bone and Chondroblastoma.Cleven AH et al
4980161979Cytophotometric studies of the nuclear DNA content in cartilaginous tumors.Cuvelier CA et al
13842281992Chondroblastoma of bone. A clinical, radiological, light and immunohistochemical study.Edel G et al
35884001987Histology and biology of metastatic chondroblastoma. Report of a case with a review of the literature.Kunze E et al
21976121990Chondroblastoma of bone.Kurt AM et al
17289441992Human benign chondroblastoma with a pseudodiploid stemline characterized by a complex and balanced translocation.Mark J et al
80019221994Ultrastructural cytochemical demonstration of proteoglycans and calcium in the extracellular matrix of chondroblastomas.Mii Y et al
25790181985S-100 protein immunostaining in the differential diagnosis of chondroblastoma.Monda L et al
36281081987Radiologic case study. Chondroblastoma.Monticciolo DL et al
32763871988Immunohistochemical distribution of S-100 protein in tumors and tumor-like lesions of bone and cartilage.Okajima K et al
84647741993Chondroblastoma.Pflueger P et al
128854592003Updates on the cytogenetics and molecular genetics of bone and soft tissue tumors: osteosarcoma and related tumors.Sandberg AA et al
86497391996Benign cartilage tumors.Scarborough MT et al
16920051990Cytokeratin expression in chondroblastomas.Semmelink HJ et al
39979271985Chondroblastoma. A review of seventy cases.Springfield DS et al
117933712002Correlation between clinicopathological features and karyotype in 100 cartilaginous and chordoid tumours. A report from the Chromosomes and Morphology (CHAMP) Collaborative Study Group.Tallini G et al
82534611993Chondroblastoma.Turcotte RE et al
15147551992Chondroblastoma of the temporal bone. Case report and literature review.Varvares MA et al
82844011994Chondroblastoma: classic and confusing appearance at MR imaging.Weatherall PT et al

External Links


Arjen Cleven ; Judith Bovée

Bone: Chondroblastoma

Atlas Genet Cytogenet Oncol Haematol. 2017-11-01

Online version:

Historical Card

2003-07-01 Bone: Chondroblastoma by  Salvatore Romeo,Pancras CW Hogendoorn 

Leiden University Medical Center, P.O. box 9600, L1-Q, 2300 RC Leiden, The Netherlands