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Samargandi R, Bafail A, Le Nail LR, Berhouet J. Comprehensive Insights into Chondroblastoma Metastasis: Metastatic Patterns and Therapeutic Approaches. Cancers (Basel) 2024; 16:2283. [PMID: 38927987 PMCID: PMC11201376 DOI: 10.3390/cancers16122283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 06/19/2024] [Accepted: 06/19/2024] [Indexed: 06/28/2024] Open
Abstract
Chondroblastoma metastasis, though rare, represents a clinically significant and notably important aspect of bone tumors. Understanding its epidemiological characteristics, pathological features, and treatment modalities, despite its infrequency, is imperative for comprehensive patient management. This review aims to elucidate the epidemiology, molecular mechanisms, diagnostic challenges, and therapeutic strategies associated with chondroblastoma metastasis. The patterns, prognostic factors, and treatment outcomes were explored through an analysis of case studies and clinical reports. Notably, we highlighted emerging therapeutic perspectives aimed at improving patient outcomes. To the best of our knowledge, there has been no previous review addressing these matters cumulatively, highlighting a significant gap in the existing scholarly literature. By shedding light on the nuances of chondroblastoma metastasis, this review contributes to the advancement of knowledge in this field and informs clinical decision-making for improved patient care.
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Affiliation(s)
- Ramy Samargandi
- Service de Chirurgie Orthopédique et Traumatologique, Centre Hospitalier Régional Universitaire (CHRU) de Tours, 1C Avenue de la République, 37170 Chambray-les-Tours, France; (L.-R.L.N.); (J.B.)
- Department of Orthopedic Surgery, Faculty of Medicine, University of Jeddah, Jeddah 23218, Saudi Arabia
| | - Abrar Bafail
- Service de Médecine Nucléaire, Centre Hospitalier Régional Universitaire (CHRU) de Tours, 1C Avenue de la République, 37170 Chambray-les-Tours, France;
| | - Louis-Romée Le Nail
- Service de Chirurgie Orthopédique et Traumatologique, Centre Hospitalier Régional Universitaire (CHRU) de Tours, 1C Avenue de la République, 37170 Chambray-les-Tours, France; (L.-R.L.N.); (J.B.)
| | - Julien Berhouet
- Service de Chirurgie Orthopédique et Traumatologique, Centre Hospitalier Régional Universitaire (CHRU) de Tours, 1C Avenue de la République, 37170 Chambray-les-Tours, France; (L.-R.L.N.); (J.B.)
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Samargandi R, Bernard M, Miquelestorena-Standley E, Nail LRL. Efficacy of denosumab treatment for lung metastasis secondary to proximal humerus chondroblastoma. Saudi Med J 2024; 45:633-638. [PMID: 38830665 PMCID: PMC11147590 DOI: 10.15537/smj.2024.45.6.20230720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 04/18/2024] [Indexed: 06/05/2024] Open
Abstract
Chondroblastoma is a rare benign cartilaginous tumor that accounts for approximately 1% of bone tumors, but it can be associated with lung metastasis in extremely rare cases, leading to a poor prognosis and death. Herein, we report the case of a 19-year-old male patient who presented with an aggressive chondroblastoma of the proximal humerus and bilateral lung metastasis. The patient was treated with wide local resection, partial metastasectomy, and denosumab. Denosumab treatment was effective in controlling metastatic progression and preventing local recurrence.
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Affiliation(s)
- Ramy Samargandi
- From the Department of Orthopedic Surgery and Traumatology (Samargandi, Bernard, Le Nail); from the Department of pathology (Miquelestorena-Standley), Tours Regional University Hospital, Tours, France, and from the Department of Orthopedic Surgery (Samargandi), Faculty of Medicine, University of Jeddah, Jeddah, Kingdom of Saudi Arabia.
| | - Mathilde Bernard
- From the Department of Orthopedic Surgery and Traumatology (Samargandi, Bernard, Le Nail); from the Department of pathology (Miquelestorena-Standley), Tours Regional University Hospital, Tours, France, and from the Department of Orthopedic Surgery (Samargandi), Faculty of Medicine, University of Jeddah, Jeddah, Kingdom of Saudi Arabia.
| | - Elodie Miquelestorena-Standley
- From the Department of Orthopedic Surgery and Traumatology (Samargandi, Bernard, Le Nail); from the Department of pathology (Miquelestorena-Standley), Tours Regional University Hospital, Tours, France, and from the Department of Orthopedic Surgery (Samargandi), Faculty of Medicine, University of Jeddah, Jeddah, Kingdom of Saudi Arabia.
| | - Louis Romée Le Nail
- From the Department of Orthopedic Surgery and Traumatology (Samargandi, Bernard, Le Nail); from the Department of pathology (Miquelestorena-Standley), Tours Regional University Hospital, Tours, France, and from the Department of Orthopedic Surgery (Samargandi), Faculty of Medicine, University of Jeddah, Jeddah, Kingdom of Saudi Arabia.
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Miyagawa K, Enomoto T, Morishita T, Aoki M, Nonaka M, Abe H, Nabeshima K, Inoue T. Functional Prognosis following Temporal Bone Chondroblastoma Resection: A Systematic Review and A Case Illustration. World Neurosurg 2021; 158:e287-e297. [PMID: 34737097 DOI: 10.1016/j.wneu.2021.10.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 10/25/2021] [Accepted: 10/26/2021] [Indexed: 11/15/2022]
Affiliation(s)
- Ken Miyagawa
- Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Toshiyuki Enomoto
- Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
| | - Takashi Morishita
- Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Mikiko Aoki
- Department of Pathology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Masani Nonaka
- Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Hiroshi Abe
- Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Kazuki Nabeshima
- Department of Pathology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Tooru Inoue
- Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
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Bae H, Ryu DM, Kim HK, Hong SO, Lee HW, Shin Y, Jee YJ. A large invasive chondroblastoma on the temporomandibular joint and external auditory canal: a case report and literature review. Maxillofac Plast Reconstr Surg 2021; 43:26. [PMID: 34259979 PMCID: PMC8280261 DOI: 10.1186/s40902-021-00313-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 07/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chondroblastomas, which account for approximately 1% of all bone tumors, typically occur in long bones, such as the femur, humerus, and tibia. However, in extremely rare cases, they may also occur in the craniofacial region where the tumor is often found in the squamous portion of the temporomandibular joint (TMJ) and in the temporal bone. CASE PRESENTATION This case report describes a large chondroblastoma (diameter, approximately 37 mm) that occurred in the TMJ. The tumor was sufficiently aggressive to destroy the TMJ, mandibular condyle neck, external auditory canal (EAC), mandibular fossa of the temporal bone, and facial nerve. The tumor was completely excised using a pre-auricular approach. The EAC and surgical defect were successfully reconstructed using a temporoparietal fascia flap (TPFF) and an inguinal free fat graft. There was no local tumor recurrence at the 18-month follow-up visits. However, the patient developed sensory neural hearing loss, and his eyebrow paralysis worsened, eventually requiring plastic surgery. CONCLUSION Large, invasive chondroblastomas of the TMJ can be completely removed through a pre-auricular approach, and the resulting surgical defect can be reconstructed using TPFF and free fat grafts. However, preoperative evaluation of the facial nerve and auditory function is necessary. Therefore, a multidisciplinary approach is essential.
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Affiliation(s)
- Heeyeon Bae
- Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gang-dong, #892 Dongnam-ro, Gangdong-gu, Seoul, 05278, Republic of Korea.
| | - Dong-Mok Ryu
- Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gang-dong, #892 Dongnam-ro, Gangdong-gu, Seoul, 05278, Republic of Korea.,Department of Oral and Maxillofacial Surgery, College of Dentistry, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| | - Hyung Kyung Kim
- Department of Pathology, Kyung Hee University Hospital at Gang-dong, Seoul, Republic of Korea
| | - Sung-Ok Hong
- Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gang-dong, #892 Dongnam-ro, Gangdong-gu, Seoul, 05278, Republic of Korea
| | - Hyen Woo Lee
- Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gang-dong, #892 Dongnam-ro, Gangdong-gu, Seoul, 05278, Republic of Korea
| | - Youngjin Shin
- Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gang-dong, #892 Dongnam-ro, Gangdong-gu, Seoul, 05278, Republic of Korea
| | - Yu-Jin Jee
- Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gang-dong, #892 Dongnam-ro, Gangdong-gu, Seoul, 05278, Republic of Korea. .,Department of Oral and Maxillofacial Surgery, College of Dentistry, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea.
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Wu Y, Guan J, Zhang K, Chen H, Wu W, Zhang J. Rare chondroblastoma of the 6th left rib, video-assisted thoracoscopy resected: one case report and literature review. J Cardiothorac Surg 2021; 16:192. [PMID: 34233697 PMCID: PMC8265116 DOI: 10.1186/s13019-021-01572-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 06/28/2021] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Chondroblastoma is a rare, benign locally but aggressive bone tumor. It accounts for < 1% of primary bony tumors, and mostly arises from long bones; the rib chondroblastoma is especial rare. Due to its rarity, there are no definitive or standard treatment guidelines. CASE PRESENTATION A case of a 24-year-old male with a chondroblastoma located on the 6th posterior left rib. Computed tomography (CT) demonstrated a rib tumor that was a well-defined oval lesion of 20 mm × 18 mm, with lytic bone destruction. The imaging first diagnosis was Langerhans cell histiocytosis (LCH), a giant cell tumor, or other type of neoplasm. The whole tumor and a part of partial rib were resected by video-assisted thoracoscopy surgery (VATS). Pathological and immunohistochemical (IHC) examination made a diagnosis of chondroblastoma. Compared with traditional open thoracic surgery, VATS can achieve the same effects and cause less injury to patient. No postoperative adjuvant therapy was given, and had followed up 23 months after surgery, there was no recurrence or metastasis. CONCLUSION Chondroblastoma has a risk of recurrence and metastasis, surgery plays an important role in the treatment of chondroblastoma, VATS can achieve the same outcome as traditional open thoracic surgery with less pain and lung function. Close follow-up is needed postoperative.
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Affiliation(s)
- Yonghui Wu
- Department of Cardiothoracic Surgery, the Third Affiliated Hospital of Sun Yat-Sen University, No.600 Tianhe Road, Guangzhou, China
| | - Jiexia Guan
- Department of Pathology, The Third Affiliated Hospital of Sun Yat-Sen University, No. 600 Tianhe Road, Guangzhou, China
| | - Kai Zhang
- Department of Cardiothoracic Surgery, the Third Affiliated Hospital of Sun Yat-Sen University, No.600 Tianhe Road, Guangzhou, China
| | - Huiguo Chen
- Department of Cardiothoracic Surgery, the Third Affiliated Hospital of Sun Yat-Sen University, No.600 Tianhe Road, Guangzhou, China
| | - Weibin Wu
- Department of Cardiothoracic Surgery, the Third Affiliated Hospital of Sun Yat-Sen University, No.600 Tianhe Road, Guangzhou, China
| | - Jian Zhang
- Department of Cardiothoracic Surgery, the Third Affiliated Hospital of Sun Yat-Sen University, No.600 Tianhe Road, Guangzhou, China.
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Chondroblastoma Expresses RANKL by RNA In Situ Hybridization and May Respond to Denosumab Therapy. Am J Surg Pathol 2021; 44:1581-1590. [PMID: 32826531 DOI: 10.1097/pas.0000000000001568] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Lesions of bone featuring osteoclast-like giant cells comprise a diverse group of entities, including giant cell tumor (GCT) of bone, chondroblastoma, and aneurysmal bone cyst, among others. The receptor activator of nuclear factor-κB ligand (RANKL) has been implicated in the pathogenesis of GCT of bone and may play a role in the pathogenesis of other giant cell-rich lesions as well. In addition, RANKL inhibitors (denosumab) have also been shown to have some efficacy in treating some giant cell-rich lesions. Herein, we examine RANKL expression by RNA in situ hybridization in a total of 84 osseous lesions with a focus on chondroblastoma, GCT, fibrous dysplasia, and aneurysmal bone cyst. The lesions were tested for RANKL expression using a chromogenic RNA in situ hybridization assay. RANKL expression was identified in 24/25 (96%) GCT, 24/26 (92%) chondroblastomas, 6/7 (86%) aneurysmal bone cysts, and 3/16 (19%) patients with fibrous dysplasia. RANKL expression was statistically lower in chondroblastoma and aneurysmal bone cyst compared with GCT. RANKL reactivity in fibrous dysplasia was exclusively seen in the 3 cases with osteoclast-type giant cells. Our results indicate a high proportion of chondroblastomas, GCTs, and aneurysmal bone cysts express RANKL while reactivity in fibrous dysplasia is dependent on the presence of osteoclast-type giant cells. On the basis of the success of denosumab therapy for GCTs, our results indicate that it may be a potential therapeutic option in other primary osseous tumors.
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Focaccia M, Gambarotti M, Hakim R, Paioli A, Cesari M, Spazzoli B, Spinnato P, Donati D, Rocca M, Longhi A. Chondroblastoma's Lung Metastases Treated with Denosumab in Pediatric Patient. Cancer Res Treat 2020; 53:279-282. [PMID: 32777878 PMCID: PMC7812007 DOI: 10.4143/crt.2020.384] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 08/05/2020] [Indexed: 12/15/2022] Open
Abstract
Chondroblastoma is a rare benign chondrogenic tumor that occurs in skeletally immature patients between ages 10 and 20 years old. In literature are reported few cases of lung metastases, mainly occurred after surgery or local recurrences. There is no evidence on the pathogenesis of lung metastasis, as well as pulmonary disease course. Few treatments for metastases with aggressive behavior were based on chemotherapy regimen employed in other sarcoma with no results or not satisfying ones. Denosumab is approved for treatment of giant cell tumors and it is under investigation for other giant cell-rich bone tumors. Here, we report a case of a 16-year-old male chondroblastoma of the left humerus with bilateral lung metastases at presentation and progressing during follow-up, treated with denosumab for almost 2 years. We confirm that denosumab treatment can be effective in controlling chondroblastoma metastasis and it has been a safe procedure in an adolescent patient.
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Affiliation(s)
- Marco Focaccia
- Orthopedic Division, IRCCS, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Marco Gambarotti
- Department of Pathology, IRCCS, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Rossella Hakim
- Chemotherapy Division, IRCCS, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Anna Paioli
- Chemotherapy Division, IRCCS, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Marilena Cesari
- Chemotherapy Division, IRCCS, Istituto Ortopedico Rizzoli, Bologna, Italy
| | | | - Paolo Spinnato
- Department of Radiology, IRCCS, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Davide Donati
- Orthopedic Division, IRCCS, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Michele Rocca
- General Surgery Division, IRCCS, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Alessandra Longhi
- Chemotherapy Division, IRCCS, Istituto Ortopedico Rizzoli, Bologna, Italy
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Functional treatment of temporal bone chondroblastoma: retrospective analysis of 3 cases. Eur Arch Otorhinolaryngol 2020; 278:1271-1276. [PMID: 32661717 DOI: 10.1007/s00405-020-06203-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 07/08/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To describe and analyse functional treatment of temporal bone chondroblastoma (TBCh). METHODS From January 2000 to June 2019, at the Department of Otorhinolaryngology, Hôpital Lariboisière, Paris, France, patients with TBCh were enrolled in this study. All cases routinely performed pre-operatory work-up including evaluation of performance status, audio-vestibular function test, ear endoscopy, contrasted CT scan and MRI of head and neck region; in one case we also performed an angio-CT scan. All patients underwent resection of the tumour with a "functional" approach RESULTS: Three male patients (mean age 46,6 years)-two primary tumours and one recurrence-were treated. In all three cases the tumour invaded the middle ear with a variable degree of hearing loss and infiltration of temporal bone structures. All surgeries were performed with a microscopic approach associated with open/endoscopic approach when necessary. Inner ear and facial nerve were speared in all cases and the TMJ was partially resected in 2 cases due to its moderate involvement. At present, after a mean follow-up of 103 months (range 40-225 months), only one case presented recurrence which has been successfully treated with radiotherapy. CONCLUSIONS Our results of treatment suggest that functional surgery can be relevant in the management of TBCh since it is focused on both treatment of this pathology and maintenance of a good quality of life.
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Muhammed A, Meshneb M, Saro H, Elnakib N, Elnakib E. Management of cranial chondroblastoma in adults; a pooled analysis. Am J Otolaryngol 2020; 41:102486. [PMID: 32305254 DOI: 10.1016/j.amjoto.2020.102486] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 04/04/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Chondroblastoma is a rare bone tumour that often affects children more than adults. The adult cranial affection is a unique presentation of the disease (less than 2%) that mandates specific management. Through this pooled-analysis, we aimed to examine this disease group and obtain reliable scientific conclusions. METHODS The literature was searched for case-reports of cranial chondroblastoma. Afterwards, a pooled analysis was done for the selected articles. The data in question were the patient's age, gender, disease site, modalities of treatment, disease control, salvage treatment, and disease-specific survival. RESULTS 122 case reports were retrieved from the literature. The median age at diagnosis was 38.5 years. Up to the moment, the standard of care remains complete resection. The relapse-free survival was 29.5 months, with a three-year relapse rate of 9% and disease-specific mortality of 0%. Most of the relapses were salvaged excellently with excision. The strongest predictor for relapse was the post-resection residual disease, with three-years relapse rates of 23.8% and 2.4% for positive and negative residuals, respectively. Adjuvant Radiotherapy failed to improve the relapse rates. CONCLUSION Complete surgical excision is the standard of care. Post-surgical residual is the only adverse prognostic factor that predicts poor disease control.
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Affiliation(s)
- Amr Muhammed
- Clinical Oncology Department, Sohag University Hospital, Egypt.
| | | | - Hossam Saro
- Clinical Radiology department, Sohag University Hospital, Egypt
| | | | - Esraa Elnakib
- Clinical Oncology Department, Sohag University Hospital, Egypt
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Temporal Bone Chondroblastoma: Systematic Review of Clinical Features and Outcomes. World Neurosurg 2020; 142:e260-e270. [PMID: 32603862 DOI: 10.1016/j.wneu.2020.06.192] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/22/2020] [Accepted: 06/23/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Chondroblastoma is an uncommon benign neoplasm of cartilaginous origin usually involving the long bones. The temporal bone is a rare location for this tumor. The clinical profile, optimal medical and surgical management, and outcomes of treatment for temporal bone chondroblastoma remain unknown. METHODS We performed a systematic review of the SCOPUS, PubMed, and CENTRAL databases for case reports and case series on patients with histopathologically proven temporal bone chondroblastoma. Data on demographics, clinical manifestation, surgical management, adjuvant treatment, and outcome on last follow-up were collected. RESULTS A total of 100 cases were reported in the literature, including one described in the current study. The mean age of patients was 42.3 years (range, 2-85 years), with a slight male predilection (1.3:1). The most common clinical manifestations were otologic symptoms (e.g., hearing loss [65%], tinnitus, and otalgia) and a palpable mass. Surgical excision was performed in all cases, with gross total excision achieved in 58%. Radiation therapy was performed in 18% of cases, mostly as adjuvant treatment after subtotal excision. There were no deaths at a median follow-up of 2 years. Among the patients with detailed status on follow-up, 58% had complete neurologic recovery, 38% had partial recovery, and 4% had progression of symptoms as a result of tumor recurrence. CONCLUSIONS Temporal bone chondroblastoma has a distinct clinical profile from chondroblastoma of long bones. Surgery is the mainstay of treatment, and radiation therapy may be given after subtotal excision. Outcomes are generally favorable after treatment.
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