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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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Tosyalı HK, Kaya H, Kececi B, Sabah D. Management of Chondroblastoma in Pediatric Patients: 21 Years of Single-Center Experience. CHILDREN (BASEL, SWITZERLAND) 2024; 11:672. [PMID: 38929251 PMCID: PMC11202176 DOI: 10.3390/children11060672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 05/22/2024] [Accepted: 05/29/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Chondroblastoma (CB), a rare benign bone tumor that produces chondrocytes, often develops in the epiphysis or apophysis of children and young adults. The treatment of these rare tumors is complex. The standard treatment protocol involves curettage with local adjuvants and bone graft or cement application. The authors examined 38 CBs to determine risk factors for local recurrence, complications, and functional outcomes following epiphyseal curettage. METHODS Twenty-two girls and sixteen boys aged 10 to 17 years with histologically confirmed chondroblastoma who arrived at our hospital between January 2000 and June 2021 were reviewed retrospectively. Clinical data, radiographic images, histological results, treatment, functional outcomes, and the local recurrence rate were examined-surgical treatment involved total tumor curettage, followed by bone grafting and adjuvant techniques. Local recurrences have also been reported. RESULTS The most frequently affected site was the proximal femur. Sites of involvement included the proximal femur in 10 (26.3%) cases, the proximal tibia in 8 (20.8%), the humerus in 5 cases (13.2%), the distal tibia in 4 cases (10.5%), the distal femur in 3 cases (7.9%), the supracetabular region in 3 cases (7.9%), the talus in 1 case (2.6%), the calcaneus in 1 case (2.6%), the scapula in 1 case (2.6%), the lumbar spine in 1 case (2.6%), and the iliac bone in 1 (2.6%) patient. The mean follow-up was 144.2 months (24 to 276). The local recurrence rate was 7.9%. The mean Musculoskeletal Tumor Society (MSTS) score was 28.3 points (17 to 30). The mean duration of symptoms at presentation was 5.8 (range, 1 to 28) months. CONCLUSION Aggressive curettage and bone grafting resulted in local control and good outcomes in most pediatric patients. In a relatively small proportion of cases, long-term complications and recurrence can occur due to growth plate damage and late diagnosis. In patients admitted to the pediatric clinic with pain, which is often accompanied by localized edema and joint effusion, early detection via advanced radiological scans (X-ray, CT, or MRI) may prevent delays in diagnosis.
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Affiliation(s)
- Hakan Koray Tosyalı
- Department of Orthopedics and Traumatology, Faculty of Medicine, Celal Bayar University, 45140 Manisa, Türkiye
| | - Hüseyin Kaya
- Department of Orthopedics and Traumatology, Faculty of Medicine, Ege University, 35040 Izmir, Türkiye; (H.K.); (B.K.); (D.S.)
| | - Burcin Kececi
- Department of Orthopedics and Traumatology, Faculty of Medicine, Ege University, 35040 Izmir, Türkiye; (H.K.); (B.K.); (D.S.)
| | - Dündar Sabah
- Department of Orthopedics and Traumatology, Faculty of Medicine, Ege University, 35040 Izmir, Türkiye; (H.K.); (B.K.); (D.S.)
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Tang L, Liu G, Li X, Zhang D. Chondroblastoma accompanied with aneurysmal bone cyst at the left distal femur. Asian J Surg 2023; 46:5139-5141. [PMID: 37423858 DOI: 10.1016/j.asjsur.2023.06.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 06/22/2023] [Indexed: 07/11/2023] Open
Affiliation(s)
- Lin Tang
- Department of Oncology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, 441000, China
| | - Gang Liu
- Department of Gynecology and Obstetrics, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, 441000, China
| | - Xuanyu Li
- Department of Gynecology and Obstetrics, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, 441000, China.
| | - Dongdong Zhang
- Department of Oncology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, 441000, China.
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Jagiella-Lodise O, McAleese T, Curtin M, Molloy A, Walsh J. Recurrent chondroblastoma of the talus: A case report and literature review of recurrent lesions in the foot and ankle. Int J Surg Case Rep 2023; 106:108192. [PMID: 37105027 PMCID: PMC10164886 DOI: 10.1016/j.ijscr.2023.108192] [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: 12/30/2022] [Revised: 04/06/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Chondroblastoma is a benign cartilaginous tumour that usually presents in the epiphysis of long bones in patients aged 10-20 years old. Only 4 % of primary chondroblastoma occur in the talus. Recurrence is rare, especially in the foot and ankle and there is no consensus regarding how it is best managed. This unique case and literature review add to a limited evidence base. CASE PRESENTATION A 21-year-old male was referred to our elective orthopaedic clinic with persistent anterior ankle pain exacerbated by weight-bearing. Radiographs and MRI revealed a 2.5 cm non-homogenous mass in the anteromedial talus with expansion of overlying bone consistent with chondroblastoma-ABC. Our patient was initially managed by intralesional curettage and autologous bone grafting but had recurrence 4.5 months postoperatively. Subsequent en bloc resection of the talar neck with talonavicular and calcaneocuboid joint fusion resulted in excellent functional outcomes and disease-free survival at 2 years follow-up. CLINICAL DISCUSSION There are few reports discussing treatment options for recurrence in the foot and ankle. Successful treatment of primary and recurrent lesions depends on complete local resection. Repeat curettage or en bloc resection are effective options depending on tumour size and location. Type of bone graft or void filler should be considered on a case-by-case basis. Novel therapies (e.g. phenol instillation) may be beneficial. CONCLUSION This case details successful management of recurrent chondroblastoma with en bloc resection of the talar neck and hindfoot reconstruction. We review the efficacy and outcomes of all previously reported recurrent chondroblastoma in the foot and ankle. We highlight multiple potential treatment options.
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Affiliation(s)
| | | | - Mark Curtin
- Department of Orthopaedics, Beaumont Hospital, Dublin, Ireland
| | - Alan Molloy
- Department of Orthopaedics, Cappagh National Orthopaedic Hospital, Dublin, Ireland
| | - James Walsh
- Department of Orthopaedics, Beaumont Hospital, Dublin, Ireland; Department of Orthopaedics, Cappagh National Orthopaedic Hospital, Dublin, Ireland
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Chalamgari A, Valle D, Palau Villarreal X, Foreman M, Liu A, Patel A, Dave A, Lucke-Wold B. Vertebral Primary Bone Lesions: Review of Management Options. Curr Oncol 2023; 30:3064-3078. [PMID: 36975445 PMCID: PMC10047554 DOI: 10.3390/curroncol30030232] [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: 02/04/2023] [Revised: 02/26/2023] [Accepted: 03/03/2023] [Indexed: 03/08/2023] Open
Abstract
The assessment and treatment of vertebral primary bone lesions continue to pose a unique yet significant challenge. Indeed, there exists little in the literature in the way of compiling and overviewing the various types of vertebral lesions, which can often have complicated intervention strategies. Given the severe consequences of mismanaged vertebral bone tumors-including the extreme loss of motor function-it is clear that such an overview of spinal lesion care is needed. Thus, in the following paper, we aim to address the assessment of various vertebral primary bone lesions, outlining the relevant nonsurgical and surgical interventional methods. We describe examples of primary benign and malignant tumors, comparing and contrasting their differences. We also highlight emerging treatments and approaches for these tumors, like cryoablation and stereotactic body radiation therapy. Ultimately, we aim to emphasize the need for further guidelines in regard to correlating lesion type with proper therapy, underscoring the innate diversity of vertebral primary bone lesions in the literature.
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Affiliation(s)
| | | | | | | | | | | | | | - Brandon Lucke-Wold
- Department of Neurosurgery, University of Florida College of Medicine, Gainesville, FL 32601, USA
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Muratori F, Scanferla R, Roselli G, Frenos F, Campanacci DA. Long term outcome of surgical treatment of chondroblastoma: analysis of local control and growth plate/articular cartilage related complications. BMC Musculoskelet Disord 2023; 24:139. [PMID: 36814214 PMCID: PMC9945643 DOI: 10.1186/s12891-023-06239-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 02/10/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Chondroblastoma (CBL) is a rare benign chondroid producing bone tumor that typically occurs in epiphysis or apophysis of growing children and young adults. Intralesional curettage is the treatment of choice, while resection is required in selected cases, even though the use of minimally invasive ablation techniques has been advocated. Authors reviewed a series of 75 CBLs with the aim of assess risk factors for local recurrence, the growth plate related complications after epiphyseal curettage and the risk of arthritis of the adjacent joint after epiphyseal curettage. METHODS We retrospectively review 69 CBLs treated with intralesional curettage and 6 treated with resection from March 1995 to February 2020. The median age was 18.8 years (7 to 42, median 16). The site was proximal humerus in 18 cases, proximal tibia in 17, distal femur in 16, talus in 6, femur's head in 4, calcaneus in 3, acromion in 3, trochanteric region in 2, distal tibia in 2, patella in 2, supracetabular region in 1 and distal humerus in 1 patient. RESULTS Mean follow-up was 124.2 months (24 to 322, median 116). Among patients treated with curettage, 7.3% of local recurrence was observed and 12 (17.4%) patients developed osteoarthritis of the adjacent joint. Five patients (7.3%) presented limb length discrepancy of the operated limb ranging from 0.5 to 2 cm. Recurrence free survival rate was 94.2% at 5 and 91.6% at 10 years. A mean Musculoskeletal Tumor Society (MSTS) of 29.3 points (20 to 30, median 30) was observed. CONCLUSION More than 90% of CBLs were successfully treated with aggressive curettage but segmental resection is required in selected cases. In a relatively small proportion of cases long term complications can occur due to growth plate damage or osteoarthritis. TRIAL REGISTRATION Retrospectively registered.
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Affiliation(s)
- Francesco Muratori
- Department of Orthopaedic Oncology and Reconstructive Surgery, AOU Careggi, Florence, Italy.
| | | | | | - Filippo Frenos
- Department of Orthopaedic Oncology and Reconstructive Surgery, AOU Careggi, Florence, Italy
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Sakamoto A, Noguchi T, Matsuda S. Reconstruction using low-porosity β-tricalcium phosphate for a chondroblastoma in the proximal humeral epiphysis. J Surg Case Rep 2022; 2022:rjac526. [PMID: 36479225 PMCID: PMC9722241 DOI: 10.1093/jscr/rjac526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 10/27/2022] [Indexed: 12/12/2022] Open
Abstract
Chondroblastoma is a locally aggressive tumor, commonly occurring in the epiphysis of long bones. Damage after curettage at the joint surface can occur. Low porosity β-tricalcium phosphate (β-TCP) blocks are characterized by their high compression resistance. Reconstruction in which low-porosity β-TCP blocks are used as a strut have been reported for bone tumors around the knee. In the current report, a 13-year-old female with a chondroblastoma that extended to the subchondral bone of the proximal humeral epiphysis was treated with curettage and strut reconstruction using low-porosity β-TCP blocks. The implanted β-TCP blocks were incorporated without damage or shoulder dysfunction. Application of the strut reconstruction method using low-porosity β-TCP blocks is suitable for a chondroblastoma of the epiphysis in the humerus.
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Affiliation(s)
- Akio Sakamoto
- Correspondence address. Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Shogoin, Kawahara-cho 54, Sakyo-ku, Kyoto 606-8507, Japan. Tel: +81-75-751-3366; Fax: +81-75-751-8409. E-mail:
| | - Takashi Noguchi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shuichi Matsuda
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Martin JR, Auran RL, Duran MD, de Comas AM, Jacofsky DJ. Management of Primary Aggressive Tumors of the Knee. J Knee Surg 2022; 35:585-596. [PMID: 35181876 DOI: 10.1055/s-0042-1743221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Primary bone sarcomas and aggressive benign bone tumors are relatively rare. It is essential to recognize features that are concerning for these aggressive tumors based on a patient's history, physical exam, and radiographs. Physicians and other health care providers should have a high suspicion for these tumors and promptly refer these patients to orthopaedic oncologists. A multidisciplinary, team-based approach is required to obtain an accurate diagnosis and provide comprehensive care. This review discussed the appropriate work-up, biopsy principles, relevant peri-operative medical management, and surgical treatment options for patients with aggressive primary bone tumors around the knee. Primary bone sarcomas (osteosarcoma and chondrosarcoma) and aggressive benign bone tumors (giant cell tumor, chondroblastoma, and chondromyxoid fibroma) that have a predilection to the distal femur and proximal tibia are the focus of this review.
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Affiliation(s)
- John R Martin
- Department of Orthopaedic Surgery, University of Arizona College of Medicine, Phoenix, Arizona
| | - Richard L Auran
- Department of Orthopaedic Surgery, University of Arizona College of Medicine, Phoenix, Arizona
| | - Michael D Duran
- The Center for Orthopedic Research and Eduction (CORE) Institute, Phoenix, Arizona
| | - Amalia M de Comas
- Department of Orthopaedic Surgery, University of Arizona College of Medicine, Phoenix, Arizona.,The Center for Orthopedic Research and Eduction (CORE) Institute, Phoenix, Arizona
| | - David J Jacofsky
- The Center for Orthopedic Research and Eduction (CORE) Institute, Phoenix, Arizona
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Ruiz Santiago F, Láinez Ramos-Bossini AJ, Martínez Martínez A, García Espinosa J. Chondroblastoma treatment by radiofrequency thermal ablation: Initial experience and implementation. Eur J Radiol 2021; 144:109950. [PMID: 34560504 DOI: 10.1016/j.ejrad.2021.109950] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 08/27/2021] [Accepted: 09/01/2021] [Indexed: 01/21/2023]
Abstract
PURPOSE To present our experience on the implementation of radiofrequency thermal ablation (RFA) for the treatment of chondroblastoma. MATERIALS AND METHODS This case series includes 12 patients (10 males) with chondroblastoma using RFA under CT guidance. Tumours were located in the humeral head (3), femoral head (2), distal femoral epiphysis (4), tibial epiphysis (2) and calcaneus (1). Tumour size ranged from 12 to 60 mm (median: 33 mm). According to tumour size and location, monopolar electrode's active tip ranged from 1 to 3 cm. Dry and perfused ablation mode was used to treat smaller (6) and larger (6) lesions, respectively. Cementation was also made in 5 cases. Technical success was considered if the tumour was treated according to the protocol and complete ablation was achieved. Clinical success was assessed according to a visual analogue scale. RESULTS Technical success was achieved in 11 of 13 cases (83%) afters the first treatment. After a second treatment in the 2 failed cases, pain control was achieved in all cases eventually (100% of clinical success). Follow-up MRI demonstrated resolution of oedema in all cases, as well as a necrotic area extending beyond the outer edge of the lesion in all cases except one. Radiography or CT showed stability of the lesions, with increased sclerosis and no cortex collapse. In one case, a 4 cm shortening of the humerus was observed at the end of skeletal development (7 years after treatment). In another case, early hip osteoarthritis was developed (15 years after treatment). No other long-term complications were observed. CONCLUSION Successful treatment of chondroblastoma can be achieved by RFA. Cementoplasty adds strength to the ablated bone in weight bearing areas. MRI hallmarks associated with clinical success were resolution of bone marrow edema, and area of necrosis extending beyond the tumour edge. Radiography and CT proved to be useful in demonstrating cortex integrity.
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Affiliation(s)
- Fernando Ruiz Santiago
- Department of Radiology and Physical Medicine, Hospital Virgen de las Nieves, University of Granada, Spain.
| | | | - Alberto Martínez Martínez
- Department of Radiology and Physical Medicine, Hospital Virgen de las Nieves, University of Granada, Spain
| | - Jade García Espinosa
- Department of Radiology and Physical Medicine, Hospital Virgen de las Nieves, University of Granada, Spain
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Primary Aneurysmal Bone Cyst and Its Recent Treatment Options: A Comparative Review of 74 Cases. Cancers (Basel) 2021; 13:cancers13102362. [PMID: 34068844 PMCID: PMC8153560 DOI: 10.3390/cancers13102362] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/09/2021] [Accepted: 05/11/2021] [Indexed: 12/12/2022] Open
Abstract
(1) Background: An aneurysmal bone cyst (ABC) is a benign, locally aggressive tumor. Different treatment modalities are described in the literature i.e., en bloc resection, intralesional curettage and percutaneous sclerotherapy. (2) Methods: This single-center study is a review of 74 patients with primary ABCs who underwent a surgical treatment or polidocanol instillation. Cyst volume measurements using MRI and conventional radiographs are compared. (3) Results: The mean pre-interventional MRI-based cyst volume was 44.07 cm3 and the mean radiographic volume was 27.27 cm3. The recurrence rate after intralesional curettage with the need for further treatment was 38.2% (13/34). The instillation of polidocanol showed a significant reduction of the initial cyst volume (p < 0.001) but a persistent disease occurred in 29/32 cases (90.6%). In 10 of these 29 cases (34.5%) further treatment was necessary. After en bloc resection (eight cases) a local recurrence occurred in two cases (25%), in one case with the need for further treatment. (4) Conclusions: MRI scans are superior to biplanar radiographs in the examination of ABCs. Sequential percutaneous instillations of polidocanol are equally effective in the therapy of primary ABCs compared to intralesional curettage. However, several instillations have to be expected. In a considerable number of cases, a conversion to intralesional curettage or en bloc resection may be necessary.
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