Benign chondroblastoma involving the mandibular condyle

Management of cranial chondroblastoma in adults; a pooled analysis

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.

Chondroblastoma of the Clivus: Case Report and Review

Background and Importance Chondroblastoma is a benign primary bone tumor that typically develops in the epiphyses of long bones. Chondroblastoma of the craniofacial skeleton is extremely rare, with most cases occurring in the squamosal portion of the temporal bone. In this report, we describe the first case of chondroblastoma of the clivus presenting with cranial neuropathy that was treated with endoscopic endonasal resection. We review the literature on craniofacial chondroblastomas with particular emphasis on extratemporal lesions.

Case Presentation A 27-year-old woman presented with severe headache, left facial dysesthesias, and diplopia. Physical examination revealed hypesthesia in the left maxillary nerve dermatome, and complete left abducens nerve palsy. Imaging demonstrated an expansile intraosseous mass originating in the upper clivus with extension superiorly into the sella turcica and laterally to involve the medial wall of the left cavernous sinus. The tumor was completely resected via an endoscopic endonasal approach, with postoperative improvement in lateral gaze palsy. Histopathology was consistent with chondroblastoma.

Conclusion Chondroblastoma is a rare tumor of the craniofacial skeleton that should be included in the differential diagnosis of an osteolytic lesion of the clivus. Complete surgical resection remains the mainstay of treatment.

Temporal Chondroblastoma with a Novel Chromosomal Translocation (2;5) (q33;q13)

The case of a 51-year-old man with a large temporal mass is presented. The mass eroded the floor of the middle fossa medially to the sphenoid sinus. A combined approach with neurosurgery and otolaryngology was performed to achieve maximal resection of the mass. Pathology was typical for chondroblastoma: a rare, benign but locally invasive chondroid tumor. Genetic testing revealed a translocation of (2;5) (q33;q13). This is a unique genetic mutation in all chondroid tumors to our knowledge. The diagnostic utility or role of this mutation in the pathobiology of this tumor remains to be determined.

Chondroblastoma of the temporal bone involving the temporomandibular joint, mandibular condyle, and middle cranial fossa: case report and review of the literature

Chondroblastoma is a highly destructive tumor, derived from immature cartilage cells, typically occurring in epiphyses of the long bones of adolescents and young adults. Those occurring in the temporal bone and TMJ area are likely to mimic TMJ symptoms. This report describes a unique case in which a chondroblastoma resulted in extensive destruction of the temporal bone, temporomandibular joint, mandibular condyle, and cranial base, including gross intracranial and extracranial involvement. With appropriate surgical management, the outcome for patients with chondroblastoma of the temporomandibular region is quite favorable. This case brings the total reported chondroblastomas to 59 in the temporal bone and eight in the mandibular condyle as of the date of submission of this article for publication.