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Agarwal S, Shirodkar K, Hussein M, Henderson R, Kanani A, Vaiyapuri S, Botchu R. Test yourself answer: Left knee pain in a young adult. Skeletal Radiol 2024:10.1007/s00256-024-04750-z. [PMID: 39031178 DOI: 10.1007/s00256-024-04750-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 07/09/2024] [Accepted: 07/11/2024] [Indexed: 07/22/2024]
Affiliation(s)
- S Agarwal
- Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Bristol Road South, Northfield, Birmingham, UK
| | - K Shirodkar
- Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Bristol Road South, Northfield, Birmingham, UK
| | - M Hussein
- Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Bristol Road South, Northfield, Birmingham, UK
| | - R Henderson
- Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Bristol Road South, Northfield, Birmingham, UK
| | - A Kanani
- Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Bristol Road South, Northfield, Birmingham, UK
| | - S Vaiyapuri
- Department of Musculoskeletal Pathology, University Hospitals of Birmingham, Birmingham, UK
| | - R Botchu
- Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Bristol Road South, Northfield, Birmingham, UK.
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Guillois C, Yang S, Biau D, Feydy A, Larousserie F. Periosteal chondroblastoma of the femoral neck: two cases and a review of the literature. Skeletal Radiol 2024; 53:1003-1009. [PMID: 37733062 DOI: 10.1007/s00256-023-04440-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 08/12/2023] [Accepted: 08/26/2023] [Indexed: 09/22/2023]
Abstract
Chondroblastoma is a rare benign cartilaginous tumor mostly confined to the epiphyses and apophyses. Cases outside the epiphyseal region are exceedingly rare. Extramedullary chondroblastomas are exceptional; to our knowledge, only two cases qualified as "periosteal chondroblastoma" have been described in the literature. We report two cases of metaphyseal periosteal chondroblastoma both located on the inferior surface of the femoral neck. Both cases were paucicellular with an unusual dense sclerotic reaction. The diagnosis of chondroblastoma was supported by the expression of histone 3.3, K36M mutant in tumor cells.
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Affiliation(s)
| | - Sisi Yang
- Service de Radiologie, Hôpital Cochin, AP-HP, Paris, France
| | - David Biau
- Service de Chirurgie Orthopédique, Hôpital Cochin, AP-HP, Paris, France
- Université Paris Cité, Paris, France
| | - Antoine Feydy
- Service de Radiologie, Hôpital Cochin, AP-HP, Paris, France
- Université Paris Cité, Paris, France
| | - Frédérique Larousserie
- Service de Pathologie, Hôpital Cochin, AP-HP, Paris, France.
- Université Paris Cité, Paris, France.
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3
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Radzinsky E, Bateni C, Theriault R, Thorpe SW, Bindra J. A rare case of chondroblastoma involving the distal phalanx of the ring finger. Radiol Case Rep 2023; 18:2441-2446. [PMID: 37235079 PMCID: PMC10206382 DOI: 10.1016/j.radcr.2023.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/10/2023] [Accepted: 04/12/2023] [Indexed: 05/28/2023] Open
Abstract
Chondroblastoma, a rare benign bone tumor, is typically found in the epiphysis of long bones, with hand involvement being particularly uncommon. We present a case of an 11-year-old female with chondroblastoma involving the fourth distal phalanx of the hand. Imaging revealed a lytic, expansile lesion with sclerotic margins and no soft tissue component. A preoperative differential diagnosis included intraosseous glomus tumor, epidermal inclusion cyst, enchondroma, and chronic infection. The patient underwent open surgical biopsy and curettage for both diagnostic and treatment purpose. The final histopathologic diagnosis was chondroblastoma.
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Affiliation(s)
- Ethan Radzinsky
- Department of Radiology, University of California Davis School of Medicine, 4860 Y St. Suite 3100 Sacramento, CA 95817, USA
| | - Cyrus Bateni
- Department of Radiology, University of California Davis School of Medicine, 4860 Y St. Suite 3100 Sacramento, CA 95817, USA
| | - Raminta Theriault
- Department of Orthopedic Surgery, University of California Davis School of Medicine, CA, USA
| | - Steven W Thorpe
- Department of Orthopedic Surgery, University of California Davis School of Medicine, CA, USA
| | - Jasjeet Bindra
- Department of Radiology, University of California Davis School of Medicine, 4860 Y St. Suite 3100 Sacramento, CA 95817, USA
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Ma JL, Wu Y, Wen JX, Zhong ZW, Yu BH, Liu C, Cao L, Sun T, Han SM, Gao BL, Wu WJ. Images of giant cell tumor and chondroblastoma around the knee: retrospective analysis of 99 cases. Quant Imaging Med Surg 2023; 13:787-800. [PMID: 36819259 PMCID: PMC9929425 DOI: 10.21037/qims-22-616] [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: 06/16/2022] [Accepted: 11/30/2022] [Indexed: 01/05/2023]
Abstract
Background It is difficult to differentiate giant cell tumors of the bone (GCTB) from chondroblastoma around the knee based on imaging findings. This study analyzed the imaging features of these 2 diseases for better differentiation. Methods This retrospective cross-sectional cohort study reviewed data of patients with pathologically confirmed GCTB (n=81; age 15-75 years; median age 33 years) and chondroblastoma (n=18; age 12-34 years; median age 14 years). In all, 18 imaging signs were analyzed. Results Patients with chondroblastoma were relatively younger than those with GCTB. On imaging, lesion length was significantly (P<0.00001) smaller in chondroblastoma [range, 15.80-78.30 mm; mean ± standard deviation (SD) 34.15±18.24 mm; 95% confidence interval (CI): 24.05-44.25 mm] than in GCTB [range, 30.10-117.50 mm; mean ± SD 59.73±15.28 mm; 95% CI: 56.24-63.22 mm]. Significantly more (P<0.05) chondroblastoma lesions had calcification (76.5% vs. 1.3%), lobulation (77.8% vs. 32.1%), and swelling range >15 mm (84.6% vs. 41.1%) than did GCTB lesions, whereas significantly more (P<0.05) GCTB lesions were greater than half the host bone diameter (74.1% vs. 16.7%) and had a lesion long axis that was consistent with that of the host bone (98.8% vs. 27.8%). There were no significant differences (P>0.05) between the 2 tumors in the remaining 11 imaging signs. Conclusions A narrow zone of transition, intratumor calcification, lobulation, tumor transverse diameter greater than the bone diameter, maximum lesion length, consistency between the tumor and bone long axes, and edema range around the lesion >15 mm are parameters that can be used to differentiate GCTB from chondroblastoma around the knee.
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Affiliation(s)
- Jie-Lin Ma
- Department of Oncology, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yuan Wu
- Hebei Provincial Gucheng Hospital, Hengshui, China
| | - Jin-Xu Wen
- Department of Radiology, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Zhi-Wei Zhong
- Department of Radiology, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Bao-Hai Yu
- Department of Radiology, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Chang Liu
- Department of Radiology, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Lei Cao
- Department of Radiology, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Tao Sun
- Department of Bone and Soft Tissue Tumors, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Shu-Man Han
- Department of Radiology, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Bu-Lang Gao
- Department of Medical Research, Shijiazhuang People’s Hospital, Shijiazhuang, China
| | - Wen-Juan Wu
- Department of Radiology, The Third Hospital of Hebei Medical University, Shijiazhuang, China
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Chiesa MP, Thompson BM, Maciel N, Diaz D, Stoppiello P, Gaiero L, Bianchi G, Casales N, Silveri C, Belzarena AC. Metaphyseal chondroblastoma in a pediatric patient. Radiol Case Rep 2023; 18:1210-1216. [PMID: 36660567 PMCID: PMC9842802 DOI: 10.1016/j.radcr.2022.12.065] [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: 12/10/2022] [Accepted: 12/27/2022] [Indexed: 01/13/2023] Open
Abstract
Chondroblastoma is a rare, benign neoplasm usually located in the epiphyses and apophyses of the long bones in the immature skeleton. Radiologically, these tumors have a classic appearance of a lytic lesion with chondroid matrix surrounded by a thin sclerotic rim. Here, we describe the case of a 5-year-old male who presented with a chondroblastoma unusually located exclusively in the metaphyseal region, which led to an elusive diagnosis. The presence of tumors outlying the traditional location or epidemiological spectrum, along with the potential for histopathological misdiagnosis, can pose a diagnostic and therapeutic challenge for the treating team.
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Affiliation(s)
- Mauricio Paradeda Chiesa
- Unidad de Patología Oncológica Musculo Esquelética, Instituto Nacional de Ortopedia y Traumatología, Luis Alberto de Herrera 2226, Montevideo, Uruguay
| | - Breanna M. Thompson
- New York Institute of Technology, College of Osteopathic Medicine, 1855 Broadway, New York, NY 10023, USA
| | - Natalia Maciel
- Unidad de Patología Oncológica Musculo Esquelética, Instituto Nacional de Ortopedia y Traumatología, Luis Alberto de Herrera 2226, Montevideo, Uruguay
| | - Dilia Diaz
- Unidad de Patología Oncológica Musculo Esquelética, Instituto Nacional de Ortopedia y Traumatología, Luis Alberto de Herrera 2226, Montevideo, Uruguay
| | - Pablo Stoppiello
- Unidad de Patología Oncológica Musculo Esquelética, Instituto Nacional de Ortopedia y Traumatología, Luis Alberto de Herrera 2226, Montevideo, Uruguay
| | - Leticia Gaiero
- Unidad de Patología Oncológica Musculo Esquelética, Instituto Nacional de Ortopedia y Traumatología, Luis Alberto de Herrera 2226, Montevideo, Uruguay
| | - Gottardo Bianchi
- Unidad de Patología Oncológica Musculo Esquelética, Instituto Nacional de Ortopedia y Traumatología, Luis Alberto de Herrera 2226, Montevideo, Uruguay
| | - Nicolas Casales
- Unidad de Patología Oncológica Musculo Esquelética, Instituto Nacional de Ortopedia y Traumatología, Luis Alberto de Herrera 2226, Montevideo, Uruguay
| | - Claudio Silveri
- Unidad de Patología Oncológica Musculo Esquelética, Instituto Nacional de Ortopedia y Traumatología, Luis Alberto de Herrera 2226, Montevideo, Uruguay
- Corresponding author.
| | - Ana C. Belzarena
- Unidad de Patología Oncológica Musculo Esquelética, Instituto Nacional de Ortopedia y Traumatología, Luis Alberto de Herrera 2226, Montevideo, Uruguay
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6
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Chondroblastoma of the femoral neck presenting with pathologic fracture: a case report. CURRENT ORTHOPAEDIC PRACTICE 2021. [DOI: 10.1097/bco.0000000000000991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mu H, Jiang Y, Xue L, Hua Y, Lin J, Cai Z. H3.3 K36M Mutation as a Clinical Diagnosis Method of Suspected Chondroblastoma Cases. Orthop Surg 2021; 13:616-622. [PMID: 33620145 PMCID: PMC7957386 DOI: 10.1111/os.12878] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 10/09/2020] [Accepted: 10/26/2020] [Indexed: 12/29/2022] Open
Abstract
Objective Whether H3.3 K36M mutation (H3K36M) could be an approach if the diagnosis of chondroblastoma (CB) patients was indistinct and it was suspected to be unclear clinically. Methods We reviewed and compared our clinical experiences of CB cases and some suspected cases, which were not diagnosed distinctly, between 2013 to 2019. A total of 15 male and four female cases included in this study were seperated into two groups, CB group and suspected case (SC) group. The CB group included 13 men and 3 women, with an age range from 9 to 54 (mean age, 22 years old). The SC group included two men and one woman, with the age range from 13 to 25 (mean age, 19 years old). In both groups the patients had been followed‐up until December 2019 and none of the patients had prior treatment history. We evaluated the clinical complaints, radiological features, and clinical‐histological features of the cases and performed an immunohistochemical (IHC) study to detect whether the H3K36M expression of cases was different, consistent with a gene‐mutation analysis. Results In both groups, the radiologic features of both groups appeared as round low‐density shadow with a clear edge, pathologic features showed diffuse proliferation of neoplastic cells with multinuclear giant cells. The radiological tumor size of CB group and SC group showed little difference, which was about 29.0*21.6 mm. Clinical‐immunohistochemical features of both groups showed chondroid matrix inside with naïve tumor cells, multinucleated giant cells, and ground substance cells. Most of them showed chondro‐related antibody positive (12 cases) but some of them showed S‐100 negative (four cases). The clear difference of both groups was the result of H3K36M IHC study and gene analysis. In our cases, the CB group showed diffuse H3K36M positive and the SC group showed negative. The gene mutation analysis revealed that H3K36M‐positive CB patients had K36M mutation, which were not found in the SC group. Sanger sequencing showed an A > T substitution at codon 36 of histone H3F3B. No other types of histone H3 mutation was detected in the CB group. Particularly, one of the suspected cases showed a G34W mutation was confirmed to be a giant cell tumor of bone (GCTB). Conclusions Our study showed H3K36M immunohistochemistry and gene mutation analysis were specific clinical diagnostic tools to distinguish suspected CB from other giant cell‐rich or cartilage matrix‐diffuse bone tumors. The clinical‐radiological and histomorphological features of patients gave suggestions on whether the H3K36M IHC and gene analysis should be required.
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Affiliation(s)
- Haoran Mu
- Department of Orthopaedics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Bone Tumor Institution, Shanghai, China
| | - Yafei Jiang
- Department of Orthopaedics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Bone Tumor Institution, Shanghai, China
| | - Linghang Xue
- Department of Orthopaedics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Bone Tumor Institution, Shanghai, China
| | - Yingqi Hua
- Department of Orthopaedics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Bone Tumor Institution, Shanghai, China
| | - Jun Lin
- Departments of Pathology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhengdong Cai
- Department of Orthopaedics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Bone Tumor Institution, Shanghai, China
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Herget GW, Maier D, Südkamp NP, Uhl M, Füllgraf H, Dovi-Akue D. Anatomical Reconstruction of the Acromion Using an Autologous Iliac Crest Graft for Treatment of Recurrent Chondroblastoma: A Case Report. JBJS Case Connect 2020; 9:e0086. [PMID: 31469667 DOI: 10.2106/jbjs.cc.19.00086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
CASE A 38-year-old man presented with recurrent chondroblastoma of the acromion after primary curettage and bone grafting. The patient underwent revision surgery with resection of the acromion and reconstruction using an autologous iliac crest graft. He had regained normal shoulder function without recurrence at a follow-up of 17 months. CONCLUSIONS This case demonstrates a rare location of chondroblastoma and successful anatomical and functional reconstruction. The described surgical procedure could be considered for large tumorous lesions of the acromion, for which curettage would be insufficient, and to preserve and reconstruct a functionally intact shoulder girdle.
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Affiliation(s)
- Georg W Herget
- Department of Orthopaedics and Trauma Surgery, Medical Center, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Germany
| | - Dirk Maier
- Department of Orthopaedics and Trauma Surgery, Medical Center, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Germany
| | - Norbert P Südkamp
- Department of Orthopaedics and Trauma Surgery, Medical Center, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Germany
| | - Markus Uhl
- Department of Diagnostic and Therapeutic Radiology, St. Josefs Hospital Freiburg, Germany
| | - Hannah Füllgraf
- Department of Pathology, Medical Center Freiburg, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Germany
| | - David Dovi-Akue
- Department of Orthopaedics and Trauma Surgery, Medical Center, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Germany
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Abstract
An 11-year-old female was referred to physical therapy due to a 3-month history of right medial knee pain. The patient's medical diagnosis was Osgood-Schlatter disease, based on radiographs obtained at the initial pediatrician consultation. An MRI scan was obtained 2 weeks after starting physical therapy and revealed a bony lesion near the medial condyle of the right femur and damage to medial joint structures. Pathology after open biopsy and curettage of the lesion revealed a chondroblastoma. J Orthop Sports Phys Ther 2020;50(5):275. doi:10.2519/jospt.2020.9021.
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