Chondroblastomas presenting in adulthood: a study of 39 patients with emphasis on histological features and skeletal distribution

Abstract

Aims Chondroblastomas (CB) are rare bone tumours that typically arise in the epiphysis/apophysis of long bones in skeletally immature patients. We explore the clinicopathological features of CB presenting in adults. Methods and results CB in patients ≥20 years of age were retrieved from our institutional archives. Thirty‐nine CB were identified (29 male/10 female; aged 20–54 years). Twenty (51%) cases occurred in long tubular bones, 10 (26%) in small bones of the feet, five (13%) in flat bones and four (10%) in the patella. All cases showed classic cytological features of CB, and chondroid matrix was universally present. Calcification was identified in 10 cases (26%), including various combinations of serpiginous (n = 7), punctate (n = 6), classic chicken‐wire (n = 4) and psammomatous (n = 2) patterns. Haemosiderin (n = 19), woven bone (n = 13), secondary aneurysmal bone cyst formation (n = 8), foamy macrophages (n = 4), hyalinised vascular spaces (n = 2) and cholesterol clefts (n = 2) were noted. Follow‐up information (n = 32, 1–452 months) revealed local recurrence in three patients, all >40 years of age with flat bone origin, one of which developed pulmonary metastases 132 months after initial diagnosis. Conclusions CB in patients >20 years of age more frequently involves the short bones of the hands/feet and flat bones compared to those arising in their younger counterparts. A subset may harbour extensive serpiginous or psammomatous calcification rather than the classic chicken‐wire pattern. Although the overall local recurrence rate in adulthood is approximately 10%, all three patients with recurrent disease had tumours involving flat bones, suggesting that tumours arising in these sites may behave more aggressively.

Clinicopathologic Analysis of Chondroblastoma in Adults: A Single-Institution Case Series

“…6 A recent study by John et al described the histologic features in a series of 39 patients. 7 Our findings demonstrated some overall similarities to the above studies (Table 4). In our case files, we found that a small subset of chondroblastoma (15%) occurred in skeletally mature individuals, the majority were younger than 40 years old, it was more common in men than women, and the tumors tended to involve the short bones of hands and feet more than the long tubular bones—common sites for the younger population.…”

“…From an anatomic perspective, we found that chondroblastomas of adults have a predilection for involvement of other unusual sites such as: vertebra, rib, and scapula, findings which were previously reported in both adult and younger populations. 6 -11 Chondroblastomas presenting in adult patients had similar clinical manifestations and radiologic findings to those presenting in younger individuals. Of note, perilesional bone marrow edema was common in our study (80%), similar to prior reports.…”

“…Our local recurrence rate was 17%, which is concordant with previously reported rates across all age groups (14% to 18%) as well as reports in other adult populations (13% to 18%; Table 4). 6,7,11 -13 One of the 2 recurrent cases was a tumor that presented in the thoracic vertebra. This patient had multiple recurrences raising the possibility that this may be related to incomplete surgical removal given the anatomic location.…”

Chondroblastoma’s Lung Metastases Treated with Denosumab in Pediatric Patient

“…Histologically, it's characterized by sheets of round to ovoid cells with well-defined cytoplasm borders and grooved nucleus, eosinophilic chondroid matrix, and osteoclast like giant cells [2]. Differential diagnosis includes primarily giant cell tumor of bone.…”

Utility of p63 in differentiating giant cell tumor from other giant cell-containing lesions

“…The presence of an open physis does not impede the tumor to involve the epiphyseal cartilage (12). On the other hand, CBL in adults more frequently involves the flat bones and short bones of the hands/feet with an aggressive behavior compared to children (13). As both the tumors are located in the epiphyseal region, absence of a chondroid matrix often causes confusion.…”