What Is a Chondroblastoma?

Chondroblastoma is also called Codman tumor. Chondroblastoma is a benign tumor derived from juvenile chondrocytes (chondroblasts). The epiphysis located mainly at the end of the long bone. It usually develops in late childhood or adolescence.

Basic Information

nickname

Codman tumor

English name

chondroblastoma

Visiting department

Orthopedics, Oncology

Multiple groups

Male, male to female ratio is 2-3: 1

Common locations

Epiphysis of long bone

Common causes

Chondroblastoma is derived from embryonic cartilage and may be an anaplastic form of chondroblast

Common symptoms

The affected bone showed mild eccentric swelling, joint function may be limited, moderate joint effusion, serous-blood exudation, and muscle atrophy

Etiology of chondroblastoma

The etiology of chondroblastoma is not very clear. Some scholars believe that chondroblastoma originates from embryonic cartilage and may be an interstitial change of chondroblast.

Clinical manifestations of chondroblastoma

Occurs most often in men, with a male to female ratio of 2 to 3: 1. Most cases occur between the ages of 10 and 20. Due to its slow growth, symptoms can remain stable for several years after the tumor has developed, so it can be seen at the age of 25 to 30 years, but it originates from the skeletal growth period.

The typical site is the epiphyseal or bony process at the proximal end of the growing cartilage. Due to dilated growth, chondroblastomas tend to destroy growing cartilage and can spread from the epiphysis to the adjacent metaphysis. In some special cases, chondroblastoma can occur on the opposite side of growing cartilage, that is, at the metaphysis.

Chondroblastoma occurs in the epiphysis and osteophyte of long bone, followed by femur, humerus and tibia. At the proximal end of the femur, the tumor may originate from the epiphysis or trochanter. Chondroblastomas that occur at the proximal end of the humerus often originate at the greater tuberosity of the humerus, and in the tibia, often at the proximal end of the tibia. Most chondroblastomas are located around the knee, shoulder, and hip joints.

Symptoms appear late and are mild. Symptoms often exist for months, and sometimes the tumor is not diagnosed until years later. Because tumors always occur around the joints, their symptoms are often related to the joints, followed by the knee, shoulder, and hip joints. Chondroblastoma is moderately painful and can show tumors due to trauma or compression. In the more swollen and superficial chondroblastoma, the affected bone may show mild eccentric swelling, joint function may be limited, moderate joint effusion, serous-blood exudation and muscle atrophy.

Chondroblastoma diagnosis

The X-ray is quite typical, especially when the tumor is in the epiphysis. The osteolytic area of chondroblastoma begins in the epiphyseal region, tending to spread over the growing cartilage and towards the metaphysis. When the growth of the body stops or is about to stop, when the growth cartilage has disappeared or is about to disappear, such as continuous radiographs, you can clearly see the tumor destruction and the remaining growth cartilage.

Chondroblastoma is a small or medium-sized tumor with a diameter ranging from 1 to 2 cm to 6 to 7 cm. Epithelial osteolysis is often central or eccentric. When the tumor originates from a large humerus nodule, osteolysis is often located proximal to the humerus, eccentric, round or mildly polycyclic. Its X-ray permeability is not very strong, cloud-like or thin weak X-ray particles can be seen.

Chondroblastomas have well-defined boundaries, sometimes marked by thin lines of sclerosis, and are very characteristic. In eccentric and more swollen cases, the cortical bone can swell to almost disappear. Chondroblastomas can invade all subchondral bone, with little or no periosteal reaction in the metaphyseal cortex.

Chondroblastoma treatment

Resection can be performed after the frozen biopsy. The bone-periosteal and articular cartilage invaded by the tumor must be removed. A few centimeters of the deep bone wall must be removed and treated with carbolic acid. A layer of autocancellous bone was planted between the cement. Bone-cartilage bone grafts (allogous femoral head, autologous sacrum) can be used when the joint surface has to be removed. In rare cases with severe swelling or extensive local recurrence, marginal or extensive resections are required to remove part or all of the joint bone segments, functional reconstruction with allogeneic or autograft bone, restoration of joint function or joint fusion

Chondroblastoma, whether alone or in combination with surgery, is contraindicated to radiotherapy.