Chondroblastoma

Case contributed by Dr Jeremy Jones

Presentation

Knee pain after fall during football.

Patient Data

Age: 15 years
Gender: Male
X-ray

Large proximal tibial lucency centered on the metaphysis extending across the almost-fused physis into the epiphysis. Extension to the lateral tibial plateau joint surface. Possible central calcification. No periosteal reaction. No soft tissue mass.

MRI

Right proximal tibial abnormality centered adjacent to the physis within the lateral metaphysis. Mixed solid and cystic components. Some fluid-fluid levels. Extension to the joint surface including the tibial spines. No pathological fracture.

CT

Well defined predominantly lucent tumor with central calcification (rings and arcs).

4 x 5 cm juxta articular lesion right tibial proximal metastasis.  Thinning cortex proximally and posteriorly.  Radiology appearances suggestive of giant cell tumour.  Largely empty cavity with some lining curettage for specimen.  

Right tibia, tissue from cystic cavity juxta-articular proximal tibia
                                
Macroscopy                                
Multiple gritty fragments measuring up to 8 mm.  All processed for decalcification.  
                                
Microscopy
Sections show multiple fragments of a bone tumour composed of plump oval histiocytoid cells with scatterd osteoclast-like giant cells. Within the cellular tissue there are islands of chondroid/cartilage. The appearances are consistent with those of a chondroblastoma.

Case Discussion

The plain film appearances are predominantly of a non-aggressive lesion. The MRI confirms its location and surrounding edema and the CT characterization of internal calcification is helpful. The differential, in this case, is of a chondroid lesion, with the most likely differential being chondroblastoma. This was confirmed by biopsy.

PlayAdd to Share

Case information

rID: 62721
Published: 30th Aug 2018
Last edited: 26th Jan 2019
Inclusion in quiz mode: Included
Institution: NHS Lothian

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.