Chondroblastoma

  • What is chondroblastoma?

    Chondroblastoma is a rare, benign tumor found in the epiphysis (the rounded end) of long bones.

    It accounts for about 1 percent of all bone tumors and generally occurs in young adults around 20 years old. However, chondroblastomas have occurred in patients as young as age 2. It is more common in males than females.

  • Cause of chondroblastoma

    It is uncertain why chondroblastomas occur, but it is sometimes found in conjunction with other growths, such aneurysmal bone cysts, which are found in 20-25 percent of all patients with chondroblastomas.

  • Symptoms of chondroblastoma

    Symptoms of chondroblastoma usually occur in the shoulder, hip, knee or spine and include:

    • Swelling
    • Pain
  • Diagnosing chondroblastoma

    At The Children’s Hospital of Philadelphia, our clinical experts use a variety of diagnostic tests to diagnose chondroblastoma, including:

    • Radioisotope bone scan, which can help locate areas of abnormality. 
    • Magnetic resonance imaging (MRI), which uses a combination of large magnets, radiofrequencies and a computer to produce detailed images of organs and structures within the body.
    • Computed tomography (CT) scan, which uses a combination of X-rays and computer technology to produce cross-sectional images ("slices") of the body.
    • X-rays, which produce images of bones and internal organs on film.
    • EOS imaging, an imaging technology that creates 3-dimensional models from two planar images. Unlike a CT scan, EOS images are taken while the child is in an upright or standing position, enabling improved diagnosis due to weight-bearing positioning.

    In addition to imaging tests, a biopsy may also be necessary to confirm the diagnosis of chondroblastoma. A biopsy is a procedure where a sample of the abnormal tissue is surgically removed and then tested for malignant and benign cells.

  • Treating chondroblastoma

    Surgery is the recommended treatment for most children with chondroblastoma tumors.

    Though surgery for chondroblastoma is highly effective, we understand that any surgery can be a stressful experience for your child and family. At CHOP, we offer a wealth of resources about how to prepare your child for surgery and what to expect during surgery.

    Additionally, we employ numerous best practices before, during and after surgery to decrease the risk of infection and increase positive outcomes. Safety in spine surgery is a top priority at Children’s Hospital.

    Surgical options for chondroblastoma include:

    • Intralesional curettage, which involves scraping out the bone to completely remove the tumor and filling the space with material such as methyl methacrylate cement, phenol or liquid nitrogen
    • High-speed bur, which involves “shaving” the affected bone to be smooth with a high-speed drill

    Sometimes chondroblastoma growths spread to other parts of the body, including the lungs. While these tumors are usually benign, they still need to be surgically treated. In cases where cutting out the chondroblastoma would leave a large, bony defect, reconstruction of the area may be necessary.

  • Follow-up care for chondroblastoma

    There is a 10 percent risk of recurrence of chondroblastoma after treatment, so it is important for your child to continue to see a doctor after treatment.

    Follow-up care and ongoing support and services are available at our Main Campus and throughout our CHOP Care Network. Our team is committed to partnering with parents and referring physicians to provide the most current, comprehensive and specialized care possible for your child.

    At follow-up visits, your child will receive a complete physical exam and will likely have routine X-rays to monitor the condition.

    If the chondroblastoma returns, it typically does so within three years of treatment.

    Patients without symptoms of recurrence of chondroblastoma will usually be clinically followed until they reach skeletal maturity (their adult height).

  • Long-term outcomes for chondroblastoma

    If recurrence of the original chondroblastoma should occur, it can be managed with surgery of the bone and soft tissue and/or a bone graft. Some chondroblastomas can become malignant (cancerous) years after the treatment — usually more than 10 years later — and, if that happens, the chance of recovery is poor.

    CHOP is currently conducting a long-term outcome study of patients with chondroblastoma. The study includes multiple hospitals and includes a review of numerous cases of children with this condition.

Reviewed by John P. Dormans, MD, FACS on May 19, 2014