Abstract
Chondroblastoma is a rare benign cartilage-producing tumor, with an incidence of approximatively 1% of all primary bone tumors. It arises mostly in the second decade of life, affecting mainly the ends of the long tubular bones. We present two cases of chondroblastoma diagnosed and treated in the “Foişor” Orthopedics, Traumatology and Oesteoarticular TB Clinical Hospital, Bucharest, Romania. The purpose of this study is to contrast two different forms of presentation of the same histologic entity: one case of a 19-year-old male patient with a chondroblastoma located in the proximal humerus, and the case of a 37-year-old male patient with a chondroblastoma of the calcaneus. The morphological features, radiologic aspects and immunohistochemical studies have been assessed. None of the cases presented with specific radiologic signs for chondroblastoma, both lesions being osteolytic and well-delineated, in favor of a benign entity. The classic morphological aspects of chondroblastoma represented by tumor cells with round polygonal shape and nuclei with longitudinal grooves were associated with variable amounts of chondroid matrix, pericellular calcification and few randomly distributed osteoclast-like giant cells. The immunohistochemical studies showed the osteoblastic and chondroblastic phenotype of the neoplastic cells, sustained by positivity for CD56 and S100. DOG1, cytokeratin 8/18 and smooth muscle actin (SMA) were also found focally positive. All cases were treated by curettage with bone grafting, without recurrence in the short-term follow-up. Given the nonspecific radiologic findings and the histologic heterogeneity, chondroblastoma is sometimes misinterpreted as a malignant tumor, while this neoplastic lesion has a benign behavior and benefits from conservative surgical treatment only.
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