Abstract
Chondroblastoma (CB) is a rare bone tumour usually occurring in long bones of males in the second decade. Though these are considered benign, rare cases show aggressive behaviour and metastases. However, there are no defined histological criteria to diagnose aggressiveness, except soft tissue (ST) infiltration. With the identification of specific immunohistochemical and genetic signatures, recent research has nurtured the concept of malignant CB and raised concerns that malignant CBs are being frequently misdiagnosed. Here we report a case of a CB with unusual features, in a 62-year-old woman which includes rare location in the scapula, recurrence following a long period after excision, extensive soft tissue invasion, and predominant small round cell morphology. This case intends to add to the limited literature on aggressive CB as well as to the evolving concept of malignant CB. The case also highlights the importance of follow up of patients with CB preventing mutilating surgery.
Highlights
Chondroblastoma(CB) is a benign cartilaginous tumour comprising less than 1% of bone tumours[1]
Considering the soft tissue involvement seen on imaging and intraoperative findings confirmed by histology, the tumour was regarded as a CB with aggressive behavior
Atypical chondrocytes lying in lacunae, multinucleation, and the presence of hyaline cartilage in a chondrosarcoma are helpful in differentiation
Summary
Chondroblastoma(CB) is a benign cartilaginous tumour comprising less than 1% of bone tumours[1]. Rare primary and recurrent CB can show extensive soft tissue involvement simulating malignancy. This aggressive behaviour could occur in recurrences or in the primary tumour. The present imaging showed multiple expansile lytic lesions in the scapular blade and few lytic lesions in the humeral head These lesions showed significant destruction of the scapular blade with soft tissue involvement. The histology showed a cellular tumour comprising sheets of small to medium rounded tumour cells with scant cytoplasm and hyperchromatic nuclei. Considering the soft tissue involvement seen on imaging and intraoperative findings confirmed by histology, the tumour was regarded as a CB with aggressive behavior
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