Abstract
BackgroundChondroblastomas are rare epiphyseal bone tumors. Very few cases with extra-cortical aggressive soft tissue invasion or metastasis are reported.Case presentationWe report a 28 year-old adult male who presented with a large swelling over the left shoulder region. Pre-operative imaging revealed a large tumor arising from upper end of humerus with extensive soft tissue involvement necessitating a fore-quarter amputation. Patient received adjuvant radiation.ConclusionsThis patient is one of the largest chondroblastomas to be reported. Although chondroblastomas are typically benign, rarely they can be locally aggressive or metastatic. Early diagnosis and institution of proper primary therapy would prevent mutilating surgeries and recurrences.
Highlights
Sixty years since chondroblastoma has been identified as a distinct entity, there have been very few reports of virulent behavior in the form of local aggressiveness or metastasis [2]
'Atypical' indicates features of chondroblastoma with hemangiopericytoma like areas or presence of myxoid substance or spindle cells arranged in storiform pattern [6]
Since only some of the aggressive chondroblastomas metastasize, it is possible that additional genetic changes determine the metastatic event
Summary
Chondroblastomas are benign lesions but can be locally aggressive and rarely even metastatic disease has been documented. We report a third case of non-recurrent primary aggressive chondroblastoma. To our knowledge this is the largest aggressive chondroblastoma to be reported. This patient had to undergo a mutilating fore-quarter amputation due to inordinate delay in presentation. Diagnosis and appropriate therapy can prevent recurrences and mutilating surgeries. KH was the principal clinician who planned the evaluation and procedure, in addition to conceptualizing and drafting the article. All authors read and approved the final manuscript
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