Chondroblastomas in Children and Young Adults: Revision of 55 Cases.
J Pediatr Orthop
; 44(2): e184-e191, 2024 Feb 01.
Article
de En
| MEDLINE
| ID: mdl-38084007
ABSTRACT
BACKGROUND:
Chondroblastomas are uncommon primary bone tumors localized in long bone epiphyses in children and young adults. The risk of metastasis is rare, but they have a high capacity for local recurrence. Surgical curettage with bone grafting or bone substitute is the preferred treatment.METHODS:
We performed an observational retrospective study of chondroblastomas treated in 2 hospitals in Barcelona from 1988 to 2018. We reviewed the location of the tumor, clinical presentation, imaging, histopathology, initial treatment, and cases of recurrence with a review of their treatment. We assessed the correlation between recurrence and index surgery, anatomic location, and certain histopathologic findings (presence of mitotic figures, necrosis, and positivity for protein S-100).RESULTS:
The series included 55 patients treated from 1988 to 2018, with ages ranging from 6 to 26, and a mean follow-up of 6.1 years (±3.7). The most common location was the distal femur metaphyseal/epiphyseal region. The most frequent clinical presentation was pain in the affected. Forty-five cases (81.8%) were treated with curettage of the tumor, and 4 cases (7.3%) with a wide resection. Forty-two cases (85.7%) received bone substitutes after curettage or resection. We found 5 cases of recurrence (9.1% recurrence rate); however, we could not find a statistically significant correlation between index surgery and recurrence ( P =0.24), anatomic location and recurrence ( P =0.49), or recurrence and histopathologic findings (mitotic figures, P =0.49; necrosis, P =0.60; positivity for protein S-100, P =0.52). In all the cases the treatment for the local recurrence was surgical, with a final healing rate of 100%.CONCLUSIONS:
Chondroblastomas should be considered in children and adolescents when presenting with pain and an image suggestive of a tumoral lesion on plain x-ray, most frequently in epiphyses of long bones.Surgical treatment is preferred, obtaining good results after curettage and bone substitute. Chondroblastomas are tumors with a high capacity for recurrence, therefore an adequate surgical technique and surgeon experience are paramount to achieve good outcomes. LEVEL OF EVIDENCE Level IV (case series). Therapeutic studies-investigating results or treatment.
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Tumeurs osseuses
/
Chondroblastome
/
Substituts osseux
Limites:
Adolescent
/
Adult
/
Child
/
Humans
Langue:
En
Journal:
J Pediatr Orthop
Année:
2024
Type de document:
Article