Skeletal Radiology

, Volume 40, Issue 12, pp 1563–1573 | Cite as

Metaphyseal and diaphyseal chondroblastomas

  • Aditya V. MaheshwariEmail author
  • James S. Jelinek
  • Albert J. Song
  • Kenneth J. Nelson
  • Mark D. Murphey
  • Robert M. Henshaw
Scientific Article



Epiphyseal/apophyseal locations are important diagnostic radiological features of chondroblastomas (CB). Although the tumor may secondarily involve the metaphysis, reports of primary metaphyseal or diaphyseal CB without any epiphyseal or apophyseal involvement are exceptionally rare and frequently present as a diagnostic dilemma. The purpose of this study was to present seven cases of pure metaphyseal and/or diaphyseal CB along with a review of pertinent literature.


A retrospective review of databases at two major referral centers revealed 390 cases of CB between 1960 and 2009. Out of these, seven histologically proven CB cases (1.8%) were found to be radiologically located in metaphysis and/or diaphysis, without involving the epiphysis and/or apophysis, and formed the study cohort.


There were four males and three females (age range 2–25 years). Locations included proximal femur (n = 1), distal femur (2), proximal humerus (2), clavicle (1), and proximal radius (1). All lesions showed marginal sclerosis. A periosteal reaction was seen in five cases (71%), cortical expansion in four cases (57%), and chondroid matrix in four cases (57%). A CT (two cases) demonstrated a matrix in both cases. An MR (one case) showed extensive perilesional edema. Bone scan (one case) showed intense uptake.


Pure metaphyseal and/or diaphyseal CB are exceedingly rare. A presumptive diagnosis may be considered in the appropriate age group in the presence of chondroid matrix, perilesional edema, periosteal reaction, and marginal sclerosis. Regardless of all the diagnostic possibilities, biopsy may still be required. However, knowledge of this entity will help make the final diagnosis and guide the correct treatment.


Bone tumor Chondroblastoma Extra-epiphyseal chondroblastoma Metaphyseal chondroblastoma Diaphyseal chondroblastoma Metadiaphyseal chondroblastoma MRI Radiographs 


Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Kolodny A. Bone sarcoma: the primary malignant tumors of bone and the giant cell tumor. Surg Gynec Obstet. 1927;44 Suppl 1:1–214.Google Scholar
  2. 2.
    Ewing J. Neoplastic diseases: a treatise on tumors. Philadelphia: Saunders; 1928.Google Scholar
  3. 3.
    Codman EA. Epiphyseal chondromatous giant cell tumors of the upper end of the humerus. Surg Gynec Obstet. 1931;52:543–8.Google Scholar
  4. 4.
    Jaffe HL, Lichtenstein L. Benign chondroblastoma of bone. A reinterpretation of the so-called calcifying or chondromatous giant cell tumor. Am J Pathol. 1942;18:969–91.PubMedPubMedCentralGoogle Scholar
  5. 5.
    Huvos AG, Marcove RC. Chondroblastoma of bone. A critical review. Clin Orthop Relat Res. 1973;95:300–12.CrossRefGoogle Scholar
  6. 6.
    Kurt AM, Unni KK, Sim FH, McLeod RA. Chondroblastoma of bone. Hum Pathol. 1989;20:965–76.CrossRefGoogle Scholar
  7. 7.
    Dahlin DC, Ivins JC. Benign chondroblastoma: a study of 125 cases. Cancer. 1972;30:401–13.CrossRefGoogle Scholar
  8. 8.
    Schajowicz F, Gallardo H. Epiphyseal chondroblastoma of bone: a clinico-pathological study of 69 cases. J Bone Joint Surg Br. 1970;52:205–26.CrossRefGoogle Scholar
  9. 9.
    Springfield DS, Capanna R, Gherlinzoni F, Picci P, Campanacci M. Chondroblastoma. A review of seventy cases. J Bone Joint Surg Am. 1985;67:748–55.CrossRefGoogle Scholar
  10. 10.
    Bloem JL, Mulder JD. Chondroblastoma: a clinical and radiological study of 104 cases. Skeletal Radiol. 1985;14:1–9.CrossRefGoogle Scholar
  11. 11.
    McLeod RA, Beabout JW. The roentgenographic features of chondroblastoma. Am J Roentgenol Radium Ther Nucl Med. 1973;118:464–71.CrossRefGoogle Scholar
  12. 12.
    Sailhan F, Chotel F. Parot R; SOFOP. Chondroblastoma of bone in a pediatric population. J Bone Joint Surg Am. 2009;91:2159–68.CrossRefGoogle Scholar
  13. 13.
    Aggrwal ND, Khanna SD, Bhalla R. Benign chondroblastoma of shaft of radius. Indian J Orthop. 1978;12:91–6.Google Scholar
  14. 14.
    Aronsohn RS, Hart WR, Martel W. Metaphyseal chondroblastoma of bone. Am J Roentgenol. 1976;127:686–8.CrossRefGoogle Scholar
  15. 15.
    Azorin D, Gonzalez-Mediero I, Colmenero I, De Prada I, Lopez-Barea F. Diaphyseal chondroblastoma in a long bone: first report. Skeletal Radiol. 2006;35:49–52.CrossRefGoogle Scholar
  16. 16.
    Bliss DG, Mann RJ. Chondroblastoma of a metacarpal. Report of a case and review of the literature. Clin Orthop Relat Res. 1985;194:211–3.Google Scholar
  17. 17.
    Bousdras K, O'Donnell P, Vujovic S, Henderson S, Boshoff C, Flanagan AM. Chondroblastomas but not chondromyxoid fibromas express cytokeratins: an unusual presentation of a chondroblastoma in the metaphyseal cortex of the tibia. Histopathology. 2007;51:414–6.CrossRefGoogle Scholar
  18. 18.
    Brien EW, Mirra JM, Ippolito V. Chondroblastoma arising from a nonepiphyseal site. Skeletal Radiol. 1995;24:220–2.Google Scholar
  19. 19.
    Clapper AT, DeYoung BR. Chondroblastoma of the femoral diaphysis: report of a rare phenomenon and review of literature. Hum Pathol. 2007;38:803–6.CrossRefGoogle Scholar
  20. 20.
    Dwaik M, Devlin PB. Case report: metadiaphyseal chondroblastoma. Clin Radiol. 1992;45:131–3.CrossRefGoogle Scholar
  21. 21.
    Fechner RE, Wilde HD. Chondroblastoma in the metaphysis of the femoral neck. J Bone Joint Surg Am. 1974;56:413–5.CrossRefGoogle Scholar
  22. 22.
    Hameed MR, Blacksin M, Das K, Patterson F, Benevenia J, Aisner S. Cortical chondroblastoma: report of a case and literature review of this lesion reported in unusual locations. Skeletal Radiol. 2006;35:295–7.CrossRefGoogle Scholar
  23. 23.
    Hatcher CH, Campbell JC. Benign chondroblastoma of bone. Bull Hosp Joint Dis. 1951;12:411–30.Google Scholar
  24. 24.
    Ippolito E, Tudisco C, Mariani PP. Rare forms of chondroblastoma: cystic and diaphyseal types. Ital J Orthop Traumatol. 1986;12:455–60.Google Scholar
  25. 25.
    Kim J, Kumar R, Raymond AK, Ayala AG. Non-epiphyseal chondroblastoma arising in the iliac bone, and complicated by an aneurysmal bone cyst: a case report and review of the literature. Skeletal Radiol. 2010;39:583–7.CrossRefGoogle Scholar
  26. 26.
    Kumar VP, Pang M, Pho RWH. Benign chondroblastoma. Ann Acad Med Singapore. 1981;10:316–22.Google Scholar
  27. 27.
    Kunkel MG, Dahlin DC, Young HH. Benign chondroblastoma. J Bone Joint Surg Am. 1956;38:817–26.CrossRefGoogle Scholar
  28. 28.
    Lichtenstein L, Bernstein D. Unusual benign and malignant chondroid tumors of bone. Cancer. 1959;12:1142–57.CrossRefGoogle Scholar
  29. 29.
    Ma X, Dong Y, Zhang C, Zeng B, Ding J. Diaphyseal chondroblastoma in the tibia: one case report and literature review. Chin J Clinical Oncol. 2008;5:459–61.CrossRefGoogle Scholar
  30. 30.
    Neviaser RJ, Wilson JN. Benign chondroblastoma in the finger. J Bone Joint Surg Am. 1972;54:389–92.CrossRefGoogle Scholar
  31. 31.
    Nimbkar SA, Sane SY, Pradhan CG. Benign chondroblastoma in the metaphysis of the femoral neck. J Postgrad Med. 1980;26:259–60.Google Scholar
  32. 32.
    Peh WC, Shek TW, Ip WY. Metadiaphyseal chondroblastoma of the thumb. Skeletal Radiol. 2000;29:176–80.CrossRefGoogle Scholar
  33. 33.
    Pignatti G, Nigrisoli M. Case report 537. Chondroblastoma. Skeletal Radiol. 1989;18:225–7.CrossRefGoogle Scholar
  34. 34.
    Ramappa AJ, Lee FYI, Tang P, Carlson JR, Gebhardt MC, Mankin HJ. Chondroblastoma of bone. J Bone Joint Surg Am. 2000;82:1140–5.CrossRefGoogle Scholar
  35. 35.
    Rana TA, Bohrer SP. Chondroblastoma. South Med J. 1992;85:668–9.CrossRefGoogle Scholar
  36. 36.
    Salzer M, Salzer-Kuntschik M, Kretschmer G. Benign chondroblastoma. Arch Orthop Unfallchir. 1968;64:229–44.CrossRefGoogle Scholar
  37. 37.
    Schwinn CP. Differential diagnosis of giant cell lesions of bone. In: Ackerman LV, Spjut HJ, Abell MR, editors. Bones and joints. Baltimore: Williams and Wilkins; 1976. p. 236–99.Google Scholar
  38. 38.
    Sherman RS, Uzel AR. Benign chondroblastoma of bone: its roentgen diagnosis. Am J Roentgenol Radium Ther Nucl Med. 1956;76:1132–40.Google Scholar
  39. 39.
    Sotelo-Avila C, Sundaram M, Kyriakos M, Graviss ER, Tayob AA. Case report 373. Skeletal Radiol. 1986;15:387–90.CrossRefGoogle Scholar
  40. 40.
    Sundaram TKS. Benign chondroblastoma. J Bone Joint Surg Br. 1966;48:92–104.CrossRefGoogle Scholar
  41. 41.
    Znati K, Ahaouch M, Fatemi H, Chbani L, Affifi A, Kamaoui I, et al. Femoral metaphyso-diaphyseal chondroblastoma: a case report. Rev Chir Orthop Reparatrice Appar Mot. 2007;93:283–7.CrossRefGoogle Scholar
  42. 42.
    Atalar H, Basarir K, Yildiz Y, Erekul S, Saglik Y. Management of chondroblastoma: retrospective review of 28 patients. J Orthop Sci. 2007;12:334–40.CrossRefGoogle Scholar
  43. 43.
    Brower AC, Moser RP, Kransdorf MJ. The frequency and diagnostic significance of periostitis in chondroblastoma. AJR Am J Roentgenol. 1990;154:309–14.CrossRefGoogle Scholar
  44. 44.
    Lin PP, Thenappan A, Deavers MT, Lewis VO, Yasko AW. Treatment and prognosis of chondroblastoma. Clin Orthop Relat Res. 2005;438:103–9.CrossRefGoogle Scholar
  45. 45.
    Suneja R, Grimer RJ, Belthur M, Jeys L, Carter SR, Tillman RM, et al. Chondroblastoma of bone: long-term results and functional outcome after intralesional curettage. J Bone Joint Surg Br. 2005;87(7):974–8.CrossRefGoogle Scholar
  46. 46.
    Welsh RA, Meyer AT. A histogenetic study of chondroblastoma. Cancer. 1964;17:578–89.CrossRefGoogle Scholar
  47. 47.
    Levine GD, Bensch KG. Chondroblastoma—the nature of the basic cell. A study by means of histochemistry, tissue culture, electron microscopy and autoradiography. Cancer. 1972;29:1546–62.CrossRefGoogle Scholar
  48. 48.
    Romeo S, Bovée JVMG, Jadnanansing NAA, Taminiau AHM, Hogendoom PCW. Expression of cartilage growth plate signalling molecules in chondroblastoma. J Pathol. 2004;202:113–20.CrossRefGoogle Scholar

Copyright information

© ISS 2011

Authors and Affiliations

  • Aditya V. Maheshwari
    • 1
    • 2
    Email author
  • James S. Jelinek
    • 3
  • Albert J. Song
    • 3
  • Kenneth J. Nelson
    • 2
  • Mark D. Murphey
    • 4
  • Robert M. Henshaw
    • 2
  1. 1.Department of Orthopaedics and RehabilitationState University of New York Downstate Medical CenterBrooklynUSA
  2. 2.Department of Orthopedic OncologyWashington Hospital CenterWashingtonUSA
  3. 3.Department of RadiologyWashington Hospital CenterWashingtonUSA
  4. 4.The American Institute for Radiologic PathologySilver SpringUSA

Personalised recommendations