Deventer Niklas, Deventer Nils, Gosheger Georg, de Vaal Marieke, Budny Tymoteusz, Laufer Andrea, Heitkoetter Birthe, Luebben Timo
Department of Orthopedics and Tumororthopedics, University Hospital Munster, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany.
Gerhard-Domagk-Institute of Pathology, University Hospital Munster, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany.
J Bone Oncol. 2020 Dec 5;26:100342. doi: 10.1016/j.jbo.2020.100342. eCollection 2021 Feb.
Chondroblastoma is a rare benign cartilaginous bone tumor that represents 1-2% of all primary bone tumors. It is characterized by aggressive growth, possible recurrence after surgical treatment and, in rare cases, metastasis. Surgical management is the primary treatment and includes intralesional curettage with or without adjuvants. Local recurrence rates vary between less than 10% up to more than 30%.
In this retrospective study between 2009 and 2020 we analysed 38 cases of chondroblastoma with a mean follow-up of 27.9 months who underwent a surgical treatment in our institution. Epidemiological data, radiographic and histological examinations, different surgical techniques, complications and local recurrence were evaluated to comment on the question if curettage with or without adjuvants is a sufficient way of therapy.
The study includes 25 male (65.8%) and 13 female (34.2%) patients with a mean age of 17.2 (11-51) years. The most common location of manifestation was the proximal epiphyseal humerus (34.2%), followed by the proximal tibia (26.3%) and the distal femur (15.8%). Joint involvement occurred in 28 patients (73.7%). In all cases intralesional curettage was performed; in 25 cases (65.8%) the resulting cavity was filled with bone substitute, in 7.9% (3 cases) with bone cement and in 10.5% (4 cases) with autogenous bone graft. Adjuvant hydrogen peroxide was used in 64.9% of the cases. The overall recurrence rate was 39.5% (15 cases). The following subgroup analysis showed a recurrence rate of 100% (4/4 cases) after curettage and defect reconstruction with autogenous bone. In the case of intralesional curettage and filling of the cavity with bone substitute but without use of adjuvant the recurrence rate was 50% (4/8 cases). A low recurrence rate of 11.8% (2 cases) was observed in the case of intralesional curettage, using hydrogen peroxide as adjuvant (17 cases) and bone substitute for defect reconstruction.
Chondroblastoma represents a rare pathology. Therapeutically an aggressive intralesional curettage with use of hydrogen peroxide as adjuvant and filling up the defect with bone substitute leads to low recurrence rates.
软骨母细胞瘤是一种罕见的良性软骨性骨肿瘤，占所有原发性骨肿瘤的1%-2%。其特点是生长活跃，手术治疗后可能复发，罕见情况下会发生转移。手术治疗是主要治疗方法，包括病灶内刮除术，可加用或不加用辅助剂。局部复发率在不到10%至超过30%之间。
在这项2009年至2020年的回顾性研究中，我们分析了38例软骨母细胞瘤患者，这些患者在我们机构接受了手术治疗，平均随访27.9个月。评估了流行病学数据、影像学和组织学检查、不同的手术技术、并发症和局部复发情况，以探讨病灶内刮除术加用或不加用辅助剂是否是一种充分的治疗方法。
该研究包括25名男性（65.8%）和13名女性（34.2%）患者，平均年龄17.2岁（11-51岁）。最常见的发病部位是肱骨近端骨骺（34.2%），其次是胫骨近端（26.3%）和股骨远端（15.8%）。28例患者（73.7%）有关节受累。所有病例均进行了病灶内刮除术；25例（65.8%）刮除后的骨腔用骨替代物填充，7.9%（3例）用骨水泥填充，10.5%（4例）用自体骨移植填充。64.9%的病例使用了辅助过氧化氢。总体复发率为39.5%（15例）。以下亚组分析显示，自体骨刮除及缺损重建后的复发率为100%（4/4例）。在病灶内刮除并用骨替代物填充骨腔但未使用辅助剂的情况下，复发率为50%（4/8例）。在病灶内刮除术中，使用过氧化氢作为辅助剂（17例）并用骨替代物进行缺损重建，复发率较低，为11.8%（2例）。
软骨母细胞瘤是一种罕见的病理类型。在治疗上，积极的病灶内刮除术，使用过氧化氢作为辅助剂并使用骨替代物填充缺损，可导致较低的复发率。
