Chondroblastoma of bone in a pediatric population.

BACKGROUND: Chondroblastoma is a rare benign bone lesion that occurs in young patients and has a high rate of recurrence. The purpose of the present study was to report on eighty-seven cases of chondroblastoma in children and to identify the possible factors that increase the risk of recurrence.
METHODS: We retrospectively reviewed eighty-seven cases of chondroblastoma in patients with open physes at the time of diagnosis and treatment. Historical data, complete imaging data, histological findings, and surgical charts were analyzed. Multiple logistic regression was used to identify predictors of recurrence.
RESULTS: The series included fifty-three boys and thirty-four girls with a mean age of 12.5 years. Lesions were located in the epiphysis in 68% of the patients, especially in the proximal part of the tibia (twenty-four patients) and the proximal part of the femur (twenty-three patients). Pain was the presenting symptom in 84% of the patients. The treatment consisted of intralesional curettage with autogenous bone-grafting in 63% of the patients. The functional outcome at an average of 62.5 months of follow-up was good for 68.5% of the patients. At a minimum of twenty-four months of follow-up, 32% of the lesions had recurred. Sex, radiographic aggressiveness, an aneurysmal bone-cyst component on histological analysis, and the method of surgical treatment had no significant influence on recurrence. Epiphyseal chondroblastomas were associated with a higher risk of recurrence when compared with metaphyseal, apophyseal, and epiphyseal-metaphyseal lesions (p = 0.004).
CONCLUSIONS: Chondroblastoma in growing children is most frequently located in the proximal part of the tibia and the proximal femoral epiphysis. The recurrence rate is high, particularly for strictly epiphyseal lesions. Proximal femoral lesions and tarsal lesions are associated with a poorer outcome.