Benign chondroblastoma with secondary aneurysmal bone cyst in scapula

نویسندگان

  • S Nithin
  • P Puttaswamy
چکیده

Introduction Chondroblastoma is a rare benign bone tumour, but locally destructive lesion although metastases may occur. It usually presents in the second decade of life. It is typically localised in the epiphyses of the long bones. Localisation in flat bones is unusual. Males are affected more often than females, the ratio being approximately 2:1. Common clinical symptoms are pain and a decreasing range of motion of adjacent joints. The authors report a case of a 17-year-old female who presented with an expansive osteolytic lesion in the infraspinous part of the left scapula, mimicking aneurysmal bone cyst (ABC). Computed tomographic (CT) scan showed cystic areas, thinning and erosion of the overlying cortex. The biopsy led to the diagnosis of chondroblastoma. Scapula is a rare site for this lesion to develop and to the best of the authors’ knowledge only a few cases have been reported. This tumour is rare in flat bones, and may mimic other benign or malignant lesions. It is, therefore, essential to perform a biopsy in order to obtain a definite diagnosis. We describe a rare case of a large primary scapular chondroblastoma effectively treated with subtotal removal of the scapula, discussing the most prominent radiological and histopathological characteristics. Case report A 17-year-old female was admitted in our institute with complaints of progressive painless swelling of the left scapula for three months. There was no history of trauma or infection, no history of loss of appetite or loss of weight. On physical examination there was a firm, large, mild tender mass located at the infraspinous part of the left scapula. Margins were ill defined and gradually merging with the rest of the scapula. Swelling was mobile along with the scapula. Her shoulder movements were normal. There was no pigmentation or venous dilation on the overlying skin. There is ecchymosis over the swelling due to fine needle aspiration cytology (Figure 1). Plain X-ray showed an expansile, osteolytic lesion in the infraspinous part of the left scapula. Fine needle aspiration cytology showed haemorrhagic fluid with features suggestive of ABC (Figure 2). CT scan showed an expansile, osteolytic lesion of the left scapula involving the body with soft tissue Abstract Introduction Chondroblastoma is a rare benign bone tumour, which presents as a locally destructive lesion, although metastases is not uncommon. It commonly presents in the second decade of life. It is typically localised in the epiphyses of the long bones. Chondroblastoma is a rare benign tumour which is common in long bones. However, there may be unusual presentations such as those in flat bones (scapula). We report a rare case of chondroblastoma in scapula. Case report A 17-year-old female was admitted in our institute with complaints of progressive painless swelling of the left scapula for three months. On physical examination there was a firm, large, mild tender mass located at the infraspinous part of the left scapula. Margins were ill defined and gradually merging with the rest of the scapula. Swelling was mobile along with scapula. Through a posterior scapular approach (Das Gupta’s approach), the tumour was excised enbloc along with marginal resection of scapula below the spinous process. The whole specimen was sent for histopathological examination, which confirmed the diagnosis of chondroblastoma with areas of aneurysmal bone cyst. Postoperative patient recovery was uneventful with complete range of movements. Conclusion Radiographic diagnosis of an atypical chondroblastoma is more difficult

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تاریخ انتشار 2014