J Korean Foot Ankle Soc.  2019 Mar;23(1):31-34. 10.14193/jkfas.2019.23.1.31.

Chondroblastoma of the Talus Mimicking an Aneurysmal Bone Cyst: A Case Report

• Park JS
• Suh JS
• Choi JY

• KMID: 2440582
• DOI: http://doi.org/10.14193/jkfas.2019.23.1.31

Abstract

Chondroblastoma is a rare benign tumor that produces giant cells and cartilage matrix. The tumor occurs in people between 10 and 25 years with slightly higher incidence in males. The condition occurs in the proximal epiphysis of the tibia and humerus, distal epiphysis of the femur, but its occurrence in the talus is relatively rare, accounting for 4% of the total number of chondroblastoma cases. Chondroblastoma is often misdiagnosed as a primary aneurysmal bone cyst, giant cell tumor, chondromyxoid, and lesion of a secondary aneurysmal bone cyst by fibrous dysplasia. The most commonly used surgical method for chondroblastoma is broad curettage with bone grafting. In general, an aneurysmal bone cyst is associated with a second degree chondroblastoma, which is approximately 20%. Chondroblastoma of the talus and secondary aneurysmal bone cysts can be misdiagnosed as primary aneurysmal bone cysts. This paper reports a case of a young male patient with chondroblastoma of the talus, which was initially misdiagnosed as an aneurysmal bone cyst with involvement of the talo-navicular joint.

Keyword

Talus; Chondroblastoma; Aneurysmal bone cyst; Bone graft

MeSH Terms

Aneurysm*
Bone Cysts*
Bone Cysts, Aneurysmal
Bone Transplantation
Cartilage
Chondroblastoma*
Curettage
Epiphyses
Femur
Giant Cell Tumors
Giant Cells
Humans
Humerus
Incidence
Joints
Male
Methods
Talus*
Tibia

Figure

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  Figure 1 Preoperative standing foot anteroposterior (A) and lateral (B) radiographs present well circumscribed osteolytic lesion (arrows) with a sclerotic rim involving talo-navicular joint in the talar head.

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  Figure 2 Preoperative computed tomographic images (A, B) show well marginated bony cyst with a preserved articular cartilage at talo-navicular joint. A low on T1-weighted coronal image (C), high signal intensity on T2-weighted coronal image (D), and T2-weighted sagittal image (E) on magnetic resonance imaging were shown.

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  Figure 3 (A) A 1×1 cm2 cortical window was made on the dorsal side of talar head with an osteotome to approach the intraosseous mass lesion. (B) An aspiration of hemorrhagic fluid and removal of sclerotic wall with curette were conducted. Mixed bone graft was filled in the space.

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  Figure 4 (A) A removed sclerotic wall tissue was sent for histopathologic confirmation. (B) Multinucleated giant cell with a background of chondroid matrix compatible to chondroblastoma was noted. (H&E stain, ×200) Dystrophic calcification surrounding individual cells, giving the classic “chicken wire appearance” was not detected.

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  Figure 5 A consolidation of bone graft site was noted on the postoperative 1 year radiography.

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