Capitate Chondroblastoma: A Case Report and Review of the Literature

Abstract

Background: Chondroblastomas are benign tumors that typically occur in the epiphysis of long bones. Carpal bone chondroblastomas are very rare and are known to have less aggressive behavior with no evidence of recurrence reported. Methods: We present a case of a recurrent chondroblastoma in the capitate that was treated with repeat curettage, application of phenol, and bone grafting. Results: At 3 years post surgery, the patient is disease free with excellent functional return. Conclusion: Chondroblastomas are rare within the carpus. We present a review of the literature detailing their occurrence and treatment.

Keywords: arthrodesis; capitate chondroblastoma; recurrence.

Figure 1.

Imaging studies demonstrating initial presentation at outside institution. (a) AP and lateral radiographs of the wrist showing a lesion within the capitate. (b) Coronal and sagittal T1 MRI sequences showing cortical expansion of the capitate.

Figure 2.

Imaging studies following (a) plain radiographs, (b) magnetic resonance images showing the recurrence, and (c) computed tomography images showing cortical expansion to the capitohamate articular surface.

Figure 3.

Images demonstrating (a) operative approach and capitohamate arthrodesis using bone graft and (b) Kirschner wires.

Figure 4.

Chondroblastoma showing (a) sheets of uniform, well-defined, polygonal cells with ovoid indented or twisted nuclei and scattered osteoclast-like giant cells and (b) multiple foci of pericellular “chicken wire” calcifications.

Figure 5.

Imaging studies demonstrating the capitohamate arthrodesis after curettage and phenol application 6 weeks postoperative prior to pin removal. (a) AP and (b) lateral radiographs demonstrating the capitohamate arthrodesis after curettage and phenol application 6 weeks postoperative prior to pin removal.

Figure 6.

Imaging studies at 2-year follow-up demonstrating resolution of lesion after repeat curettage and phenol application with bone graft and capitohamate arthrodesis: (a) plain radiographs and (b) computed tomography images.