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Chondroblastoma of
the temporal bone: consistent middle fossa involvement. Skull Base
Surg.1999;9(4):301-5.
The
objective of this study is to describe the presentation and clinical
course of two patients with temporal bone chondroblastoma, and to
review the literature on temporal bone chondroblastoma to identify
characteristic clinical and radiological presentations, and optimal
treatment regimens. MEDLINE literature searches covering the period
from 1966 to January 1998, in all languages, were performed as well
as a review of the bibliographies of the identified studies. Strict
inclusion criteria were upheld, In total 18 studies had patients
whose data could be analyzed. From the 18 studies, 34 patients were
identified, but only 21 cases met the inclusion criteria.
Demographic, clinical presentation, radiological, operative and
treatment parameters were analyzed in this cohort of patients.
Ninety-five percent of patients were found to have invasion of the
middle cranial fossa and 76% were found to have erosion into the
superior aspect of the external auditory canal by temporal bone
chondroblastoma. The characteristic growth pattern of temporal bone
chondroblastoma may result from embryonal or cartilagenous rests
entrapped in the tympanosquamous suture line in the middle fossa
floor. Temporal bone chondroblastoma represents a pathology that
does not arise from, or have a growth pattern resembling other
pathologies in the temporal bone.
Temporal bone
chondroblastoma: a review. Neuropathology.2005 Jun;25(2):159-64.
The
objective of this paper was to review temporal bone chondroblastomas
in regard to their presentation, radiographic findings,
histopathology, and treatment. A case report of a 38-year-old man
who presented with the left-sided hearing impairment and temporal
swelling was reviewed. A CT scan revealed an osteolytic lobulated
expansile mass. MRI depicted two cystic components with fluid-fluid
level and enhanced solid mass. Immunohistochemical study of S-100
was performed using avidinbiotin-complex method. The tumor was
totally removed, with eroded squamous bone and temporal muscle, via
the left zygomatic-extended middle fossa approach. The pathology of
the tumor showed that the tumor cell was spindle-shaped, along with
multinucleated giant cells. These cells had oval to polygonal
nuclei; some cells showed grooved nuclei. Intercelluar calcification
and hemorrhagic components were also observed in the tumor. Tumor
cells were strongly positive for S-100 protein. Temporal bone
chondroblastomas are extremely rare osseous tumors with only 45
cases previously reported in the published literature. They may be
confused with more common lesions seen in the temporal bone.
Diagnostic radiology, including CT and/or MRI, as well as
immunohistochemical staining with S-100 protein, may assist in
making the diagnosis. Treatment is complete surgical excision with
preservation of vital neurovascular structures.
Surgical treatment of temporal bone chondroblastoma.Surg. Neurol.2005
Mar;63(3):265-8; discussion 268.
BACKGROUND:
Temporal bone chondroblastoma is a rare primary bone tumor that
affects the floor of the middle cranial fossa. This tumor is known
to have high recurrence rate after curettage, and wide resection is
therefore recommended. However, the literature provides little
information regarding long-term results after wide resection of
temporal bone chondroblastoma. METHODS: Four cases of surgically
treated temporal bone chondroblastoma underwent long-term follow-up.
RESULTS: Four patients, 3 males and 1 female, with mean age of 34,
were surgically treated at the neurosurgery department of Keio
University Hospital. Two patients were treated for recurrent tumor
and the other two for new disease. In all cases the tumor mainly
involved the mandibular fossa with variable degree of infiltration
into tympanic and petrous parts. The tumor was totally removed via
zygomatic approach in all patients. In 3 patients, the mandibular
condyle was removed to expose the tumor. These patients had
temporary malocclusion and restricted motion postoperatively, which
resolved within 3 to 12 months with conservative treatment. All
patients have no recurrence to date with a mean follow-up period of
9 years. CONCLUSION: Temporal bone chondroblastoma was removed
totally with skull base surgical technique and no recurrence has
occurred for 6 to 13 years postoperatively. We found that removal of
the mandibular head does not cause permanent problems of mastication
in patients with normal dentures.
Chondroblastoma of
the temporal bone involving the temporomandibular joint, mandibular
condyle, and middle cranial fossa: case report and review of the
literature. Cranio.2004 Apr;22(2): 160-8.
Chondroblastoma
is a highly destructive tumor, derived from immature cartilage
cells, typically occurring in epiphyses of the long bones of
adolescents and young adults. Those occurring in the temporal bone
and TMJ area are likely to mimic TMJ symptoms. This report describes
a unique case in which a chondroblastoma resulted in extensive
destruction of the temporal bone, temporomandibular joint,
mandibular condyle, and cranial base, including gross intracranial
and extracranial involvement. With appropriate surgical management,
the outcome for patients with chondroblastoma of the
temporomandibular region is quite favorable. This case brings the
total reported chondroblastomas to 59 in the temporal bone and eight
in the mandibular condyle as of the date of submission of this
article for publication.
Temporal bone
chondroblastomas. Am J Otolaryngol.2003 Nov-Dec;24 (6):370-3.
OBJECTIVES:
To review temporal bone chondroblastomas in regards to their
presentation, radiographic findings, histopathology, and
treatment.Study design Case report and literature review. METHODS: A
case report of a 38-year-old man is reviewed who presented with
left-sided mixed hearing loss, otalgia, otorrhea, and a left
external auditory canal mass. A computed tomography scan revealed a
6-cm mass involving the petrous and squamous portions of the left
temporal bone. CONCLUSIONS: Temporal bone chondroblastomas are
extremely rare osseous tumors with only 35 cases previously reported
in the literature. Presenting symptomatology and pathology may be
confused with more common lesions seen in the temporal bone.
Diagnostic radiology, including computed tomography and/or magnetic
resonance imaging, as well as immunohistochemical staining with
S-100 protein may assist in making the diagnosis. Treatment is
complete surgical excision with preservation of vital neurovascular
structures.
Chondroblastoma of
the temporal base with high mitotic activity. Neurol Med Chir
(Tokyo).2002 Nov;42(11):516-20.
A
24-year-old man presented with a rare chondroblastoma of the
temporal base manifesting as local pain accompanied by difficulty in
opening the mouth. Gross total removal was achieved at initial
surgery, but the tumor demonstrated rapid and destructive regrowth
from a very small residual volume without definite histological
malignant transformation. Growth activity estimated by MIB-1
staining increased spontaneously from 2.5% at the initial operation
to 18.7% at recurrence. Further extensive radical tumor removal by
surgeons from multiple disciplines was performed. The patient has
been free of recurrence for 3 years without radiotherapy.
Chondroblastoma of the temporal bone is widely accepted as a benign
tumor and regrowth after gross total removal is very rare. However,
some cases of chondroblastoma have potentially high mitotic
activity.
Chondroblastoma of
the temporal bone. Skeletal Radiol.2001
Dec;30(12):714-8.
A rare case
of chondroblastoma arising from the temporal bone that occurred in a
60-year-old woman is reported. The tumor appeared well demarcated
and osteolytic on the radiographs. CT scan clearly depicted marginal
and central calcification in the tumor. MR imaging demonstrated two
components in the tumor: a solid component with predominantly low
signal intensities on both T1- and T2-weighted sequences, and a
multilocular cystic component with T1- and T2-elongation and
fluid-fluid levels on the T2-weighted images. Postcontrast MR
imaging revealed marked enhancement in the solid component and the
septa of the cystic component.
Chondroblastoma
of the temporal bone: a clinicopathologic study of five cases. J
Korean Med Sci.1999 Oct;14(5):559-64.
Chondroblastoma
is a rare benign bone tumor. It commonly affects the epiphysis of
long bones during the second and third decades of life.
Chondroblastoma of the temporal bone is extremely rare. We reviewed
five cases of chondroblastoma arising in the temporal bone. Four
cases were female and one was male. The ages ranged from 41 to 60
years (mean, 53.6 years). All cases involved the temporal bone.
Three involved the left side and two the right. Chief complaints
were long-standing localized pain and hearing difficulty. A sharply
demarcated lobulated mass was the main radiological finding.
Microscopic findings were those of chondroblastoma of usual
locations. Two cases showed aneurysmal bone cyst-like areas.
Immunohistochemical studies for CD34, CD99, S-100 protein and
cytokeratin were performed. Tumor cells were diffusely positive for
S-100 protein in three cases and weakly positive for cytokeratin in
one case. CD34 and CD99 were negative in all cases. In summary,
chondroblastoma of the temporal bone is rare and occurs in older age
group than reported cases of chondroblastoma of the usual location
in the literature.
Chondroblastoma of the temporal bone: a case report. No Shinkei
Geka.1997 Jun;25(6):555-9.
A
30-year-old male had been suffering from left temporalgia of six
months duration and then developed left hearing disturbance.
Craniogram and bone window CT revealed a well defined osteolytic
lesion in the left temporal bone. CT scan showed an expansile
heterogenous mass with calcification. Both T1 and T2 weighted MRI
demonstrated a well lobulated mixed intensity mass, but no evidence
of dural or intracranial invasion. The tumor exhibited homogenous
enhancement on CT and MRI. Angiogram revealed a well marked staining
supplied by the left middle meningeal and deep temporal arteries.
Subtotal removal of the tumor was carried out with cranioplasty.
Histologically, this tumor was composed of round or polygonal
chondroblasts, scattered osteoclast-like giant cells with a foci of
cartilage in the stroma. Many reports describe giant cell tumor can
be differentiated by immunohistochemical demonstration of S100
protein. Although in our case, histological findings simulated those
of eosinophilic granuloma, it was diagnosed as chondroblastoma
because of the foci of cartilage in the stroma. Because this tumor
is usually benign, recurrence of the tumor is rare after surgical
resection. Post-operative irradiation has been reported to be
effective in decreasing the recurrence of the tumor. But it should
be carefully observed because of possible sarcomatous change in such
tumors.
Temporal bone
chondroblastoma: big and small. J Laryngol Otol.1994
Dec;108(12):1115-9.
Chondroblastoma
represents approximately one per cent of all primary bone tumours.
It is even rarer in the temporal bone and so far only 34 cases have
been reported. We report here two cases with chondroblastoma of the
temporal bone. The first case was discovered as a small lesion of
the attic and root of zygoma. It was removed via mastoidectomy and
reconstruction of the bony defect achieved normal external ear canal
anatomy and hearing post-operatively. The second case presented as
an advanced tumour involving the infratemporal fossa and
parapharyngeal space. It was treated surgically via the
infratemporal fossa approach. As clear surgical margins were not
obtained, post-operative radiotherapy was also given to minimize the
chance of recurrence.
Chondroblastoma of
the temporal bone--report of a case and a review of the literature
of 54 cases. No To Shinkei.1992 Feb;44(2):143-8.
Chondroblastoma
of the skull is a rare tumor and only 54 cases have been reported to
date. A case of chondroblastoma arising from the squamous part of
the left temporal bone is reported. A 34-year-old woman had 6-month
history of left conductive hearing disturbance and tenderness in the
left temporal region. Plain skull X-ray showed a well demarcated
osteolytic lesion in the temporal bone. CT demonstrated a
heterogeneously high density mass, with enhancement. T1-weighted MRI
showed a low intensity mass while T2-weighted images showed no
signal area. The left external carotid angiograms showed a marked
staining supplied by the left middle meningeal artery. This tumor
grew destroying the left temporal squama and pyramidal bone, and
extended to the external auditory canal and the middle ear cavity.
The tumor was subtotally resected. Histologically, this tumor
consisted of clusters of round or polygonal chondroblasts with oval
or grooved nuclei and well-defined cell border. Multinucleated giant
cells were also observed. Chondroid matrix was found in some areas.
Immunohistochemically, the tumor cells were positive for S-100
protein. These findings lead us to the diagnosis of chondroblastoma.
The diagnosis, histology, therapy, and prognosis of chondroblastoma
are discussed including the review of 54 cases in the literature.
Chondroblastoma of
temporal bone: unusual histologic features.Ann Otol Rhinol Laryngol.1986
May-Jun;95(3 Pt 1):260-3.
Chondroblastoma
of bone only rarely affects the skull and, depending on its
location, may have an uncertain prognosis. The histologic spectrum
demonstrated by this tumor has been a source of diagnostic
confusion, which still persists. A case of chondroblastoma of the
temporal bone with unusual histologic features is presented and
discussed. Chondroblastoma must be included in the differential
diagnosis of bone tumors of the skull containing giant cells.
Radical excision is suggested as the treatment of choice in view of
unanswered questions regarding its tendency to recur or to progress
to frank malignancy.
Benign
chondroblastoma of the temporal bone.Otolaryngol Head Neck Surg.1979
Mar-Apr;87(2):229-36.
Benign
chondroblastoma is a rare tumor in the temporal bone. It occurs
preponderantly in middle-aged men as a mass in the postero-superior
region of the ear canal and is accompanied by hearing loss. On
pathologic examination, giant cells and focal regions of chondroid
differentiation are noted. After the extent of the tumor has been
determined, the treatment is surgical removal. Preoperative
irradiation may be helpful. Long-term follow-up is essential.
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