Treatments for Chondroblastoma in Children

At Boston Children's Hospital, we know how stressful a diagnosis of a chondroblastoma can be, both for your child and for your whole family. That's why our physicians are focused on family-centered care: From your first visit, you'll work with a team of professionals committed to supporting all of your family's physical and emotional needs.

Your child's physician will determine a specific course of treatment based on several factors, including:

  • your child's age, overall health and medical history
  • the location and size of the tumor (including whether a joint is involved)
  • the risk of fracture from bone weakness
  • whether the disease has recurred

Prompt medical attention and aggressive therapy are important in minimizing any possibility of the tumor spreading. Continuous follow-up care is essential because chondroblastomas have up to a 20 percent chance of recurring after successful removal.

Surgical options
Treatment aimed at removing the tumor and preventing damage to the end of the affected bone usually involves a surgical procedure, such as:

  • curettage and bone grafting: This is the most common treatment for chondroblastomas. During this procedure, the tumor is scraped out of the bone with a special instrument called a curette that has a scoop, loop or ring at its tip. The remaining cavity is usually filled with donor bone tissue (allograft), bone chips taken from another bone in the child's body (autograft). The graft takes two or three months to heal into the bone.
  • biopsy: During the operation, doctors will take a tissue sample of the tumor so that they can confirm the diagnosis under a microscope.
  • extended curettage: In some cases, our orthopedic surgeons perform an “extended” curettage using a special instrument to remove additional layers of cells around the chondroblastoma. This is done to reduce the risk of recurrence.
  • en bloc resection: Doctors may need to surgically remove bone containing the tumor if the tumor is located in the pelvis or certain other sites. They may insert pins and other hardware (internal fixation) to restore the structural integrity of the bone.

Alternative to surgery

  • percutaneous radiofrequency ablation: If the tumor is in a hard-to-reach location, doctors may prefer to perform this procedure, in which radio frequency waves  pass through a probe to kill the tumor cells by heating them to a high temperature. This procedure has the benefits of being minimally invasive and requiring less recovery time.

Care after surgery
Your child may need physical therapy after surgery to help him restore strength and function in the affected limb. If his leg was affected, he may need crutches for some part of the two to three months of healing time.

Follow-up care
Chondroblastomas can return after treatment up to 20 percent of the time. To monitor the possibility of recurrence, we see children for follow-up care after surgery and treatment every three months for the first two years after treatment.

A typical follow-up visit may include:

  • a physical exam
  • x-rays
  • imaging scans

A recurrent chondroblastoma is usually treated using the same techniques described above, although your child's orthopedic surgeon may opt for a more aggressive treatment to prevent further recurrence.

Long-term outlook
The long-term outlook for a child who's been treated for chondroblastoma depends in part on:

  • the extent of the disease
  • the presence or absence of metastasis to the lungs
  • the size and location of the tumor
  • the tumor's response to therapy
  • the age and overall health of your child
  • your child's tolerance for specific medication, procedures or therapies

Generally, surgery usually successfully treats a chondroblastoma that is caught before metastasis (spreading). Prompt medical attention, aggressive therapy, and regular follow-up care are important for the best long-term outlook. With these, your child should be able to walk and run normally, and to engage in sports and physical activities.

Coping and support

A hospital visit can be difficult. So, we offer many amenities to make your child's—and your own—hospital experience as pleasant as possible. Visit The Center for Families for all you need to know about:

  • getting to Children's
  • accommodations
  • navigating the hospital experience
  • resources that are available for your family

In particular, we understand that you may have a lot of questions when your child is diagnosed with chondroblastoma. Will my child need surgery? How long will his recovery take? Will it affect my child long term? What should we do at home? Children's can help you connect with extensive resources to help you and your family through this stressful time, including:

  • patient education: From doctor's appointments to treatment to recovery, our nurses and physical therapists will be on hand to walk you through your child's diagnosis, treatment and healing. And once your child is home, we'll help you coordinate and continue the care and support he received at Children's.

  • parent-to-parent: Want to talk with someone whose child has been treated for a chondroblastoma? We can often put you in touch with other families who've been through the same experience that you and your child are facing.

  • faith-based support: If you're in need of spiritual support, we'll connect you with the Children's chaplaincy. Our program includes nearly a dozen clergy—representing Protestant, Jewish, Muslim, Catholic and other faith traditions—who will listen to you, pray with you and help you observe your own faith practices during your child's hospital experience.

  • social work: Our social workers and mental health clinicians have helped many other families in your situation. We can offer counseling and assistance with issues such as coping with your child's diagnosis, stresses relating to coping with illness and dealing with financial issues.