Chondroblastoma vs clear cell chondrosarcoma

Last revised by Henry Knipe on 17 Feb 2023

Distinguishing between a chondroblastoma and epiphyseal clear cell chondrosarcoma can be difficult and differences are listed.

Both bone tumors have been reported at any age, but chondroblastomas are usually seen in the 2nd and early 3rd decade whereas clear cell chondrosarcomas have their peak in the 3rd to 5th decade of life 1,2.

Men are more commonly affected in both entities, so the male gender predilection does not help.

Radiographic features that help to differentiate the two entities include 1-3:

  • size

    • clear cell chondrosarcomas are usually larger on detection

    • chondroblastomas are usually <5 cm

  • location

    • clear cell chondrosarcomas usually have an epi-metaphyseal location

    • chondroblastomas are found in the epiphysis or apophysis

  • matrix calcification: more common in clear cell chondrosarcomas

  • periosteal reaction 

    • usually absent in clear cell chondrosarcomas

    • common in chondroblastomas, which might be solid or layered and distant to the lesion in the metaphysis

  • surrounding adjacent bone marrow edema 2,3

    • usually absent or mild in clear cell chondrosarcomas

    • prominent in chondroblastomas

  • T2 signal: the solid components tend to display a higher signal in clear cell chondrosarcomas than in chondroblastomas

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