Chondroblastoma of a Thumb Sesamoid: a Case Report and Review of Literature
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SURGERY
Chondroblastoma of a Thumb Sesamoid: a Case Report and Review of Literature Pradyumna Raval 1 & Irfan Ali Merchant 1 & Joby George-Malal 1 Accepted: 2 April 2020 / Published online: 21 April 2020 # Springer Nature Switzerland AG 2020
Abstract Chondroblastomas are benign tumours commonly arising at the epiphysis of long bones such as the femur, tibia and humerus. Literature consists primarily of case reports describing chondroblastomas arising at unusual sites such as the carpus and patella. We report a yet unreported case of a chondroblastoma affecting a thumb sesamoid which was treated successfully by excision. A 27-year-old female was referred to the orthopaedic specialist service with a history of a gradually increasing swelling overlying her thumb on the volar aspect. Ultrasound examination raised a suspicion of either a ganglion cyst or a giant cell tumour. A biopsy confirmed it to be chondroblastoma. CT and MRI scans were then performed to know more about the extent of the tumour. It was confined to the sesamoid of the thumb. An excision performed under general anaesthesia proved to be curative. The patient continues to be asymptomatic 18 months after the surgery and has since returned back to her job as a waitress. Keywords Chondroblastoma . Thumb . Sesamoid . Rare
Introduction Chondroblastomas are rare benign tumours with a reported incidence of less than 1% of all primary bone tumours [1]. They commonly arise from the epiphyses of long bones such as the femur, tibia and humerus [2]. Chondroblastomas commonly affect people in their second decade of life [3]; however, presentation at unusual sites has been reported in older patients [4]. Chondroblastoma affecting the hand and wrist is very rare [5]. To the best of our knowledge, there is no case reported of a chondroblastoma affecting a thumb sesamoid. We report an extremely rare case of a chondroblastoma affecting a thumb sesamoid which was treated successfully by excision.
Case Presentation A 27-year-old right hand dominant female, employed as a waitress, was referred from her general practitioner with a This article is part of the Topical Collection on Surgery * Pradyumna Raval [email protected] 1
Department of Trauma & Orthopaedics, Bedford Hospital NHS Trust, Bedford MK42 9DJ, UK
lump on her right hand. This was located in the first web space on the volar aspect of her hand overlying the metacarpophalangeal (MCP) joint of the thumb (Fig. 1). It had been present for at least a year and enlarged initially but had stayed the same size for 6 months. It was associated with pain going down the thumb occasionally. On examination it was a poorly defined diffuse globular swelling that was not attached to the skin and measured approximately 1 cm in diameter. It was located directly over the A1 pulley, but the finger did not demonstrate any triggering or restriction. The patient did not have any other significant past medical or surgical history. An ultrasound scan in the community had shown a 25 mm × 16 mm × 10 mm oval cystic structure in the s
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