Codman’s tumor is an older name for chondroblastoma, a rare, usually benign bone tumor that grows from immature cartilage-forming cells called chondroblasts at the end of long bones, close to the joint and growth plate. It makes up less than 1% of all primary bone tumors and happens mostly in children, teenagers, and young adults, especially boys. The tumor is considered “benign but locally aggressive,” which means it does not usually behave like a cancer, but it can destroy nearby bone, damage the joint surface, and come back if it is not fully removed.
Most Codman’s tumors are found in the epiphysis (end) of long bones such as the femur (thigh), tibia (shin), and humerus (upper arm). Less often, they can appear in flat or short bones like the pelvis, heel bone (calcaneus), or bones of the foot and spine. People usually come with deep, aching joint pain, sometimes a limp, stiffness, or swelling around the joint. Although it is called “benign,” rare cases can spread to the lungs or recur several times, so careful diagnosis, complete surgery, and follow-up are important.
Codman’s tumor is another name for chondroblastoma, a rare, benign (non-cancer) bone tumor that grows from cartilage-forming cells (chondroblasts). It usually appears at the end of a long bone, near a joint, especially around the knee, hip, or shoulder in teenagers and young adults. The tumor causes pain deep in the joint, swelling, and stiffness. It can damage the nearby bone, and in rare cases it can come back after treatment or even spread. Because it grows close to the growth plate in young people, doctors must treat it carefully to protect the joint and future growth.
Other Names for Codman’s Tumor
Codman’s tumor is simply another name for chondroblastoma, but several related terms are used in the literature. It is often described as a calcifying giant cell tumor or calcified chondromatous giant cell tumor, because under the microscope the tumor contains cartilage-like cells, scattered giant cells, and areas of calcification. Some articles describe it as a benign chondroid neoplasm of the epiphysis or a benign, locally aggressive cartilaginous bone tumor, all referring to the same condition.
You may see synonyms such as “chondroblastoma of bone,” “epiphyseal chondroblastoma,” or “Codman tumor of the proximal humerus” in case reports and radiology texts. These names emphasize its typical location at the end of the bone and its historic association with Codman, who first described similar epiphyseal lesions.
Types of Codman’s Tumor (Chondroblastoma)
Clinically and pathologically, experts describe several patterns or types of Codman’s tumor rather than strict official subtypes. These types are based on location, behavior, and microscopic features:
Classic epiphyseal chondroblastoma – The most common pattern, arising in the epiphysis of long bones (femur, tibia, humerus) in adolescents or young adults, causing joint pain and local bone destruction.
Atypical-site chondroblastoma – Tumors that occur in unusual bones such as the pelvis, ribs, skull base, patella, talus, calcaneus, navicular, or acromion. They show the same microscopic features but may be harder to recognize on imaging because the location is uncommon.
Chondroblastoma with aneurysmal bone cyst (ABC) change – Some tumors develop blood-filled cystic spaces called aneurysmal bone cysts inside them. This makes the lesion more expansile and can increase pain and swelling, but it is still considered a chondroblastoma with secondary ABC.
Recurrent chondroblastoma – When the tumor returns after surgery, often because the first curettage did not remove all tumor cells. Recurrent lesions can be more aggressive and may require wider excision and reconstruction.
Malignant or metastatic chondroblastoma – Very rare forms that show more aggressive cell changes, repeated recurrences, and spread to the lungs or other bones. These are sometimes called malignant chondroblastoma and may need surgery plus systemic therapy.
Causes and Risk Factors
The exact cause of Codman’s tumor is still not fully known. Research has found key genetic changes and patterns that help explain why the tumor grows in certain people and bones, but in most patients there is no clear lifestyle or environmental trigger.
Unknown main cause – For most patients, doctors cannot point to one clear factor that “caused” the tumor. It is considered a random growth of cartilage-forming cells in the bone, not something the child or family did wrong.
Histone H3.3 (H3F3B) K36M mutation – Most chondroblastomas have a specific change in a histone gene called H3F3B, where lysine 36 is replaced by methionine (K36M). This mutation changes how DNA is packaged and how genes are switched on and off in cartilage cells, driving abnormal cell growth.
H3F3A pathway involvement – Some tumors show mutations in a related histone gene, H3F3A, which also affects chromatin structure. These histone changes are considered “driver” mutations that push normal chondroblasts toward tumor behavior.
Abnormal chondroblast cell cycle control – The mutated histone and other genetic changes disturb the normal balance between chondroblast cell division and cell death. As a result, these cells keep dividing and form a mass instead of maturing into stable cartilage and bone.
Growth plate (epiphyseal) vulnerability – Codman’s tumors almost always arise near the growth plate at the end of long bones. This region is full of rapidly dividing cartilage cells, which may be more vulnerable to DNA errors and tumor formation during growth.
Adolescent growth spurts – The tumor is most common between about 10 and 25 years, when bones are growing quickly. Rapid growth may create more chances for random mutations in cartilage cells, although this is a pattern, not a proven direct cause.
Male sex predominance – Boys and young men are affected about twice as often as girls. This suggests that sex-related hormones or growth patterns could influence risk, but there is no strong proof of a direct hormonal cause.
Local mechanical stress or micro-trauma – Many patients are active in sports. Repeated stress or small injuries around the joint may stimulate repair processes in the growth plate, and in a few individuals with the right mutations this repair may turn into a tumor. This remains a theory rather than a confirmed cause.
Previous bone injury at the epiphysis – Case reports sometimes note a history of earlier injury near the affected joint. It is possible that healing tissue with rapidly dividing cells is more likely to accumulate mutations, but evidence is limited.
Association with aneurysmal bone cyst changes – In some tumors, secondary aneurysmal bone cysts form. Although ABCs are not a cause of chondroblastoma, the same underlying abnormal signals in bone and blood vessels may contribute to both processes.
Local blood supply differences – The epiphyseal region has a complex blood supply. Some authors suggest that minor circulation disturbances and repair responses might help trigger abnormal cartilage growth in genetically vulnerable cells.
Bone development variations – Chondroblastoma arises from immature cartilage at secondary ossification centers. Subtle developmental variations in these centers may leave small nests of cells that behave abnormally later, especially when driver mutations develop.
Epigenetic changes from H3K36M – The H3K36M histone mutation alters methylation patterns on chromatin. This epigenetic reprogramming can silence or activate many genes at once, shifting chondroblasts from normal differentiation into a tumor-like state.
Possible inherited susceptibility (rare) – A few reports suggest that some individuals may have inherited tendencies in genes regulating histone function or cartilage growth. However, most chondroblastomas appear sporadic, not strongly linked to known familial cancer syndromes.
Background bone micro-environment – Cytokines, growth factors, and matrix proteins in the joint and growth plate may create a “supportive soil” that lets mutated chondroblasts survive and multiply instead of being removed by normal control systems.
Chronic joint overload or malalignment – In some patients, abnormal joint mechanics (for example, from sports or mild deformities) could increase stress near the epiphysis. This may keep repair signals switched on and interact with underlying genetic changes, although evidence is mainly observational.
Delayed skeletal maturity – Tumors are more common while the growth plates are still open. In people whose growth plates close later, there is a longer window in which abnormal chondroblasts might appear and form a lesion.
Rare malignant transformation factors – In very uncommon cases, especially after radiation therapy or multiple recurrences, chondroblastoma may transform into a high-grade sarcoma. Prior radiation and long-standing local genetic instability are thought to contribute to this shift.
Immune response and inflammation – Some tumors show inflammatory infiltrates and bone remodeling. Local immune responses may, in theory, either restrain or partly support tumor growth, depending on the balance of signals in the tumor micro-environment.
Random somatic mutations during growth – Overall, Codman’s tumor is best understood as a result of random (“somatic”) genetic and epigenetic errors in cartilage cells during bone growth. Most children never develop such mutations, which explains why the tumor is extremely rare.
Symptoms and Clinical Features
Localized bone or joint pain – The most common symptom is a deep, nagging pain at or near the end of the bone, often around the knee, hip, or shoulder. The pain usually starts gradually and becomes more noticeable over weeks or months.
Pain that worsens with activity – Pain often increases when the person walks, runs, climbs stairs, or uses the affected limb in sports. Rest may relieve it at first, but as the tumor grows, pain can appear even with light activity.
Night pain or rest pain – Some patients report pain that wakes them at night or continues even when they are not moving. Persistent night pain is a red flag and usually prompts imaging to rule out a bone tumor.
Swelling or a palpable lump – There may be visible swelling around the joint or a firm, tender lump if the tumor reaches the bone surface or lifts the periosteum. This swelling may slowly enlarge over time.
Joint stiffness – The nearby joint often becomes stiff and harder to move fully. Patients may find it difficult to bend or straighten the knee or shoulder completely because pain and guarding limit motion.
Limited range of motion – On examination, doctors may measure reduced flexion, extension, or rotation of the joint. This limitation occurs when the tumor irritates joint structures or when pain prevents full movement.
Limp or abnormal gait – When the tumor is in the leg, children and adolescents may start limping or shifting weight to the other side. Parents may notice that their child avoids running or uses a different walking pattern.
Muscle weakness or wasting around the joint – Because pain discourages normal use, muscles around the affected joint can gradually weaken and shrink (atrophy). This can be seen as a thinner thigh, calf, or upper arm compared to the opposite side.
Tenderness to touch – Pressing over the tumor site often causes sharp or aching pain. This local tenderness helps the doctor locate the lesion, especially when imaging is planned.
Warmth or mild redness over the area – In some cases, increased blood flow and mild inflammation around the tumor make the skin feel warmer or slightly red, which may be confused with infection.
Joint effusion (fluid in the joint) – Tumors near a joint can irritate the synovium and lead to extra fluid inside the joint, causing swelling, tightness, and reduced motion, especially around the knee.
Mechanical symptoms (catching or locking) – If the tumor alters the joint surface or causes loose fragments, the patient may feel catching, locking, or giving-way sensations, especially in weight-bearing joints.
Growth disturbance or limb-length difference – When Codman’s tumor affects an open growth plate, surgery or the lesion itself can disturb normal growth. Over time, this may lead to a shorter limb or joint deformity if not carefully managed.
Functional limitation in sports and daily tasks – Many patients notice that they can no longer participate fully in sports, run, jump, or lift objects due to pain and stiffness. Simple tasks like walking long distances, climbing stairs, or reaching overhead become difficult.
Rare pathological fracture symptoms – In a small number of cases, the tumor weakens the bone so much that it breaks with minor trauma. Sudden severe pain, inability to bear weight, and deformity suggest a fracture through the lesion.
Diagnostic Tests for Codman’s Tumor
Physical Examination Tests
General musculoskeletal inspection – The doctor looks for swelling, deformity, muscle wasting, and asymmetry between sides. In Codman’s tumor, they may see localized swelling near a joint or reduced muscle bulk, which guides further imaging.
Local palpation of the bone and joint – Gentle pressure over the suspected area helps find the exact point of maximal tenderness and detect a firm mass or bony prominence. This supports the suspicion of a deep bone lesion rather than only soft-tissue strain.
Joint range-of-motion testing – The clinician moves the joint through flexion, extension, and rotation to see how far it can go and when pain appears. Pain and reduced motion around the end of the bone suggest an intra-articular or epiphyseal process like chondroblastoma.
Gait and functional assessment – Observing how the patient walks, runs, squats, or climbs a step shows how much the tumor affects daily function. A limp, guarded movement, or inability to bear weight normally points toward a significant structural problem in the limb.
Manual Tests
Local bone percussion tenderness test – Tapping lightly over the bone can reproduce pain when a tumor is present, helping differentiate deep bony pain from more superficial muscular pain. This finding prompts further imaging of the specific region.
Manual muscle strength testing – The examiner tests major muscle groups around the joint against resistance. Weakness due to pain inhibition or disuse helps document functional impact and provides a baseline for follow-up after treatment.
Joint stress tests – Gentle varus–valgus or rotational stress across the joint may reproduce localized pain without clear ligament laxity, suggesting the pain source is the underlying bone near the joint rather than the ligaments alone.
Limb length and alignment measurement – In growing children, the doctor measures both limbs and checks alignment at the knee, hip, or ankle. Differences can signal growth plate involvement by the tumor or after surgery, which is important for long-term planning.
Laboratory and Pathological Tests
Complete blood count (CBC) and inflammatory markers – Blood tests like CBC, ESR, and CRP are often normal or only mildly raised in chondroblastoma. They help rule out infection or systemic inflammatory disease when evaluating bone pain and swelling.
Serum biochemistry (including alkaline phosphatase) – Basic metabolic panels may be ordered to assess general health and bone turnover. Alkaline phosphatase can be mildly elevated but is often less striking than in aggressive malignant bone tumors, helping in differential diagnosis.
Core needle or open biopsy of the lesion – Biopsy is the definitive test. A small piece of the tumor is removed and studied under the microscope to confirm the diagnosis and distinguish chondroblastoma from other bone tumors such as giant cell tumor or clear-cell chondrosarcoma.
Histopathology with routine stains (H&E) – On H&E staining, Codman’s tumor shows sheets of polygonal chondroblasts, scattered osteoclast-like giant cells, and characteristic “chicken-wire” calcification around cells. These features are classic for chondroblastoma and guide the final report.
Immunohistochemistry for H3F3 K36M – Special antibodies detect the H3F3 K36M mutant histone protein. This stain is highly specific and sensitive for chondroblastoma and helps confirm the diagnosis when the microscopic picture overlaps with other giant-cell–rich lesions.
Molecular testing for H3F3A/H3F3B mutations – DNA-based tests can identify the exact histone gene mutation (usually H3F3B K36M). This is particularly useful in complex or atypical cases and is now considered a strong diagnostic marker for this tumor.
Electrodiagnostic Tests
Nerve conduction studies (NCS) – When the tumor is near major nerves and the patient reports numbness, tingling, or weakness, NCS can check whether nerve signals are slowed or blocked. This does not diagnose the tumor itself but assesses nerve compression before surgery.
Electromyography (EMG) – EMG measures electrical activity in muscles. It can show if muscle weakness is due to nerve involvement from the tumor, pain-related inhibition, or another neuromuscular problem, helping the team plan surgery and rehabilitation.
Imaging Tests
Plain radiograph (X-ray) of the affected bone – X-ray is usually the first imaging test. In Codman’s tumor, it often shows a well-defined, lytic (hole-like) lesion in the epiphysis with a thin sclerotic rim and sometimes arc-like or speckled calcifications inside the tumor.
Computed tomography (CT) scan – CT provides detailed images of bone structure and calcification. It helps define the exact size, internal mineralization, and cortical thinning or breakthrough, which is important for surgical planning and for distinguishing this tumor from others.
Magnetic resonance imaging (MRI) – MRI shows the tumor’s extent in bone marrow and surrounding soft tissue. Typical features include a well-circumscribed lesion with variable signal and surrounding marrow or soft-tissue edema. MRI is very useful for assessing joint involvement and guiding the surgical approach.
Bone scintigraphy and chest imaging (bone scan / CT chest) – A bone scan can show increased uptake (“hot spot”) at the tumor site and screen for additional lesions, while CT or X-ray of the chest is used to look for rare lung metastases, especially in recurrent or aggressive cases.
Non-pharmacological treatments
Education and reassurance
The care team explains what Codman’s tumor is, that it is usually benign, and how it is treated. Simple, clear information reduces fear, helps you follow the plan, and encourages early reporting of new pain or swelling.Activity modification and rest
Doctors often advise avoiding high-impact sports, running, or jumping on the affected limb until treatment is complete. This reduces pain, lowers the risk of fracture, and protects the joint surface around the tumor.Joint protection and bracing
A brace, splint, or supportive bandage may be used around the affected joint. It helps keep the joint stable, decreases stress on the weakened bone, and can make walking or daily tasks safer and less painful.Crutches or walking aids
Using crutches, a cane, or a walker temporarily takes weight off the painful limb. This can prevent micro-fractures, reduce pain during movement, and give the bone time to be treated and to heal after surgery.Range-of-motion exercises
A physiotherapist gently guides safe stretching and joint-movement exercises. These help prevent stiffness, maintain flexibility, and support joint nutrition while avoiding motions that put pressure on the tumor area.Muscle-strengthening program
Targeted strengthening of the muscles around the hip, knee, or shoulder improves support of the damaged bone. Strong muscles reduce load on the joint and can help you walk, climb stairs, or lift your arm with less pain.Balance and gait training
Physiotherapists work on walking patterns, balance, and coordination. This lowers the risk of falls, which are dangerous when the bone is fragile, and helps you return to normal walking after surgery.Hydrotherapy (water exercises)
Exercising in warm water lets you move the joint with less weight and less pain. Buoyancy supports the body, so you can safely work on mobility and strength even when land-based exercise is still painful.Cold packs (cryotherapy at skin level)
Ice packs around the joint (not deep tumor cryosurgery) reduce inflammation in nearby soft tissues. Short, repeated applications can ease pain and swelling after activity or after physical therapy.Heat therapy
Warm packs or warm showers can relax tight muscles around the joint. This may ease stiffness and discomfort before stretching or gentle exercises, but heat is usually not applied directly over a very inflamed or post-operative area.Transcutaneous electrical nerve stimulation (TENS)
Small sticky pads send a low electrical current through the skin. This can block some pain signals and may reduce the need for higher doses of pain medicines in certain patients under therapist guidance.Manual therapy and joint mobilization
Trained therapists may gently mobilize the joint (within safe limits) to maintain movement and relieve muscle spasm. This is always done according to the surgeon’s instructions to avoid stressing the weakened bone.Posture and ergonomic advice
Adjusting sitting, standing, study, or work positions can reduce uneven loading on the affected limb. Simple changes like proper chair height or computer position help keep pain under control through the day.Weight-bearing progression plan
After surgery or RFA, doctors and therapists give a step-by-step plan to increase weight on the limb. Gradual loading encourages bone healing while avoiding sudden overload that could cause collapse or fracture.Weight-management support
For patients with overweight, gentle nutrition advice and safe activity can slowly reduce body weight. Less body weight means less stress on the healing bone and joint, reducing pain and long-term wear.Psychological support / CBT style pain coping
Living with a tumor and repeated hospital visits can cause anxiety or low mood. Counseling and cognitive-behavioral techniques help you cope with pain, fear of recurrence, and temporary limits in sport or school.School or workplace accommodations
Temporary changes, such as extra rest breaks, reduced sports participation, or remote learning, help protect the limb. They also reduce stress and allow time for treatment and rehabilitation without feeling left behind.Home safety modifications
Simple changes like removing loose rugs, improving lighting, or adding handrails reduce fall risk. This is important when the bone is weakened or when you are on pain medicines that can cause dizziness.Structured home exercise program
Therapists often give daily home exercises to keep strength and mobility between clinic visits. A written plan with clear pictures helps you follow the routine safely and consistently.Long-term follow-up and imaging
Regular check-ups with X-rays or MRI look for tumor recurrence and check bone healing. Early detection of regrowth allows timely retreatment and helps protect joint function.
Drug treatments
Warning: These descriptions are general. Doses, timing, and combinations must be decided by a doctor. Many of these medicines have serious side effects and are not safe for self-treatment.
Acetaminophen (paracetamol)
Acetaminophen is a basic pain and fever medicine. It is often the first drug used for mild joint pain from Codman’s tumor before or after surgery. It works mainly in the brain to reduce pain signals but does not reduce inflammation, and high doses can damage the liver.Ibuprofen (NSAID)
Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) that reduces both pain and inflammation around the tumor or surgical area. It blocks COX enzymes and lowers prostaglandins, but can irritate the stomach and increase heart and kidney risks if used incorrectly.Naproxen / naproxen sodium
Naproxen is a longer-acting NSAID often used for bone and joint pain. It can give longer relief between doses but carries similar risks of stomach bleeding, kidney strain, and cardiovascular problems, especially at high doses or with long-term use.Celecoxib (selective COX-2 inhibitor)
Celecoxib is an NSAID that mainly blocks COX-2 and may cause less stomach irritation than older NSAIDs, while still reducing pain and inflammation. However, it can increase the risk of heart attack or stroke and must be used cautiously in people with heart disease.Diclofenac
Diclofenac is a strong NSAID used for moderate to severe musculoskeletal pain. It reduces inflammation in and around the joint but has higher risk for gastrointestinal and cardiovascular side effects, so doctors usually use the lowest effective dose for the shortest time.Ketorolac
Ketorolac is a powerful NSAID used only for short-term moderate to severe pain, often just after surgery. Because it has a high risk of kidney injury and bleeding, it is limited to a few days and carefully dosed in hospital settings.Tramadol
Tramadol is a centrally acting pain medicine with weak opioid activity plus re-uptake inhibition of serotonin and norepinephrine. It is sometimes used when NSAIDs and acetaminophen are not enough, but it can cause nausea, dizziness, drowsiness, and seizures at high doses.Stronger opioids (e.g., morphine, oxycodone)
In severe pain, especially just after major surgery, doctors may briefly use strong opioids. These act on opioid receptors to block intense pain but can cause constipation, sleepiness, breathing depression, and dependence, so they are used under strict monitoring.Opioid–acetaminophen combinations
Fixed-dose tablets combining an opioid with acetaminophen allow lower opioid doses while still giving strong pain relief. They are reserved for acute, severe pain and are limited in duration because of the risk of liver injury from acetaminophen and dependence from the opioid part.Gabapentin
Gabapentin is used when nerve-type pain develops, for example from nerve irritation near the tumor or after surgery. It stabilizes nerve activity but can cause drowsiness, dizziness, and weight gain, so dosing is slowly increased and later reduced as pain improves.Pregabalin
Pregabalin works similarly to gabapentin and may help burning or shooting pain. Doctors sometimes use it short-term after surgery when nerve pain is expected, but it can cause swelling, blurred vision, and sleepiness.Topical lidocaine (patch or gel)
Lidocaine patches reduce pain from irritated skin, scars, or superficial nerves after surgery. The medicine blocks local sodium channels in nerves and lowers pain signals without affecting the whole body as much as oral drugs.Proton pump inhibitors (e.g., omeprazole) with NSAIDs
When strong or long-term NSAIDs are needed, doctors may add a stomach-protecting PPI to lower the risk of ulcers and bleeding. These drugs reduce acid production in the stomach but can cause diarrhea, headache, and may affect mineral absorption if used long-term.Antiemetics (e.g., ondansetron)
After anesthesia, opioids, or strong pain medicines, nausea and vomiting are common. Antiemetics like ondansetron block serotonin receptors in the gut and brain and help patients keep food and medicines down while they recover.Antibiotic prophylaxis (e.g., cefazolin)
During open surgery, a short course of antibiotics helps reduce the risk of bone and wound infection. These drugs kill or stop the growth of bacteria but are used carefully to avoid resistance and allergic reactions.Low-molecular-weight heparin (e.g., enoxaparin)
After major limb surgery, some patients receive blood thinners to prevent clots in the legs or lungs. These medicines reduce clot formation but increase bleeding risk, so the surgeon judges carefully who should receive them.Short-course corticosteroids (selected cases)
Steroids are rarely used directly for Codman’s tumor but may be given briefly to reduce severe inflammation around the joint or to manage certain post-operative complications. They suppress immune activity but can raise blood sugar and weaken bone if used for long periods.Bisphosphonates (e.g., alendronate – experimental/adjunct)
Bisphosphonates slow bone breakdown and are mainly used for osteoporosis. In some complex bone cases they may be considered to support bone strength, but they are not standard therapy for chondroblastoma and would be specialist decisions.Calcium–vitamin D medicinal preparations
Prescription-strength calcium and vitamin D tablets may be used if blood tests show deficiency, especially after surgery or prolonged limited weight-bearing. They support bone mineralization but must be dosed carefully to avoid kidney stones or high blood calcium.Multimodal analgesic combinations (e.g., ibuprofen + acetaminophen products)
Fixed-dose combinations of acetaminophen and ibuprofen allow good pain control with lower doses of each drug. Labels clearly warn about maximum daily doses, so doctors use them in structured plans to reduce the need for opioids.
Dietary molecular supplements
Always check supplements with your doctor, especially if you are already on medicines or preparing for surgery.
Calcium – main mineral for bone strength and callus formation after bone surgery.
Vitamin D – helps the gut absorb calcium and supports bone mineralization and muscle function.
Collagen peptides – provide amino acids used in cartilage and bone matrix; may support recovery together with good diet.
Omega-3 fatty acids – have anti-inflammatory effects that may modestly help joint symptoms and overall cardiovascular health.
Magnesium – co-factor in bone metabolism and muscle function; low levels can affect bone quality and cramps.
Vitamin K2 – helps direct calcium into bone rather than soft tissues; usually used as part of a balanced regimen.
Protein supplements (whey, etc.) – support muscle repair and may aid fracture healing when normal food intake is low.
Antioxidant mix (vitamin C, E, etc.) – may support tissue repair and immune health but should not replace standard treatment.
Curcumin (turmeric extract) – has mild anti-inflammatory properties in some studies; quality and dose vary widely between brands.
Probiotics – can help gut health, which may be disturbed by antibiotics or pain medicines, and indirectly support nutrient absorption.
Immunity-booster / regenerative / stem-cell–related drugs
These approaches are not standard treatment for Codman’s tumor. They are mentioned only as concepts you may see in research. Any use would be in specialist or research settings.
Teriparatide (synthetic PTH fragment) – stimulates bone-forming cells and is used for severe osteoporosis; may enhance fracture healing in selected cases.
Romosozumab (sclerostin inhibitor) – increases bone formation and decreases resorption; mainly for high-risk osteoporosis, not for routine tumor care.
Bone morphogenetic proteins (e.g., BMP-2) – growth factors sometimes added to bone grafts to stimulate new bone formation in complex defects.
Platelet-rich plasma (PRP) – concentrated platelets from the patient’s blood injected into surgical sites to deliver growth factors that may help soft-tissue and bone repair.
Mesenchymal stem cell therapy – experimental infusions or local injections of stem cells from bone marrow or fat to support bone regeneration in difficult cases.
Bone marrow aspirate concentrate (BMAC) – concentrated marrow cells placed into bone defects along with grafts to enhance healing; still a specialist technique.
Surgical and interventional procedures
Intralesional curettage
The surgeon opens the bone and carefully scrapes out the tumor with special instruments. This is the most common treatment and aims to remove all tumor cells while preserving as much healthy bone and joint cartilage as possible.Curettage with bone grafting or bone cement
After scraping, the remaining cavity is filled with bone graft (from the patient or a donor) or bone cement (PMMA). This restores strength, supports the joint surface, and may reduce recurrence by sealing off remaining tumor cells.Extended curettage with adjuvants (phenol, cryotherapy, burr)
Surgeons may use a high-speed burr, chemical agents like phenol, or local freezing to kill microscopic tumor cells in the bone edge. This more aggressive approach lowers recurrence but must be balanced against the risk of joint damage.En bloc resection and reconstruction
In large or repeatedly recurrent tumors, the whole affected bone segment may be removed as one block, followed by reconstruction with grafts, plates, or joint replacement. This offers strong local control but is a major operation with long rehabilitation.Radiofrequency ablation (RFA) / percutaneous ablation
For small, well-placed lesions, interventional radiologists can insert a needle into the tumor under CT or MRI guidance and burn it from inside using radiofrequency energy, sometimes combined with cementoplasty. This joint-sparing technique can relieve pain quickly with a small skin incision.
Prevention
There is no known way to prevent Codman’s tumor itself, because it arises from abnormal growth of cartilage cells for reasons we do not fully understand.
However, you can reduce complications and support overall bone health:
Seek medical review early for persistent joint pain lasting more than a few weeks.
Do not ignore limping, swelling, or night pain in a limb, especially in children and teens.
Follow imaging and follow-up visits strictly after treatment to detect recurrence early.
Keep bones strong with enough calcium, vitamin D, and weight-bearing activity allowed by your doctor.
Avoid smoking or vaping, as these harm blood supply and bone healing.
Keep alcohol, if any, very low or zero, since it can weaken bone over time.
Maintain a healthy body weight to reduce stress on joints.
Use protective gear and safe techniques in sports to limit fractures through weak bone.
Manage other medical conditions (like vitamin D deficiency or hormonal problems) that might affect bone strength.
Follow all physiotherapy and home-exercise plans to restore strength and balance, lowering fall risk.
When to see a doctor
You should see a doctor or bone specialist as soon as possible if you, your child, or a teenager has:
Deep, localized bone or joint pain that lasts for weeks or wakes you at night
A visible lump, swelling, or warmth near a joint
New limping, stiffness, or trouble using the limb
Sudden severe pain after a minor injury in a limb already known to have a bone lesion
After treatment, urgent review is needed if there is:
Return of pain in the same area
Redness, fever, or wound discharge (possible infection)
New weakness, numbness, or loss of movement near the joint
What to eat and what to avoid
Good to eat:
Calcium-rich foods – milk, yogurt, cheese, tofu, and leafy greens to support bone repair.
Vitamin-D sources – oily fish, fortified milk, and safe sunlight exposure as guided by your doctor.
Lean proteins – eggs, beans, lentils, fish, and poultry help muscle and tissue healing after surgery.
Colorful fruits and vegetables – provide vitamins, minerals, and antioxidants that support overall recovery.
Whole grains and healthy fats – such as oats, brown rice, nuts, seeds, and olive oil for steady energy.
Better to limit or avoid:
Very sugary drinks and snacks, which add calories but few nutrients important for healing.
Highly processed fast foods that are high in salt and unhealthy fats.
Excess caffeine (strong tea/coffee/energy drinks) that may interfere with sleep and calcium balance if taken in large amounts.
Smoking or vaping, which reduces blood supply and slows bone healing.
Alcohol, which can weaken bones and interact with pain medicines; for young people and during treatment, avoiding it completely is safest.
FAQs
Is Codman’s tumor cancer?
Codman’s tumor (chondroblastoma) is usually benign, which means it is not classic cancer. However, it can act aggressively, damage bone, and sometimes come back after treatment, so it is treated very seriously.Who usually gets Codman’s tumor?
It most often affects teenagers and young adults, more often boys than girls, and usually appears at the ends of long bones around major joints like the knee, hip, or shoulder.What causes Codman’s tumor?
The exact cause is unknown. It seems to come from abnormal growth of cartilage-forming cells in the bone end. There is no clear link with diet, injuries, or lifestyle in most patients.Is surgery always needed?
In almost all cases, some form of surgery or ablation is needed because the tumor does not go away on its own and can damage the joint if left untreated.Can radiofrequency ablation replace open surgery?
For small, well-located tumors, RFA can be a good alternative and may give fast pain relief with a tiny incision. For large or complex lesions, open curettage and grafting is still more common.Will the tumor come back after treatment?
Recurrence rates vary but can reach 5–30%, depending on location and technique. Careful extended curettage and proper follow-up imaging help keep this risk as low as possible.Can Codman’s tumor spread to other parts of the body?
Very rarely, chondroblastoma can metastasize (often to the lungs), so doctors follow patients for several years and may order chest imaging in selected cases.How long is recovery after surgery?
Recovery depends on tumor size, location, and type of surgery. Many patients need weeks to months before full weight-bearing and several months of physiotherapy to regain strength and movement.Can I play sports again?
Many young people do return to sports once the bone has healed and strength is restored, but this decision is made by the surgeon and physiotherapist after imaging shows good healing.Are pain medicines safe long-term?
Long-term NSAIDs or opioids can cause serious side effects (stomach bleeding, kidney damage, dependence). Doctors prefer the lowest effective dose for the shortest time, combined with non-drug strategies.Do supplements cure Codman’s tumor?
No. Supplements like calcium or vitamin D can support bone health but do not remove the tumor. The only curative treatments are surgery or ablation.Is radiotherapy used?
Radiotherapy is rarely used because of the risk of damaging the growth plate and the small but real risk of malignant change. Surgery and RFA are preferred in modern practice.Can this tumor affect growth in children?
Yes. Because it sits near the growth plate, both the tumor and surgery can affect limb growth or joint shape, so surgeons plan very carefully to protect growth as much as possible.How often are follow-up visits needed?
Follow-up schedules vary, but many patients are seen every few months at first, then yearly, with imaging to look for recurrence or joint damage, especially in the first 2–5 years.What is the long-term outlook?
With proper surgery and follow-up, most patients have good pain relief and keep useful joint function. A small number may have ongoing stiffness, limb length differences, or need further surgery if the tumor recurs.
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The article is written by Team RxHarun and reviewed by the Rx Editorial Board Members
Last Updated: January 12, 2026.
