Juxtacortical Chondromyxoid Fibroma of Tibia
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2017, Vol 1, Issue 5
Abstract
Introduction: Chondromyxoid fibroma, CMF, is the least common benign cartilaginous tumor composed of chondroid and myxoid matrix. It is usually located eccentrically in distal femur or proximal tibia metaphysis. Juxtacortical Chondromyxoid fibroma which may be seen in unusual places such as intracortical, or sub periosteallocations is very unusual. Case report: A 16-year-old boy presented to us with a mildly painful distal tibial mass for one year. Imaging studies showed a protruded mixed radio-opaque, radio lucent lesion at posterior surface of distal tibial metaphysis, without soft tissue involvement. A biopsy was performed which showed Chondromyxoid fibroma. Curettage and bone grafting was done as the therapeutic modality. Conclusion: Chondromyxoid fibroma is usually not considered in the differential diagnosis of a painful, superficial lesion on a long bone. Other tumors such as periosteal chondroma, parosteal or periosteal osteosarcoma, parostealmyxoma, sub periosteal ganglion cyst, or periosteal osteoid osteoma are usually considered. Our case along with similar cases has proved that Juxtacortical CMF should be included in the differential diagnosis of a surface bony lesion. Chondromyxoid fibroma CMF was first described by Jaffe and Lichtenstein [1]. It is a rare tumor which comprises less than 1% of all benign bone tumors, and it is the least common benign cartilaginous tumor of bone. It usually presents during the second and third decades of life, and has a tendency for the metaphyseal region of the distal femur and proximal tibia [2]. Chondromyxoid fibroma may occasionally appear as a surface lesion. This includes tumors which are intracortical, sub periosteal, periosteal, or parosteal. Intracortical involvement is more common [3-5]. As it is not always possible to determine the precise origin of these surface lesions, the term Juxtacortical includes comprehensively all of these surface locations [6]. Periosteal Chondromyxoid fibroma has been reported to have imprint cytology as a method of confirmation [7]. We here present a new case of Juxtacortical Chondromyxoid fibroma. A 16-year-old boy presented to us with a painful swelling above his right ankle. This swelling had been gradually increasing in size, and present for year. On physical examination, the patient had a tender, fixed, bony hard swelling on the distal part of the right tibia. The lesion was not fixed to the skin and was not associated with any ulceration, rise of temperature or sinus formation. The swelling was diffuse and large. Neurovascular status of the right lower extremity was normal. The patient did not have any other symptoms or any abnormal findings on systemic physical examination. His past medical, family, allergy and drug, and social histories were not relevant. The laboratory tests including CBC, ESR, and CRP were normal. Plain radiographs of the right tibia and ankle in anteroposterior and lateral views showed a protruded superficial calcified mass in the posterior aspect of distal tibia (Figure 1A).
Authors and Affiliations
Sam Hajialiloo Sami, Tina Shooshtarizadeh, Hajar Zekavat, Mehrdad Bahrabadi
Keywords
Related Articles
- EP ID EP578394
- DOI 10.26717/BJSTR.2017.01.000445
- Views 173
- Downloads 0
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