Chondromyxoid fibroma is a rare, benign tumor of bone that represents fewer than 1% of all benign and malignant tumors of bone. Plain skull films showed a round radiolucent mass with a sclerotic margin. An additional peak of incidence has been observed between 50 and 70 years of age. July 27, 2017 056 the tumor may be discovered incidentally during radiography 1. Chondromyxoid fibroma is a rare benign primary bone tumor of cartilage. Rarer locations include the fibula, scapula, vertebrae and ribs 3. Fineneedle aspiration biopsy of chondromyxoid fibroma an.
This article is from archives of plastic surgery, volume 41. Both clinically and histologically, it is a difficult diagnosis and can be confused with malignant lesions. Chondromyxoid fibromas cmfs are extremely rare, benign cartilaginous neoplasms that account for benign bone tumor arising in young adults. Bullous lesions in patient with lupus explore this issuefebruary 2016 her chest radiograph revealed no infiltrates. Eight new cases are added, 4 of which exhibited unusual size andor focal microscopic calcification, pathologic fracture, diaphyseal location. The differential diagnosis included the chondroblastoma, the aneurysmal cyst and. Chondromyxoid fibroma is the least commonly occurring bone tumor, accounting for approximately 1% of all biopsied primary bone tumors 7, 32.
The possibility of chondromyxoid fibroma should always be considered when a focal bone lesion is evaluated that has geographic bone destruction, a sclerotic rim, lobulated margins, and septation. Chondromyxoid fibroma of bone, with emphasis on its morphological relationship to benign chondroblastoma. It is a benign noncancerous tumor that most often develops in older children and young adults under 30 years of age. Surgical management of a giant sternal chondromyxoid. To our knowledge, this case report represents the first description of cmf involving an extragnathic site in the facial skeleton exclusive of the cranium. Chondromyxoid fibroma is a benign, although potentially aggressive tumor, with a cartilagelike matrix, accounting for approximately 1% of all bone tumors. Tumors located in the distal extremities such as the hands or feet may only present clinically with signs of painless swelling 5. We analyzed rapid romanowsky and papanicolaoustained slides with a respect to overall cellularity, the presence of hypercellular chondromyxoid fragments hcfs, nuclear atypia, cytoplasmic features, and the presence of giant cells. Fineneedle aspiration biopsy of chondromyxoid fibroma. Despite a characteristic radiographic appearance, chondromyxoid fibroma with atypical radiographic findings may mimic more common tumors.
Chondromyxoid fibroma is a type of cartilaginous tumor. Jaffe and lichtenstein first described the condition in 1943. Chondromyxoid fibroma is an uncommon benign cartilaginous tumor of the bone. Chondromyxoid fibroma cmf is a rare, benign bone tumour. The diagnosis of cmf depends upon its characteristic histological appearance like a lobular pattern with stellateshaped cells in a myxoid or. Chondromyxoid fibroma cmf is one of the rarest of bone tumors, accounting for less than 1% of all bone tumors. It is usually located eccentrically in distal femur or proximal tibia metaphysis. Complete local excision with tumorfree margins avoids the recurrence of cmf, the underlying tumor in this case report. A primary chondromyxoid fibroma cmf arising from sternum is quite uncommon tumor in thoracic surgery.
Chondromyxoid fibroma definition of chondromyxoid fibroma. Chondromyxoid fibroma cmf is a benign, locally aggressive tumor of cartilaginous origin and accounts for less than 0. It is associated with high local recurrence rates with a small risk chondromyxoid matrix in a distinctive histological pattern. Metaphysis of long tubular bones, small bones of feet or any bone, skull base clivus. Chondromyxoid fibroma with secondary aneurysmal bone cyst. A 35yearold man visited us with a chief complaint of painful swelling of the finger. Chondromyxoid fibroma cmf is one of the rarest benign tumors of cartilaginous origin. Huge chondromyxoid fibroma of the right iliac wing with. Males have a higher incidence, with no other demographic bias 3. Chondromyxoid fibromas are rare, benign tumours that consist of immature myxoid mesenchymal tissue with features of primitive cartilaginous differentiation. Sep 23, 2016 chondromyxoid fibroma cmf is a benign, locally aggressive tumor of cartilaginous origin and accounts for less than 0.
It occurs most frequently in the metaphysis of long tubular bones, and an epiphyseal location is exceedingly rare. May 12, 2014 surgical excision is the firstline choice for chondromyxoid fibroma, for which only simple curettage is performed or a bone graft is used for filling the cavitary defect following curettage. An adult male patient at the age of 28 suffered a fracture of the lateral malleolus due to an eccentric, lytic, lobular lesion in the epiphysis, during a basketball match. Since 1948, when jaffe and lichtenstein first recognized this tumor as a distinct entity, and. Tinu syndrome with concomitant synovitis rheumatology case report. Radiographic and histologic patterns of calcification in chondromyxoid fibroma. Chondromyxoid fibromas are rare, benign tumours that resemble cartilage, initially arising in the cortex of affected bones most commonly the lower limbsy their documented incidence is less than 1 % of all primary bone tumours approximately 2% of all benign bone tumours with males and females being equally affectedy. The treatment of the secondary abc is based on the appropriate treatment for the underlying tumor. Chondromyxoid fibroma of the frontal bone tatsuo morimura, 12 atsuhisa nakano, 1 tsuyoshi matsumoto, 1 and eiichi tani1 summary. Primary chondromyxoid fibroma of the sternum is quite rare, with only six cases documented in the literature see table 1. Chondromyxoid fibroma cmf is a rare benign bony tumour. We describe the cytologic features of chondromyxoid fibroma in fineneedle aspiration biopsy specimens in 4 patients.
Chondromyxoid fibroma with secondary aneurysmal bone cyst in. Most cases are characterised by grm1 gene fusion or promoter swapping. A 40yearold female presented a progressively enlarging mass of her anterior chest wall. Chondromyxoid fibroma is a rare benign tumor that usually occurs in the long bones and rarely affects the sinonasal region. Chondromyxoid fibromas cmfs are extremely rare, benign cartilaginous neoplasms that account for chondromyxoid fibroma but no cartilaginous areas, usually older adults.
Jan 01, 2009 chondromyxoid fibroma cmf is a rare neoplasm constituting less than 1% of all bone tumors. Chondromyxoid fibroma is a very rare benign cartilaginous tumor representing less than 0. A rare case of epiphyseal chondromyxoid fibroma of the. Most chondromyxoid fibromas are small 1 to 4 cm, round or ovalshaped tumors. Open access publication chondromyxoid fibroma of the foot. Chondromyxoid fibroma cmf is a benign tumor of cartilagenous origin and rarest of all bone tumors. It is most commonly found in the metaphysis of long bones and usually presents in the second or third decade of life. Jan 02, 2017 on mri, chondromyxoid fibroma shows a multilobulated pattern, with low signal intensity on t1weighted images and high signal intensity on t2weighted images. Sep 12, 2014 chondromyxoid fibroma cmf is a rare, benign bone tumour. The lesion is never purely epiphyseal, but may extend into the subchondral b. To our knowledge, this is the first reportable case of cmp presenting with undifferentiated connective tissue. A chondromyxoid fibroma cmf is an extremely rare benign cartilaginous neoplasm which accounts for chondromyxoid fibroma of the foot.
Mri of chondromyxoid fibroma article pdf available in acta radiologica 528. Clinically, it is characterized by a lobular growth pattern and. Huge chondromyxoid fibroma of the right iliac wing with tremendous soft tissue extensions hosameldeen mostafa ali, md department of radiology, benha university, benha, egypt address correspondence to. With contrast injection, the central portion of the lesion may show no enhancement due to the myxoid component.
Chondromyxoid fibroma of the finger pubmed central pmc. Chondromyxoid fibroma cmf is a benign neoplasm accounting for fewer than 1% of all bone tumors. Abstract chondromyxoid fibroma is a benign, although potentially aggressive tumor, with a cartilagelike matrix, accounting for approximately 1% of all bone tumors. The diagnosis of cmf depends upon its characteristic histological appearance like a lobular pattern with stellateshaped cells. Radiological evaluation of a chondromyxoid fibroma published. Smaller lesions are typically located in the cortex of long bones. Bullous lesions in patient with lupus explore this issuefebruary 2016 her chest radiograph revealed no. Juxtacortical chondromyxoid fibroma which may be seen in unusual places such as intracortical, or sub periosteallocations is very unusual. The treatment of the second ary abc is based on the appropriate treatment for the underlying tumor. It is associated with high local recurrence rates with a small risk sep 24, 2018 chondromyxoid fibroma. Chondromyxoid fibroma of bone, a clinicopathologic study of thirtytwo cases. Chondromyxoid fibroma may occur anywhere in the skeleton, but almost half of the cases occur around the knee. Chondromyxoid fibroma of frontal bone is a rare lesion. Removal of giant sternal tumors requires extensive resection of the anterior chest wall, and results in deformity and paradoxical movement.
In 1948, the tumor was first described by jaffe and lichtenstein as a lesion derived from cartilageforming tissue and composed of various proportions of chondroid, fibrous, and myxoid tissues. Sep 24, 2018 chondromyxoid fibroma cmf is a rare, slowgrowing, benign bone tumor of chondroblastic derivation. It has a predilection for men in the second and third decades of life with the metaphyseal regions of the long bones of the lower extremities as the favored sites of occurrence. We present here an unusual case of a chondromyxoid fibroma that occurred in the epiphysis of the proximal tibia with an open growth plate. To present a case of chondromyxoid fibroma of the nasal bone and discuss its presentation. Less common lesions include fibrous dysplasia, fibroxanthoma nonossify ing fibroma, chondromyxoid fibroma, solitary bone cyst, fibrous histiocytoma, eosinophilic granuloma, and even osteosarcoma.
Soni r, kapoor c, shah m, turakhiya j, golwala p 2016 chondromyxoid fibroma. The most commonly affected area is the metaphysial region of the proximal tibia and the distal femur 2. It is composed of a mixture of chondroid, myxoid, and fibrous tissues. It usually affects the metaphyseal region of long bones of patients in their first or second decade of life. Chondromyxoid fibroma, cmf, is the least common benign cartilaginous tumor composed of chondroid and myxoid matrix. It has a cartilagelike matrix composed of chondroid, fibrous, and myxoid areas in varying proportions. Chondromyxoid fibroma cmf is an extremely rare, benign cartilaginous tumor that makes up 0. Chondromyxoid fibroma is a type of cartilaginous tumor most cases are characterised by grm1 gene fusion or promoter swapping. We analyzed rapid romanowsky and papanicolaoustained slides with a respect to overall cellularity, the presence of hypercellular chondromyxoid fragments hcfs, nuclear atypia, cytoplasmic features, and the presence of.
Activating rearrangements of grm1 metabotropic glutamate receptor 1. To describe the mr findings of chondromyxoid fibroma. A case of chondromyxoid fibroma cmf involving the zygoma is presented. Upon history taking, we found that the mass had formed 7 to 8 years before and had since grown. It was dense on plain ct scan and showed no convincing contrast enhancement. Well circumscribed, hypocellular lobules of poorly formed hyaline cartilage composed of chondroblasts with abundant pink cytoplasm and myxoid tissue with fibrous septae containing spindle cells and osteoclasts.
In many cases, the tumor will destroy portions of the bone and aggressively grow, pushing into the surrounding soft tissues. Chondromyxoid fibroma constitutes a rare benign tumor of the bones, which has a potential of regional enlargement towards the local tissues. Concomitant lupus with features of scleroderma, castleman disease rheumatology case report. This is an advanced case of a benign chondromyxoid fibroma. Chondromyxoid fibroma is a benign tumor of bone that is characterized by chondroid and myxoid differentiation and by ultrastructural and immunohistochemical evidence of chondral origin.
Treatment for cmf requires surgery to remove the tumor. Get a printable copy pdf file of the complete article 647k, or click on a page image below to browse page by page. The decisive role played by the radiologist in identifying the benign nature of the lesion is emphasized. Although variable depending on the reports, the recurrence is estimated at approximately 25%. In xrays, they are often surrounded by a white sclerotic rim. Pdf chondromyxoid fibroma cmf is a rare benign mesenchymal tumor of the bone.