Introduction A rare and benign chondrogenic lesion characterized by variable amounts of chondroid, fibromatoid and myxoid elements Epidemiology demographics more common in males most common in second and third decades of life may affect patients up to 75 years old location long bones (ie. tibia, distal femur) often affects metaphyseal (proximal tibia) regions pelvis feet or hands Pathophysiology may arise from physeal remnants Genetics mutations a genetic rearrangement may affect chromosome 6 (postion q13) Prognosis natural history recurrence in CMF is not uncommon may occur in 20-30% of cases negative prognostic variables children tumor is more lobulated with abundant myxoid material metastasis has not been reported Presentation History long standing pain (months to years) may be incidentally identified Symptoms pain and mild swelling Imaging Radiographs findings lytic, eccentric metaphyseal lesion sharply demarcated from adjacent bone scalloped and sclerotic rim calcifications are rare cortical expansion may be seen lesion size may range from two to ten centimeters MRI findings low signal on T1-weighted images high signal on T2-weighted images Bone scan findings increased signal uptake will be seen Studies Histology findings low-power biphasic appearance hypercellular area with lobules of fibromyxoid tissue spindle-shaped cells or stellate-shaped cells the cells contain hyperchromatic nuclei multinucleated giant cells and fibrovascular tissue are located between lobules hypocellular area with chondroid material high power myxoid stroma with stellate cells regions of pleiomorphic cells with bizarre nuclei may be seen Diagnostic criteria histopathologic examination is mandatory for confirmation of the diagnosis Differential Radiographic aneurysmal bone cyst (ABC) chondroblastoma non-ossifying fibroma Histologic chondroblastoma enchondroma chondrosarcoma Treatment Operative intralesional curretage and bone grafting (or PMMA) indications mainstay of treatment Complications Recurrence occurs in 25% of cases Ibank Location Xray Xray CT B. Scan MRI MRI Histo(1) Case A foot Case B tibia Case C femur Case D tibia (1) - histology does not always correspond to case
QUESTIONS 1 of 4 1 2 3 4 Previous Next Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK (OBQ12.133) A 12-year-old female presents for evaluation of worsening right wrist pain. She denies any trauma and is otherwise healthy. A current radiograph is shown in Figures A and B. A biopsy is obtained and shown in Figure C. What is the most likely diagnosis? Review Topic QID: 4493 FIGURES: A B C 1 Chondrosarcoma 5% (167/3374) 2 Osteosarcoma 2% (74/3374) 3 Chondromyxoid fibroma 49% (1639/3374) 4 Nonossifying fibroma 33% (1127/3374) 5 Enchondroma 10% (343/3374) ML 4 Select Answer to see Preferred Response PREFERRED RESPONSE 3 Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK