Updated: 10/4/2016

Desmoplastic Fibroma

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https://upload.orthobullets.com/topic/8029/images/Case A - tibia - xray 2 - Parsons_moved.jpg
https://upload.orthobullets.com/topic/8029/images/Case A - tibia - CT - Parsons_moved.jpg
https://upload.orthobullets.com/topic/8029/images/Histology B - Parsons_moved.jpg
https://upload.orthobullets.com/topic/8029/images/Case A - tibia - xray - Parsons_moved.jpg
https://upload.orthobullets.com/topic/8029/images/Case B - tibia - xray - Parsons_moved.jpg
https://upload.orthobullets.com/topic/8029/images/Case C - femur - xray - Parsons_moved.jpg
Introduction
  • Low-grade malignant fibrogenic tumor of bone
  • Epidemiology
    • incidence
      • extremely rare
    • demographics
      • usually occurs in adolescence and young adults (15-25)
    • body location
      • mandible and metaphysis of long bones
  • Prognosis
    • recurrence rate of 40%
Symptoms
  • Presentation
    • painful lesion
Imaging
  • Radiographs
    • findings
      • purely lytic lesion
      • soap bubble appearance (internal pseudotrabeculatins)
      • endosteal scalloping
      • may involve cortex
      • may have soft tissue mass
Histology
  • Classic characteristics are
    • dense swirling fibrous spindle cells  
    • mature fibroblasts without cellular atypia 
    • abundant bundles of collagen 
Treatment
  • Operative
    • wide surgical resection vs. intralesional curretage
      • indications
        • wide surgical resection recommended to avoid recurrence
 
  Location
Xray
Xray
CT
B. Scan
MRI
Histo(1)
Case A distal tibia
 
Case B proximal tibia    
Case C distal femur      
(1) - histology does not always correspond to case 
 

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