Presentation
Pain is the most common presenting feature, accounting for 65% to 90% of the clinical presentation in some studies.2'6 Other possible presentations include swelling and pathologic fracture, though these occur in less than 20% of the patients.1,3,6,7 Trie [healio.com]
Signs/Symptoms • Sometimes physical examination is unrevealing • Pathologic fracture may be the initial presentation. • When is symptomatic, may present discrete swelling near the affected area. • Cutaneous pigmentation (Café-au-lait spots) may be seen [tumorsurgery.org]
Lobulated areas; large pleomorphic cells may be present and get confused with chondrosarcoma (7). [arquivosdeorl.org.br]
Histopathologically, 5 patients presented the conventional type, 5 the juvenile psammomatoid variant, which was associated in 1 case with an aneurismal bone cyst, and 1 case presented the trabecular juvenile variant. [ncbi.nlm.nih.gov]
Case presentation We present the case of a 13-year-old Japanese boy with a complaint of discomfort in the thigh and a small, well-defined, osteolytic lesion with cortical thinning located in the medullary space of the distal diaphysis of the femur. [jmedicalcasereports.biomedcentral.com]
Entire Body System
- Pain
And if at the person excess perspiration of skin of feet is also observed, the itch can be added to painful feelings. Frequent because of severe pain it becomes very heavy to patient to go. [herbalthera.com]
Case Report A 75-year-old male patient presents with the complaint of pain in the first metatarsal region. He states he had been having pain, which has been getting progressively worse for the past several months. [faoj.org]
The cyst itself is not painful but since the bone is weakened, the child will present with sudden pain when a hairline or complete fracture results after a minor fall. [sarcoma.md]
These cancers usually are discovered when a patient has pain that begins in one area—most often the thigh—and gets worse over time, while a mass of soft tissue develops in the painful area. [urmc.rochester.edu]
To help differentiate bone pain from joint pain, the joint can be injected, usually with a long-lasting anesthetic (eg, bupivacaine ); if pain persists, it may be caused by the bone lesion. [merckmanuals.com]
- Asymptomatic
Fibrous cortical defects are small, asymptomatic, and intracortical lesions, while a nonossifying fibroma is a large, tumorous lesion involving spongy bone and the medullary cavity of bone, and leads to clinical symptoms. [ci.nii.ac.jp]
Extension of normal bone Originates at cartilage (physeal growth plate) and migrates away from it with growth of bone Continues to enlarge until cessation of skeletal growth Small = asymptomatic. [imageinterpretation.co.uk]
Typically, fibroxanthomas are asymptomatic. However, the larger lesions may become symptomatic, with a risk of pathologic fracture. [emedicine.medscape.com]
Nonossifying fibroma is usually asymptomatic. When non ossifying fibromas are less than 2 cm they are referred to as fibrous cortical defects. [tumorsurgery.org]
No treatment is needed in asymptomatic patients and spontaneous remission with replacement by bone tissue is to be expected. [en.wikipedia.org]
- Weakness
Abstract A 9-year-old boy presented with progressive muscle weakness, waddling gait, and diminishing growth velocity of 16 months' duration. Radiographs demonstrated active rickets and a lytic lesion of the distal radius. [pediatrics.aappublications.org]
In some cases, the tumor remains undiscovered until there is a fracture in the bone that has become weak from a growing tumor. Bone sarcomas are cancerous tumors that develop in bones. [drhosalkar.com]
Large size or the presence of symptoms can indicate that the bone is weak and likely to fracture, even with very little force. Curettage. This is the surgical procedure most commonly used to treat NOFs. [orthoinfo.aaos.org]
The bone becomes weak in the area that has this tissue, causing a deformity or a fracture. Fibrous dysplasia tends to reveal itself in adolescents and young adults. [urmc.rochester.edu]
- Severe Pain
And if at the person excess perspiration of skin of feet is also observed, the itch can be added to painful feelings. Frequent because of severe pain it becomes very heavy to patient to go. [herbalthera.com]
Injury can cause a bone weakened by tumor to break, which often leads to severe pain. Some tumors can also cause fevers and night sweats. Many patients will not experience any symptoms, but will instead note a painless mass. [health.uconn.edu]
Musculoskeletal
- Fracture
Surgery usually consists of a curettage and bone grafting. • Curettage and bone grafting is curative when required • In cases of the pathologic fractures consideration should be given to allowing the fracture to heal first then treating the nonossifying [tumorsurgery.org]
Cysts in the region of the hip are particularly prone to fracture. [www0.sun.ac.za]
If a fracture is involved, the operation is put off until the fracture heals with cast immobilization followed by a period observation after it has healed. [humpath.com]
Depending on the fracture, the surgeon may elect to treat the fracture, and if the cyst does not heal completely and resolve, a grafting procedure may be required. [benignbonecyst.com]
As they may have associated pathological fractures, treatment of the fracture is needed along with aspiration. Treatment with bone grafting also may be indicated. [pediatriceducation.org]
- Bone Disorder
Second most common bone disorder after osteoporosis. 70-90% of persons with Paget disease are asymptomatic. Study the images and then continue reading. [radiologyassistant.nl]
If the bone looks weakened, however, your doctor may recommend that the tumor be surgically removed to avoid a fracture. Fibrous Dysplasia : In this uncommon genetic disorder, a fibrous tissue grows in place of part of the normal bone. [urmc.rochester.edu]
- Osteoporosis
Second most common bone disorder after osteoporosis. 70-90% of persons with Paget disease are asymptomatic. Study the images and then continue reading. [radiologyassistant.nl]
Workup
Therefore, any workup of a bone tumor should start with a good set of plain films. Age Patient age is a very important bit of knowledge to have in the workup of a tumor. [rad.washington.edu]
The fifth patient's tumor was also an incidental finding secondary to a workup for dysuria. [healio.com]
At Children’s Hospital of Philadelphia (CHOP), our clinical experts perform a careful and complete medical workup and examination of your child. [chop.edu]
Treatment
At treatment the preparations appointed by the doctor, physical therapy and orthopedic devices are applied. If pain does not disappear or increases, there can be a need of surgical treatment. [herbalthera.com]
Treatment: Treatment requires surgery to remove the tumor. Outlook: Recurrences after curettage is common. [kucancercenter.org]
Treatment generally involves removal of the tumor, treatment of the bone cavity with cauterization, freezing or chemicals and then bone grafting. Surgery is usually successful but some can grow back. [benignbonecyst.com]
The treatment usually takes the form of six courses of treatment at intervals of three weeks, following which further management decisions will be based partly on the response to treatment. [patient.info]
What are my treatment options? Medical Treatments Treatment for benign bone tumors depends on the specific type of tumor, its size, its location, and age. Sometimes, surgery is not necessary. [my.clevelandclinic.org]
Prognosis
Prognosis: - Good. - Therapy ranges from observation to surgical removal. [pedorthpath.com]
The prognosis is good because malignant change and metastasis have not been reported. The authors are reporting a case of JPOF of the ethmoid bones with secondary ABC in a 7-year-old female patient. [ FULL TEXT ] [ PDF ]* [sjmms.net]
Prognosis The prognosis is excellent. Cytogenetics Morphological Karyotypes of 12 cases are reported in the literature. Complex cytogenic abnormalities are reported. [atlasgeneticsoncology.org]
[…] increased activity can be seen during NOF "healing", corresponding to mild hyperaemia and osteoblastic activity note that extensive uptake or hyperaemia should prompt consideration of alternative diagnosis or a superimposed fracture 4 Treatment and prognosis [radiopaedia.org]
Etiology
Genetic testing may be indicated for the evaluation of polyostotic bone lesions secondary to syndromic etiologies. References Levine SM, Lambaise RE, Petchprapa CN. [jaocr.org]
Aneurysmal bone cysts (ABC) are benign expansile tumor-like bone lesions of uncertain etiology, composed of numerous blood-filled channels, and mostly diagnosed in children and adolescents. [radiopaedia.org]
Etiology The exact cause is unknown, but the age and location distribution implicate the growing physis as the affected mechanism. [orthopaedicsone.com]
Controversy continues regarding the correct terminology and etiology of these lesions. The distinction between FCD and fibroxanthoma is based on size and natural history. [emedicine.medscape.com]
There was no prior history of trauma or any other etiology, which could contribute to the pathology of the lesion. [ispub.com]
Epidemiology
Epidemiology: - 85% of patients in the first decades of life. - Male:Female ratio 3:1. [pedorthpath.com]
Epidemiology Chondromyxoid fibroma is a very rare neoplasm accounting for less than 1% of all bone tumours, and less of 2% of all benign bone tumours. [atlasgeneticsoncology.org]
[…] can indicate the presence of Jaffe-Campanacci syndrome which can have the following findings: Multiple giant NOF Café-au-lait spots Multiple nevi Other irregular pigmentations Mental retardation Hypogonadism Occular and cardiovascular abnormalities Epidemiology [orthopaedicsone.com]
Eyre R, Feltbower RG, James PW, et al ; The epidemiology of bone cancer in 0 - 39 year olds in northern England, 1981 - BMC Cancer. 2010 Jul 610:357. [patient.info]
[…] a benign fibrogenic lesion that is the most common benign bone tumor in childhood related to dysfunctional ossification other names metaphyseal fibrous defect nonosteogenic fibroma cortical desmoid fibrous cortical defect fibromatosis fibroxanthoma Epidemiology [orthobullets.com]
Pathophysiology
Pathology and pathophysiology The gross pathology is soft tan fibrous tissue. Microscopically, there are spindled fibroblasts in a dense collagen background. [orthopaedicsone.com]
[…] demographics common in children 5-15 years old 30% of children with open physis have a NOF locations metaphysis of long bones 80% in lower extremity distal femur > proximal tibia > proximal fibula > distal tibia uncommon in proximal femur, proximal humerus Pathophysiology [orthobullets.com]
Prevention
Over the past two decades, antiviral medications have been developed to help prevent outbreaks and speed healing... Read Article [marvistadentistry.com]
Risk factors and prevention There are no particular risk factors for development of a solitary lesion. Treatment options The natural history of the lesion is spontaneous resolution with no symptoms. [orthopaedicsone.com]
It is also prescribed after surgery to kill any remaining cancer cells and prevent recurrence. [drhosalkar.com]
This is a minor procedure which helps prevent future fractures. Eventually, the bone graft is converted by the body to bone. [sarcoma.md]
[…] marrow Diseases of the different cell types Cell types and functions: White blood cells (WBCs) WBCs are of five different types: lymphocytes neutrophils (also called granulocytes) eosinophils basophils monocytes These play different roles in infection prevention [news-medical.net]