Presentation
Case Presentation A 15-year-old male patient presented with a four-month history of pain at the proximal end of the right tibia. The pain was a dull ache, mild in intensity without any diurnal variation. [cureus.com]
It typically presents with pain, swelling, and tenderness to palpation. The lesion has a predilection for the metaphysis of long bones of the lower extremity, most commonly in the proximal tibial metaphysis. [ncbi.nlm.nih.gov]
Entire Body System
- Pain
A 35-year-old man presented with history of neck pain, restriction of neck movements, pain and numbness along the medial aspect of the left forearm and weakness with wasting of the left hand. [ncbi.nlm.nih.gov]
- Swelling
It typically presents with pain, swelling, and tenderness to palpation. The lesion has a predilection for the metaphysis of long bones of the lower extremity, most commonly in the proximal tibial metaphysis. [ncbi.nlm.nih.gov]
On examination an ovoid swelling measuring 1.5 x 1.5cm and extending from the metatarso-phalangeal joint up to the middle of the toe was noted. [faoj.org]
Clinically patients presented with pain, swelling or tenderness and duration may range from weeks to years [ 7 ]. Our patient had similar symptoms. [casereports.in]
- Asymptomatic
The patient remains asymptomatic at 1-year follow-up. Despite the low incidence of CMF in the lumbar spine, differential diagnosis must include this subtype of lesion among other benign tumours of the bone and cartilage. [ncbi.nlm.nih.gov]
Although a minority of cases are asymptomatic, mild, intermittent local pain is present in the majority and some cases manifests a mass which may or may not be tender [3]. [ijri.org]
The mass was noticed by the mother to be slow growing over the last 6 months but was to be slow growing over the preceding 6 months but was asymptomatic. [jomfp.in]
On some occasions, the tumor may be asymptomatic and may present as an incidental finding on radiographic examination [5]. [cureus.com]
CMF is a commonly asymptomatic lesion that is discovered incidentally on radiography. [2] Symptomatic patients present with pain, swelling or tenderness, restrictions of movement, and rarely with pathological fracture. [2], [4], [5] The cytological differential [jcytol.org]
- Soft Tissue Mass
Axial images show a T1-hypointense and T2-hyperintense soft tissue mass with extensive T2-hyperintensity in the surrounding marrow. Fat-saturated post-contrast sagittal image shows heterogeneous, predominantly peripheral, enhancement. [roentgenrayreader.blogspot.com]
Symptoms: Chronic pain, swelling, restricted movement and a palpable soft-tissue mass. Just 5 percent of CMF cases present with a fracture. Diagnosis: Determined by CT scan and MRI which are also integral to preoperative planning and staging. [kucancercenter.org]
Direct roentgenography revealed a sacral mass ( figures 1 and 2 ). CT and MRI demonstrated an osteolytic expansile soft tissue mass on sacral (S 2–3) vertebrae ( figures 3 and 4 ). A suspected chondromyxoid fibroma was reported on needle biopsy. [casereports.bmj.com]
On CT scans, it appears as a well-circumscribed, relatively homogeneous, soft-tissue mass with curvilinear bony margins at its periphery, consistent with a slow-growing tumor. [em-consulte.com]
A soft-tissue mass is not frequently shown, and matrix calcification occurs in approximately 50% of patients15, 16. Malignant lesions are typically larger, more ill-defined, and may show medullary extension15, 17. [scielo.br]
- Localized Pain
The most common clinical symptom is mild, localized pain. [ebi.ac.uk]
Although a minority of cases are asymptomatic, mild, intermittent local pain is present in the majority and some cases manifests a mass which may or may not be tender [3]. [ijri.org]
When symptomatic, cases are associated with a long history of chronic local pain (85%), swelling (65%), edema (65%) and possibly a palpable soft tissue mass resulting in restriction of movement and more rarely, pathologic fracture. [7] In our case, there [amsjournal.com]
Musculoskeletal
- Fracture
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. [ncbi.nlm.nih.gov]
Matrix calcification, periosteal new bone production and pathological fracture rarely are associated with CMF [3]. [ijri.org]
Patient Population: Prevalence and Epidemiology Knee // Shoulder & Elbow // Hip // Spine // Foot & Ankle // Hand & Wrist Fragility Fractures: Diagnosis and Treatment Shoulder & Elbow The Characteristics of Surgeons Performing Total Shoulder Arthroplasty [mdedge.com]
- Leg Pain
We report a case of a 31-year-old woman with chondromyxoid fibroma arising from the iliac bone and presenting with leg pain due to compression on the femoral nerve. [ncbi.nlm.nih.gov]
A 10-year-old female presented with left lower leg pain that had progressively increased over the duration of 1 year. On physical examination, tenderness was elicited on palpation of the distal tibia. Routine laboratory testing was normal. [heighpubs.org]
- Lower Leg Pain
A 10-year-old female presented with left lower leg pain that had progressively increased over the duration of 1 year. On physical examination, tenderness was elicited on palpation of the distal tibia. Routine laboratory testing was normal. [heighpubs.org]
Psychiatrical
- Suggestibility
The histogenesis of chondromyxoid fibroma has not yet been postulated, even though the conventional histology and recent immunohistochemical studies on phenotype of the mesenchymal cells and extracellular matrix components suggested its origin in immature [ncbi.nlm.nih.gov]
- Aggressive Behavior
Scaglietti, et al. drew attention to the locally aggressive behavior of this tumor in the young and suggested a more radical form of local resection in its management [7]. [cureus.com]
PMID 12742153 Evidence of an association between 6q13-21 chromosome aberrations and locally aggressive behavior in patients with cartilage tumors. Sawyer JR, Swanson CM, Lukacs JL, Nicholas RW, North PE, Thomas JR Cancer. 1998 ; 82 (3) : 474-483. [atlasgeneticsoncology.org]
Evidence of an association between 6q13-21 chromosome aberrations and locally aggressive behavior in patients with cartilage tumors. Cancer. 1998;82:474–83. CrossRef PubMed Google Scholar Shek TW, Peh WC, Leung G. [link.springer.com]
View Article PubMed Google Scholar Sawyer JR, Swanson CM, Lukacs JL, Nicholas RW, North PE, Thomas JR: Evidence of an association between 6q13-21 chromosome aberrations and locally aggressive behavior in patients with cartilage tumors. [doi.org]
Workup
Preoperative tumor workup was performed for our patients. We reviewed and recorded demographic data and the sign and symptoms of patients at presentation to our center. [ncbi.nlm.nih.gov]
An extensive infection workup was negative. (click for larger image) Figure 1: CT scan of the chest with three sagittal sections revealing no evidence of interstitial lung disease or air trapping. [the-rheumatologist.org]
Treatment
Adequate surgical treatment needs to provide spinal stability. [ncbi.nlm.nih.gov]
Prognosis
[…] this highly lauded three-volume reference provides an interdisciplinary approach to the diagnosis, treatment, and management of head and neck diseases, including the incidence, etiology, clinical presentation, pathology, differential diagnosis, and prognosis [books.google.com]
[…] macrophages and monocytes No bone osteoid No matrix calcification Treatment Extra-capsular marginal excision yields almost no recurrence In rare occasions of soft tissue invasion, wide excision is necessary If skeletally immature, wait until maturity Prognosis [orthopaedicsone.com]
The prognosis is excellent for most cases, even when there is a recurrence. En bloc resection is the treatment of choice. [humpath.com]
This shall facilitate better treatment approaches and prognosis. This case is the first reported case of involvement of the zygomatic arch in a pediatric patient. [jomfp.in]
Prognosis The prognosis is excellent. Cytogenetics Morphological Karyotypes of 12 cases are reported in the literature. Complex cytogenic abnormalities are reported. [atlasgeneticsoncology.org]
Etiology
Updated, reorganized, and revised throughout, this highly lauded three-volume reference provides an interdisciplinary approach to the diagnosis, treatment, and management of head and neck diseases, including the incidence, etiology, clinical presentation [books.google.com]
To date, no definite etiologies have been documented. It is known that approximately 75% of the total cases of CMF affect the bones of the lower extremities. In particular, it occurs most frequently in the tibia and femur around the knee joint [3]. [surgicalcasesjournal.com]
A study by Romeo et al examined the DNA microarray of chondromyxoid fibroma and demonstrated that CMFs could be differentiated from other cartilaginous tumors. [8] Etiology As is the case with most bone tumors, no specific cause is known for CMF. [emedicine.medscape.com]
Epidemiology
Patient Population: Prevalence and Epidemiology Knee // Shoulder & Elbow // Hip // Spine // Foot & Ankle // Hand & Wrist Fragility Fractures: Diagnosis and Treatment Shoulder & Elbow The Characteristics of Surgeons Performing Total Shoulder Arthroplasty [mdedge.com]
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 [orthobullets.com]
As with all rare lesions, reported epidemiology varies: age: most commonly diagnosed before 30 years of age (~75%), mostly during second and third decades 1,12-15 full reported range from 3 to 70 years of age gender: conflicting data 2, 12,18 some series [radiopaedia.org]
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]
Epidemiology CMFs account for fewer than 1% of primary bone tumors in the United States. CMFs are becoming less frequently diagnosed, and thus, the current frequency is much lower than 1%. [emedicine.medscape.com]
Pathophysiology
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 [orthobullets.com]
Pathophysiology Grossly, CMFs are firm, grayish-white masses that are sharply demarcated; they are lobulated or pseudolobulated. Their appearance can mimic that of fibrous tissue or hyaline cartilage. [emedicine.medscape.com]
Prevention
A quick and accurate diagnosis of chondromyxoid fibroma can prevent unnecessary treatment that could be harmful to the patient. [ncbi.nlm.nih.gov]
This will prevent amputation of the toe and will give cosmetic success to the patient No References No Citations No Supplementary Data No Article Media No Metrics Document Type: Research Article Affiliations: 1: Department of Orthopedics, Kasturba Medical [ingentaconnect.com]