Chondromyxoid fibroma

Jump to navigation Jump to search

WikiDoc Resources for Chondromyxoid fibroma

Articles

Most recent articles on Chondromyxoid fibroma

Most cited articles on Chondromyxoid fibroma

Review articles on Chondromyxoid fibroma

Articles on Chondromyxoid fibroma in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Chondromyxoid fibroma

Images of Chondromyxoid fibroma

Photos of Chondromyxoid fibroma

Podcasts & MP3s on Chondromyxoid fibroma

Videos on Chondromyxoid fibroma

Evidence Based Medicine

Cochrane Collaboration on Chondromyxoid fibroma

Bandolier on Chondromyxoid fibroma

TRIP on Chondromyxoid fibroma

Clinical Trials

Ongoing Trials on Chondromyxoid fibroma at Clinical Trials.gov

Trial results on Chondromyxoid fibroma

Clinical Trials on Chondromyxoid fibroma at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Chondromyxoid fibroma

NICE Guidance on Chondromyxoid fibroma

NHS PRODIGY Guidance

FDA on Chondromyxoid fibroma

CDC on Chondromyxoid fibroma

Books

Books on Chondromyxoid fibroma

News

Chondromyxoid fibroma in the news

Be alerted to news on Chondromyxoid fibroma

News trends on Chondromyxoid fibroma

Commentary

Blogs on Chondromyxoid fibroma

Definitions

Definitions of Chondromyxoid fibroma

Patient Resources / Community

Patient resources on Chondromyxoid fibroma

Discussion groups on Chondromyxoid fibroma

Patient Handouts on Chondromyxoid fibroma

Directions to Hospitals Treating Chondromyxoid fibroma

Risk calculators and risk factors for Chondromyxoid fibroma

Healthcare Provider Resources

Symptoms of Chondromyxoid fibroma

Causes & Risk Factors for Chondromyxoid fibroma

Diagnostic studies for Chondromyxoid fibroma

Treatment of Chondromyxoid fibroma

Continuing Medical Education (CME)

CME Programs on Chondromyxoid fibroma

International

Chondromyxoid fibroma en Espanol

Chondromyxoid fibroma en Francais

Business

Chondromyxoid fibroma in the Marketplace

Patents on Chondromyxoid fibroma

Experimental / Informatics

List of terms related to Chondromyxoid fibroma

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rohan A. Bhimani, M.B.B.S., D.N.B., M.Ch.[2]

Synonyms and keywords:

Overview

Chondromyxoid fibroma is a rare benign bone tumor accounting for approximately 1% of all benign bone tumors. Chondromyxoid fibroma affects all age groups. It is more commonly seen during the second and third decades of life. Men are more commonly affected than women. Chondromyxoid fibroma arising from the physeal remnant is the commonly proposed theory in the pathogenesis of this tumor. It is predominantly found in the metaphyses of the long bones. The bones involved include tibia, distal femur, pelvis, feet and hands. Chromosome 6 appears to be involved in chondromyxoid fibroma. Over expression of the glutamate receptor gene GRM1 in patients with chondromyxoid fibroma via promoter swapping and gene fusion has been observed. The hallmark of chondromyxoid fibroma is pain, swelling, and pathological fracture. The mainstay of treatment for chondromyxoid fibroma is surgery (curettage and bone grafting).

Historical Perspective

In 1948, Jaffe and Lichtenstein described chondromyxoid fibroma for the first time.[1]

Classification

Chondromyxoid fibroma can be classified based on imaging findings.

Enneking (MSTS) Staging System

Stages Description
1 Latent: Well demarcated borders
2 Active: Indistinct borders
3 Aggressive: Indistinct borders

Pathophysiology

Genetics

Causes

There are no established causes of chondromyxoid fibroma.[9]

Differentiating Chondromyxoid Fibroma from Other Diseases

Chondromyxoid fibroma must be differentiated from the following bone disorders:[10]

Disease Bubbly lytic lesion on x-ray Lakes of Blood on histology Diagnosis Treatment is curretage and bone grafting
Chondromyxoid Fibroma - - Radiology and biopsy +
Unicameral bone cyst + - Radiology and biopsy -
Non ossifying fibroma + - Radiology and biopsy -
Giant cell tumor - - Radiology and Biopsy +
Chondroblastoma - - Biopsy +
Aneurysmal bone cyst + + Radiology and biopsy +
Osteoblastoma - - Radiology and biopsy +
Telangiectatic osteosarcoma - + Radiology and biopsy -

Epidemiology and Demographics

  • Chondromyxoid fibroma is a rare benign bone tumor accounting for approximately 1% of all benign bone tumors.[11]
  • Chondromyxoid fibroma affects all age groups.
  • It is more commonly seen during the second and third decades of life.
  • Men are more commonly affected than women.
  • There is no racial predilection to chondromyxoid fibroma.

Risk Factors

There are no established risk factors for chondromyxoid fibroma.

Screening

There is insufficient evidence to recommend routine screening for chondromyxoid fibroma.

Natural History, Complications, and Prognosis

Common complications of chondromyxoid fibroma include:

Prognosis is generally good for chondromyxoid fibroma.

Diagnosis

Histology of chondromyxoid fibroma showing stellate cells in a myxoid stroma..Source: Case courtesy of Sarahkayb [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0), from Wikimedia Commons]

Diagnostic Study of Choice

Under Low Power field:
Under High Power Field:

History and Symptoms

X-ray of ulna showing chondromyxoid fibroma.Source: Case courtesy of A.Prof Frank Gaillard, Radiopaedia.org, rID: 6172

Physical Examination

Common physical examination findings of chondromyxoid fibroma include:

Laboratory Findings

There are no diagnostic laboratory findings associated with chondromyxoid fibroma.

Electrocardiogram

There are no ECG findings associated with chondromyxoid fibroma.

X-ray

X-ray findings include:[14][15]

  • Size of the lesion may vary from 2 to 10 cm.
  • It has a sharply demarcated border from the adjacent bone.
CT of proximal ulna showing chondromyxoid fibroma.Source: Case courtesy of A.Prof Frank Gaillard, Radiopaedia.org, rID: 6172

Echocardiography or Ultrasound

There are no echocardiography/ultrasound findings associated with chondromyxoid fibroma.

CT scan

MRI

MRI findings of chondromyxoid fibroma include:[17][18]

MRI of proximal ulna showing chondromyxoid fibroma.Source: Case courtesy of A.Prof Frank Gaillard, Radiopaedia.org, rID: 6172
  • T1 image: Chondroid and myxoid tissues produce low signals.
  • T2 image: Chondroid and myxoid tissues produce high signals.

Other Imaging Findings

Bone Scan

  • Increased uptake is seen in chondromyxoid fibroma.

Other Diagnostic Studies

There are no other diagnostic studies associated with chondromyxoid fibroma.

Treatment

Medical Therapy

There is no treatment for chondromyxoid fibroma; the mainstay of therapy is surgery.

Surgery

Surgery is the mainstay of treatment for chondromyxoid fibroma.[19][20]

Types

1. Intralesional Curettage

  • It is the mainstay of treatment for chondromyxoid fibroma.[20]
  • The defect is filled with bone graft or bone cement in form of polymethlymethacrylate(PMMA).

2. En Bloc Excision

  • It usually reserved for recurrent cases.[21]

Recurrence Rate

  • The recurrence rate is about 25% for chondromyxoid fibroma.[22]

Primary Prevention

There are no established measures for the primary prevention of chondromyxoid fibroma.

Secondary Prevention

There are no established measures for the secondary prevention of chondromyxoid fibroma.

References

  1. JAFFE HL, LICHTENSTEIN L (1948). "Chondromyxoid fibroma of bone; a distinctive benign tumor likely to be mistaken especially for chondrosarcoma". Arch Pathol (Chic). 45 (4): 541–51. PMID 18891025.
  2. Jawad MU, Scully SP (2010). "In brief: classifications in brief: enneking classification: benign and malignant tumors of the musculoskeletal system". Clin Orthop Relat Res. 468 (7): 2000–2. doi:10.1007/s11999-010-1315-7. PMC 2882012. PMID 20333492.
  3. Peabody, Terrance (2014). Orthopaedic oncology : primary and metastatic tumors of the skeletal system. Cham: Springer. ISBN 9783319073224.
  4. Brien EW, Mirra JM, Kerr R (1997). "Benign and malignant cartilage tumors of bone and joint: their anatomic and theoretical basis with an emphasis on radiology, pathology and clinical biology. I. The intramedullary cartilage tumors". Skeletal Radiol. 26 (6): 325–53. PMID 9229417.
  5. 5.0 5.1 5.2 Cuvelier CA, Roels HJ (1979). "Cytophotometric studies of the nuclear DNA content in cartilaginous tumors". Cancer. 44 (4): 1363–74. PMID 498016.
  6. Halbert AR, Harrison WR, Hicks MJ, Davino N, Cooley LD (1998). "Cytogenetic analysis of a scapular chondromyxoid fibroma". Cancer Genet Cytogenet. 104 (1): 52–6. PMID 9648559.
  7. Buddingh EP, Naumann S, Nelson M, Neffa JR, Birch N, Bridge JA (2003). "Cytogenetic findings in benign cartilaginous neoplasms". Cancer Genet Cytogenet. 141 (2): 164–8. PMID 12606137.
  8. Nord KH, Lilljebjörn H, Vezzi F, Nilsson J, Magnusson L, Tayebwa J; et al. (2014). "GRM1 is upregulated through gene fusion and promoter swapping in chondromyxoid fibroma". Nat Genet. 46 (5): 474–7. doi:10.1038/ng.2927. PMID 24658000.
  9. Gherlinzoni F, Rock M, Picci P (1983). "Chondromyxoid fibroma. The experience at the Istituto Ortopedico Rizzoli". J Bone Joint Surg Am. 65 (2): 198–204. PMID 6337162.
  10. Bergman S, Madden CR, Geisinger KR (2009). "Fine-needle aspiration biopsy of chondromyxoid fibroma: an investigation of four cases". Am J Clin Pathol. 132 (5): 740–5. doi:10.1309/AJCPFJZ8AKMFUAFP. PMID 19846816.
  11. Pintor F, Bahamondes C, Campos O, Zivov A (2015). "Chondromyxoid fibroma of zygoma in an elderly patient: A rare presentation". Ann Maxillofac Surg. 5 (2): 244–8. doi:10.4103/2231-0746.175755. PMC 4772571. PMID 26981481.
  12. Tallini G, Dorfman H, Brys P, Dal Cin P, De Wever I, Fletcher CD; et al. (2002). "Correlation between clinicopathological features and karyotype in 100 cartilaginous and chordoid tumours. A report from the Chromosomes and Morphology (CHAMP) Collaborative Study Group". J Pathol. 196 (2): 194–203. doi:10.1002/path.1023. PMID 11793371.
  13. Desai SS, Jambhekar NA, Samanthray S, Merchant NH, Puri A, Agarwal M (2005). "Chondromyxoid fibromas: a study of 10 cases". J Surg Oncol. 89 (1): 28–31. doi:10.1002/jso.20113. PMID 15612014.
  14. Marin C, Gallego C, Manjón P, Martinez-Tello FJ (1997). "Juxtacortical chondromyxoid fibroma: imaging findings in three cases and a review of the literature". Skeletal Radiol. 26 (11): 642–9. PMID 9428071.
  15. Merine D, Fishman EK, Rosengard A, Tolo V (1989). "Chondromyxoid fibroma of the fibula". J Pediatr Orthop. 9 (4): 468–71. PMID 2732329.
  16. Cappelle S, Pans S, Sciot R (2016). "Imaging features of chondromyxoid fibroma: report of 15 cases and literature review". Br J Radiol: 20160088. doi:10.1259/bjr.20160088. PMC 5124884. PMID 27226218.
  17. Kim HS, Jee WH, Ryu KN, Cho KH, Suh JS, Cho JH; et al. (2011). "MRI of chondromyxoid fibroma". Acta Radiol. 52 (8): 875–80. doi:10.1258/ar.2011.110180. PMID 21835889.
  18. Campanacci M. Bone and soft tissue tumours. 2nd edn. Wien, Austria: Springer; 1999. pp. 265–71.
  19. Zillmer DA, Dorfman HD (1989). "Chondromyxoid fibroma of bone: thirty-six cases with clinicopathologic correlation". Hum Pathol. 20 (10): 952–64. PMID 2793160.
  20. 20.0 20.1 Dürr HR, Lienemann A, Nerlich A, Stumpenhausen B, Refior HJ (2000). "Chondromyxoid fibroma of bone". Arch Orthop Trauma Surg. 120 (1–2): 42–7. PMID 10653103.
  21. Dey B, Deshpande AH, Brar RK, Ray A (2018). "Chondromyxoid Fibroma of the Metatarsal Bone: A Diagnosis Using Fine Needle Aspiration Biopsy". J Cytol. 35 (1): 67–68. doi:10.4103/JOC.JOC_48_17. PMC 5795736. PMID 29403178.
  22. Wu CT, Inwards CY, O'Laughlin S, Rock MG, Beabout JW, Unni KK (1998). "Chondromyxoid fibroma of bone: a clinicopathologic review of 278 cases". Hum Pathol. 29 (5): 438–46. PMID 9596266.


Template:WikiDoc Sources