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Non-ossifying fibroma (NOF)

Case contributed by: Dr Frank Gaillard

Presentation:

Sprained ankle playing sport.

Patient Data:

Age: 14 years
Gender: Male
Race: Caucasian
From the case: Non-ossifying fibroma (NOF)
Modality: X-ray

Ankle x-ray demonstrates a well circumscribed lucency in the distal diaphysis / metaphysis of the tibia. The margins are slightly sclerotic. No periosteal reaction is present. It does not abut the growth plate. 

Case Discussion:

Fibroxanthomas can be divided into:

  1. Non-ossifying fibroma (> 2cm)
  2. Fibrous cortical defect (< 2cm)

Both are pathologically identical.

Non-ossifying fibromas have the following features (all shown here):

  1. Present in adolescents and young adults
  2. Commonest location is the femur and tibia
  3. Dia-metaphyseal in location
  4. Eccentric with mild expansion
  5. Well defined lucent lesion with a sclerotic margin
  6. Cortical thinning, but not breach.

Lesions are asymptomatic and are usually an incidental finding. Lesions often spontaneously regress.

Case courtesy of Dr Ian Bickle

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