Fibroxanthoma of bone is a confusing term that is sometimes used to encompass non-ossifying fibroma and fibrous cortical defect, and at other times synonymously with just non-ossifying fibromas. As non-ossifying fibroma and fibrous cortical defect are histologically the same, and differ only in size (non-ossifying fibroma >2-3 cm) it is safe to not lose too much sleep over this one.
The term metaphyseal fibrous defect is probably a safer collective term for the two entities.
Fibrous cortical defect and non-ossifying fibroma are very common, seen in up to 30-40% of skeletally immature children/adolescents 3.
- 1. Hetts SW, Hilchey SD, Wilson R et-al. Case 110: Nonossifying fibroma. Radiology. 2007;243 (1): 288-92. doi:10.1148/radiol.2431040427 [pubmed citation]
- 2. Stacy GS, Dixon LB. Pitfalls in MR image interpretation prompting referrals to an orthopedic oncology clinic. Radiographics. 2007;27 (3): 805-26. doi:10.1148/rg.273065031 [pubmed citation]
- 3. Betsy M, Kupersmith LM, Springfield DS. Metaphyseal fibrous defects. J Am Acad Orthop Surg. 2004;12 (2): 89-95. J Am Acad Orthop Surg (full text) [pubmed citation]
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The differential diagnosis for bone tumors is dependent on the age of the patient, with a very different set of differentials for the pediatric patient.
- bone-forming tumors
- cartilage-forming tumors
- chondromyxoid fibroma
- juxtacortical chondroma
- fibrous bone lesions
- bone marrow tumors
- other bone tumors or tumor-like lesions
- aneurysmal bone cyst
- benign fibrous histiocytoma
- giant cell tumor of bone
- Gorham massive osteolysis
- haemophilic pseudotumour
- intradiploic epidermoid cyst
- intraosseous lipoma
- musculoskeletal angiosarcoma
- musculoskeletal hemangiopericytoma
- primary intraosseous hemangioma
- post-traumatic cystic bone lesion
- simple bone cyst
- impending fracture risk