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Chondromyxoid fibroma-recurrent

Case contributed by Dalia Ibrahim
Diagnosis certain

Presentation

History of tibial osseous lesion treated by curettage and cement. Now recurrent tibial swelling.

Patient Data

Age: 15 years
Gender: Female

Proximal tibial metaphyseal intramedullary well-defined lesion is seen anterior to the applied cement (which elicits low signal on all pulse sequences). The lesion elicits low signal on T1 WI, high signal on T2 WI, and a high signal on STIR. It shows thick marginal enhancement.

The lesion causes overlying cortical thinning yet with no exophytic lesions.

Case Discussion

The patient had a history of proximal tibial metaphyseal chondromyxoid fibroma, which was treated surgically by curettage and cement application. The patient developed recurrent chondromyxoid fibroma.

Chondromyxoid fibroma is a rare benign cartilaginous neoplasm. Most lesions occur before 30 years of age. It shows a high rate of recurrence.

It occurs typically in the metaphysis of long bones. The classical type is the upper third of the tibia, but it might occur in the distal femur, pelvis, or foot.

The lesion shows lobulated well defined margins, elicits a low signal on T1 WI and a high signal on T2 and STIR. It usually shows peripheral nodular enhancement.

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