Chondromyxoid fibroma

Case contributed by Dr Hani Makky ALSALAM

Presentation

Knee pain and swelling

Patient Data

Age: 20 years
X-ray

Expansile lesion of the proximal tibia with sharp zones of transition and expansion. It reaches the articular surface without breach of the cortex here or elsewhere. No matrix calcification or soft tissue component. 

MRI

MRI demonstrates the lesion to have a very high T2 signal, low T1 signal with diffuse somewhat heterogeneous contrast enhancement. There is no surrounding edema (neither in the bone nor in the adjacent soft tissues). 

Diagram

Distribution of chondromyxoid fibromas

Distribution of chondromyxoid fibromas. Layout and distribution: Frank Gaillard 2012, Line drawing of skeleton: Patrick Lynch 2006, Creative Common NC-SA-BY

Nuclear medicine

Bone scan

Bone scan demonstrates thin peripheral increased activity. It is an isolated abnormality. 

Case Discussion

This is an advanced case of a benign chondromyxoid fibroma. Smaller lesions are typically located in the cortex of long bones. Tibia and foot are most commonly affected. The lesion is never purely epiphyseal, but may extend into the subchondral bone.

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Case information

rID: 10132
Published: 5th Jul 2010
Last edited: 3rd Sep 2020
Inclusion in quiz mode: Included