Non-ossifying fibroma

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Painful distal left thigh

Patient Data

Age: 9 years
Gender: Female
x-ray
Frontal
Lateral
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There is an expansile eccentric multiloculated lucent lesion with peripheral sclerotic rim, involving the posterolateral aspect of the diaphysometaphyseal region of the distal femur. No pathological fracture or periosteal reaction is seen.

mri
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Sagittal
T1
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Coronal
T1
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Axial
T1
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Coronal
STIR
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Coronal-zoomed
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Axial
T2
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Axial T1
fat sat
This study is a stack
Coronal T1
C+ fat sat
This study is a stack
Sagittal T1
C+ fat sat
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The MRI sequences demonstrate a multiloculated cortical-based lesion of intermediate signal on T1WI, heterogeneous high signal on T2WI with peripheral low signal rim corresponding to the sclerotic border. The postcontrast sequences show moderate heterogeneous enhancement. No soft tissue mass or edema is seen.

Case Discussion

Radiographic and MRI features are most consistent with a non-ossifying fibroma of the distal femur.

 

Additional contributor: C. Boukaaba, MD

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