Presentation
Sprained ankle playing sport.
Patient Data
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:
non-ossifying fibroma (>2 cm)
fibrous cortical defect (<2 cm)
Both are pathologically identical.
Non-ossifying fibromas have the following features (all shown here):
present in adolescents and young adults
commonest location is the femur and tibia
dia-metaphyseal in location
eccentric with mild expansion
well defined lucent lesion with a sclerotic margin
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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