Chondromyxoid Fibroma Clinical Presentation

  • Author: Hannah D Morgan, MD; Chief Editor: Harris Gellman, MD   more...
 
Updated: Jul 20, 2010
 

History

Approximately 70% of patients have symptoms at the time of diagnosis. The remaining lesions are discovered incidentally. Pain is the most common symptom and may be present for years. While typically mild, the pain may become more severe with time, and night symptoms may be present. Patients may also report swelling and, in very rare cases, a limitation of joint motion.

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Physical

Approximately 89% of CMFs involve the lower extremity. The proximal tibia is the most common location, followed by the distal femur, pelvis, and foot.[11] Long bones are involved much more frequently than are other bones, especially in younger patients. Flat bone involvement may be observed more often in older patients. Patients may have localized tenderness or swelling over the CMF lesion, and, in rare cases, they may incur a pathologic fracture.

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Causes

Although no specific cause is known for CMF, some authors have noted an association with certain chromosomal abnormalities. In a study of 4 patients with CMF, Granter and colleagues found that all of the subjects had a clonal rearrangement of chromosome 6.[12] Each of these rearrangements involved band 6q13, which has not been associated with other bone tumors. Thus, band 6q13 may be useful as a cytogenetic marker to distinguish CMF from other histologically similar tumors. The authors suggested that oncogene activation resulting from this clonal rearrangement is likely to be involved in the genesis of CMF.[13]

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Contributor Information and Disclosures
Author

Hannah D Morgan, MD  Consulting Staff, Connecticut Orthopaedic Specialists

Hannah D Morgan, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons and American Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Timothy A Damron, MD  David G Murray Endowed Professor, Department of Orthopedic Surgery, Professor, Orthopedic Oncology and Adult Reconstruction, Vice Chair, Department of Orthopedics, State University of New York Upstate Medical University at Syracuse

Timothy A Damron, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American College of Surgeons, American Medical Association, Children's Oncology Group, Connective Tissue Oncology Society, Musculoskeletal Tumor Society, Orthopaedic Research Society, and Society for Experimental Biology and Medicine

Disclosure: Lippincott, Williams, and Wilkins Royalty Editing/writing textbook; Genentech Grant/research funds Clinical research; Orthovita Grant/research funds Clinical research; National Institutes of Health Grant/research funds Clinical research

Specialty Editor Board

Howard A Chansky, MD  Associate Professor, Department of Orthopedics and Sports Medicine, University of Washington Medical Center

Howard A Chansky, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Dinesh Patel, MD, FACS  Associate Clinical Professor of Orthopedic Surgery, Harvard Medical School; Chief of Arthroscopic Surgery, Department of Orthopedic Surgery, Massachusetts General Hospital

Dinesh Patel, MD, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons

Disclosure: Nothing to disclose.

Chief Editor

Harris Gellman, MD  Consulting Surgeon, Broward Hand Center; Voluntary Clinical Professor of Orthopedic Surgery and Plastic Surgery, Departments of Orthopedic Surgery and Surgery, University of Miami School of Medicine

Harris Gellman, MD is a member of the following medical societies: American Academy of Medical Acupuncture, American Academy of Orthopaedic Surgeons, American Orthopaedic Association, American Society for Surgery of the Hand, and Arkansas Medical Society

Disclosure: Nothing to disclose.

References

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  2. Ralph LL. Chondromyxoid fibroma of bone. J Bone and Joint Surg. 1962;44B(1):7-24.

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  6. Baker AC, Rezeanu L, O'Laughlin S, et al. Juxtacortical chondromyxoid fibroma of bone: a unique variant: a case study of 20 patients. Am J Surg Pathol. Nov 2007;31(11):1662-8. [Medline].

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  13. Yasuda T, Nishio J, Sumegi J, Kapels KM, Althof PA, Sawyer JR, et al. Aberrations of 6q13 mapped to the COL12A1 locus in chondromyxoid fibroma. Mod Pathol. Nov 2009;22(11):1499-506. [Medline].

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  25. Konishi E, Nakashima Y, Iwasa Y, Nakao R, Yanagisawa A. Immunohistochemical analysis for Sox9 reveals the cartilaginous character of chondroblastoma and chondromyxoid fibroma of the bone. Hum Pathol. Oct 2 2009;[Medline].

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Radiograph showing the "bite" out of the metaphyseal cortex that is a diagnostic feature of chondromyxoid fibroma.
Magnetic resonance imaging (MRI) scan of chondromyxoid fibroma (T1 image).
Close-up of a lobule of a chondromyxoid fibroma.
 
 
 
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