Chondromyxoid Fibroma Treatment & Management

Updated: Sep 24, 2018
  • Author: Michael S Clarke, MD; Chief Editor: Omohodion (Odion) Binitie, MD  more...
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Treatment

Medical Care

No medical care is usually necessary in the treatment of chondromyxoid fibromas (CMFs). Nonsteroidal anti-inflammatory drugs (NSAIDs) or analgesics may be beneficial for pain control.

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Surgical Care

CMFs are treated with intralesional curettage or en-bloc excision. [33] Jaffe and Lichtenstein noted in their original description of CMF that "even with incomplete removal, spontaneous regression of the remnants followed." [5] Subsequent reports noted recurrence rates of approximately 25% with curettage and bone grafting, though this rate may be higher in young children (first or second decade of life) and in patients with tumors that are predominantly composed of myxoid areas.

Wide en-bloc excision may lower the recurrence rate, but it usually adds unnecessary morbidity. Local adjunct treatment agents, such as phenol, methylmethacrylate, and liquid nitrogen, have not been shown to decrease the recurrence rate.

Radiotherapy may be used in tumors that are considered unresectable. [34]

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Complications

Arrest of growth may occur after aggressive curettage of tumors adjacent to the physis. Malignant transformation has been noted as a possible complication, even in the absence of preceding radiation therapy. However, many authors believe that cases of CMF that have been reported as malignant transformation have not been sufficiently documented and more likely represent a misdiagnosis of chondrosarcoma.

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Activity

Activity need not be restricted unless the lesion is large enough to create a risk of fracture. This is an unusual occurrence, and pain with weightbearing should alert one to the possibility of impending fracture. Some patients may limit their activity to control discomfort.

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Long-Term Monitoring

The average time to recurrence is typically less than 2 years, but it has been reported to be as long as 19 years after the initial tumor presentation. [19, 35, 36, 37] Patients should be monitored with periodic history and physical examinations and with routine radiographs of the affected site for a minimum of 2 years.

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