Metaphyseal fibrous defect

Template:Metaphyseal fibrous defect
Diagnosis in short
Synonyms	Nonossifying fibroma
Clinical history	Incidental radiograhic finding
Radiology	Lucent defect

General

• Common
• Non-neoplastic
• Self-limited
• Skeletally immature individuals, children and adolescent
• Often small lesions discovered as an radiographic incidentaloma
• Rarely seen as a pathologic specimen (should not be biopsied)

Synonyms

• Nonossifying fibroma (larger but otherwise identical)
• Fibrous cortical defect
• Fibrous metaphyseal defect
• Fibroxanthoma of bone

Site

• Metaphysis of distal femur or proximal tibia (80%)
• Cortical
• Metaphysis
• Long bones
• Eccentric location

Gross

Firm, granular, brown to yellow to red

Microscopic

Spindle cells without cytologic atypia are arranged in a storiform pattern with scattered chronic inflammatory cells and benign giant cells. Foam cells and hemosiderin deposition are present. Mitoses are seen but cytologic atypia is absent.

Differential Diagnosis

• Giant cell tumor of bone (epiphyseal location, occurs in adults)

Relevant Diagnostic Groups

• Clinical
  • FOG MACHINES - acronym for radiographically lytic bone lesions
  • 'Skeletal do not touch list'
• Pathologic
  • Giant cell lesions of bone.
  • Spindle cell lesions of bone.

Images

• http://njms2.umdnj.edu/tutorweb/casegifs/nofhe1.jpg
• http://njms2.umdnj.edu/tutorweb/casegifs/nofhe2.jpg
• http://njms2.umdnj.edu/tutorweb/casegifs/nofhe1.jpg
• http://pathologyoutlines.com/wick/non-ossifying%20fibroma%20(metaphyseal%20fibrous%20defect)%20micro.jpg

Stains

Not relevant.

IHC

Not relevant

Molecular

Not relevant

Syndromes

Jaffe-Campanacci syndrome

Clinical history

• Incidental radiographic finding
• Pathologic fracture

Prognosis

• Ideally should not be biopied
• Radiographically characteristic and benign
• Ideally should not be treated or even biopsied
• Spontaneously resolve by ossification
• May resolve into a 'bone island'

Radiographic findings

Sharply demarcated, lucent, loculated, meta-diaphyseal lesion surrounded by a rim of sclerotic bone

Sign out

BONE; CURETTAGE: METAPHYSEAL FIBROUS DEFECT / NONOSSIFYING FIBROMA.

See also

• http://njms2.umdnj.edu/tutorweb/case8.htm
• http://www.pathologyoutlines.com/topic/bonemetaphysealfibrousdefect.html
• http://radiopaedia.org/articles/fibrous-cortical-defect
• http://radiopaedia.org/articles/non-ossifying-fibroma-1