In primary bone PH, metastases and primary spindle cell bone tumors, such as nonossifying fibroma
, osteoblastoma, fibrosarcoma, leiomyosarcoma, and undifferentiated pleomorphic sarcoma, should be considered.
: Nonossifying fibroma
commonly involves metaphysis of long bones and consists of 40% in distal femur, 40% in tibia with 10% in fibula.27 It is usually found in children as incidental finding between 02-20 years of age.
The most common pediatric benign bone tumors include nonossifying fibroma
(NOF), osteochondroma, Langerhans cell histiocytosis (LCH), unicameral bone cyst (UBC), aneurysmal bone cyst (ABC), and osteoid osteoma.
Benign fibrous histiocytoma (BFH) is a lesion that is histologically identical to nonossifying fibroma
(NOF) but occurs in the nonmetaphyseal portion of long bones or in the pelvis [1-3].
The clinical behavior of nonossifying fibroma
(NOF) appears to be a benign lesion without recurrence or canceration. Ewing's sarcoma (ES) is usually regarded as a differential diagnosis of NOF. There has not been any report on NOF and ES appearing in the same position simultaneously.
His surgical history was significant in terms of open reduction and internal fixation of a pathological fracture of the tibia and fibula after a minor sports injury; a nonossifying fibroma
was the underlying cause of the pathological fracture.
Review of outside films by a musculoskeletal radiologist and an orthopedic surgeon in our center included a differential diagnosis of infection, benign fibrous lesion such as fibrous dysplasia, and nonossifying fibroma
. At this point, the patient was lost for further follow-up at our institution due to combination of patient's status of serving in the military and living out of state.
* The spectrum of these lesions includes enchondroma, osteochondroma, hemangioma, hemangiopericytoma, enostosis, osteoid osteoma, fibrous dysplasia, Paget disease, Langerhans cell histiocytosis, aneurysmal bone cyst, eosinophilic granuloma, giant cell tumor, brown tumor, nonossifying fibroma
, and chondromyxoid fibroma.
We describe a rare case of nonossifying fibroma
of the mandible in a 15-year-old boy who presented with a left mandibular swelling.
The nonossifying fibroma
is histologically very similar to the GCG which can, however, be differentiated from the latter since the granuloma- like aggregate of giant cells and the fibrous stroma found in GCG, are not typical features of non-ossifying fibroma.