Fibroma condromixoid

Condromixoid fibroma is a rare bone tumor with slow growth and the diversion chondroblasts. It is different in form benign from malignant chondrosarcoma is. It is a benign tumor of the long tubular bones, especially femur and tibia near the knee joint.Occurs mostly in younger patients in second or third decade of life.
Tumor etiology is unknown, however an error is reported as the cause of chromosome 6. The tumor arises from cartilage tissue formed in the medullary space. Histologically consisted of myxoid tissue, and fibrous condroid in variable amounts.
Condromixoid fibroids may present with pathological fracture. If adequately treated non-fatal injury. Undiagnosed tumor continues to grow, occasionally infiltrated adjacent soft tissues. Although it is considered benign and malignant have been reported. Malignant degeneration after radiotherapy was also reported.
Condromixoid Fibroids Treatment involves curettage or en bloc resection with en bloc resection preference. Radiotherapy is contraindicated because of the risk of induction of malignant transformation.Malignant transformation is a possible complication. Patients are usually cured by excision of the block and have a recurrence rate of 25% through appropriate treatment. In most cases, radiation therapy should be avoided because the cause-effect relationship with post irradiation sarcoma. Condromixoid Occasionally fibroids can be more aggressive, especially when it is located in the axial skeleton.
The pathogenesis of fibroid condromixoidCondromixoid fibroids tumor is firm, gray-white, well demarcated, or pseudolobulata lobe. Or mimic the appearance of fibrous tissue or hyaline cartilage. And trabecular bone lesions may destroy the thin cortex. Some lesions may show areas of hemorrhage or cystic degeneration. The appearance of liquid, mucinous suggest chondrosarcoma. Many tumors shows morphological features that suggest different stages condrogeneza.
Signs and symptomsThe tumor affects mostly young adults in the second and third decade of life. 80% of patients are under 36 years. Approximately 70% of patients have symptoms at diagnosis. The remaining lesions are discovered accidentally. Pain is the most common symptom and can be present for years. Typical moderate pain can become severe over time and nocturnal symptoms may be present. Patients accused swelling and in rare cases limiting joint movement.80% of cases involve the lower limb. Proximal tibia is common location, followed by distal femur, pelvis and feet. Long bones are involved more frequently than other bones, especially in younger patients. Flat bones are affected in older patients. Patients may have localized swelling and tenderness in rare cases can include pathological fractures.
Evolution condromixoid fibroma:Local symptoms of fibroid condromixoid reduce the patient's physical activity. It may recur locally, especially after marginal excision. Can be aggressive nature but malignant conversion is extremely rare and difficult to distinguish from chondrosarcoma.Fibroma condromixoid mortality is nonexistent.
Diagnosis of fibroids condromixoidRadiograph shows well-defined lesion, eccentric, elongated, appearing in metaphysics radiolucenta long bones. Diagnosis is the sign of hemispherical cortical silent periosteala bite. The largest size is 1-10 cm. margins are sclerotic. The lesion may extend to the diaphysis or epiphysis but not exceeding Fizeau plate. The bone X-rays are visible in tumor that reflect trabeculatii edges formed bone around the tumor lobules. Calcifications of the matrix is ​​observed. If you are affected vertebrae is aggressive lesion with cortical destruction and soft tissue extension to. Small bone lesions of the hand and foot are central.
Tomography scan showed mild cortical expansion and increased density of the fluid front. Characteristic lesions are not mineralized.Bone biopsy is used for histological examination. It taken a generous sample of tissue.Histological examination: tumor is microscopic or pseudolobulata lobe with peripheral condensation. Composed of myxoid tissue or the center of each lobe is hipocelular condroid. Surrounding stroma is dense with blood vessels and multinucleated giant.Tumor nuclei are hyperchromatic, moderate size. Asleep nuclear can be seen, but mitosis are absent. Microcalcificarile are present in 20% of cases with high incidence in elderly. Note areas of cystic degeneration, hyalinisation, changes xanthomatous deposits.Local staging include plane radiographs and CT scans or MRI.Condromixoid fibroids do not metastasize. It shows a scan of the entire skeleton to ensure the solitary nature of the tumor.The differential diagnosis is made with the following conditions: Chondrosarcoma, condroblastomul, fibroids nonosificant, endocondromul, osod unicameral cyst, giant cell bone tumor, bone cyst aneurysm.
TreatmentPharmacologic therapy is indicated in these tumors do not. It can be given for pain and anti-inflammatory analgesic netseroidiene.Surgical therapy:Tumors are treated by intralesional curettage or en bloc excision.Bloc excision of tumor recurrence decreases but adds a morbidity that is not necessary. Physical activity should not be restricted if the tumor is not at risk of fracture. Aggressive pain suggests an impending fracture.
Prognosis:The average time to tumor recurrence is 2 years, but reported periods of 19 years. Patients should be monitored regularly with radiographs of the affected area every two years. As a complication may occur after tumor curettage of bone growth stops. Malignant transformation is a possible complication.Patients are usually cured by excision of the block and have a recurrence rate of 25% through appropriate treatment. In most cases, radiation therapy should be avoided because the cause-effect relationship with post irradiation sarcoma. Condromixoid Occasionally fibroids can be more aggressive, especially when it is located in the axial skeleton.