Chondroblastoma and Chondromyxoid Fibroma

Abstract

Chondroblastoma and chondromyxoid fibroma are benign but locally aggressive bone tumors. Chondroblastoma, a destructive lesion with a thin radiodense border, is usually seen in the epiphysis of long bones. Chondromyxoid fibroma presents as a bigger, lucent, loculated lesion with a sharp sclerotic margin in the metaphysis of long bones. Although uncommon, these tumors can be challenging to manage. They share similarities in pathology that could be related to their histogenic similarity. Very rarely, chondroblastoma may lead to lung metastases; however, the mechanism is not well understood.

Aggressive Tibial Lesion in a 70-year-old Man

“…On MR images, a chondromyxoid fibroma has a heterogenous appearance with hyperintense signal on T2-weighted images and isointense or hypointense to muscle on T1-weighted images. Lesions in long bones often are located eccentrically in the metaphysis [2,15], and rarely, all three segments of bone can be involved [15][16][17]. These features all were consistent with the initial imaging in our patient.…”

“…These features all were consistent with the initial imaging in our patient. Radiographic evidence of calcification is infrequent compared with other cartilaginous tumors and ranges from 2.4% to 16% [2,15].…”

“…Radiographically, a chondromyxoid fibroma appears as a well-defined radiolucent lesion with a scalloped margin and remodeled cortex imparting the appearance of bone expansion [2,8,16,17]. On MR images, a chondromyxoid fibroma has a heterogenous appearance with hyperintense signal on T2-weighted images and isointense or hypointense to muscle on T1-weighted images.…”

“…However, in retrospect, the clinical features of the patient's presentation and workup were consistent with this diagnosis, which ultimately was confirmed histologically. Chondromyxoid fibromas frequently present with intermittent, nondebilitating pain that may be present for months to years before diagnosis [2,8,17]. Patients also may present with a tender palpable mass or swelling.…”

“…Tumors arising in certain locations, such as the ribs or ilium, may be completely asymptomatic [8,17]. Compared with a chondroblastoma, a chondromyxoid fibroma typically is less painful and patients rarely present with limited ROM, limping, or pathologic fracture [2,17].…”