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Subperiosteal chondromyxoid fibroma: a rare case involving the humeral diaphysis

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Abstract

Initially described, in 1948, as a tumor that could be mistaken with chondrosarcoma at histopathology, chondromyxoid fibroma is now a well-recognized entity. Surface-type chondromyxoid fibroma, however, remains an extremely rare occurrence. We present a case of a 55-year-old woman, who experienced right arm pain for 5 years. After unsuccessful treatment for presumed thoracic outlet syndrome, MRI revealed a large mass abutting the anteromedial cortex of the distal humeral diaphysis in a subperiosteal location. Further characterization was made with radiography, CT, and bone scan, which were followed by ultrasound-guided biopsy. Although histopathologic features were suggestive of chondromyxoid fibroma, the diagnosis remained somewhat uncertain initially due to the very unusual location involving the diaphysis of the humerus. Surgical resection was performed, and subsequent histopathologic analysis confirmed the diagnosis of chondromyxoid fibroma. Despite being a rare entity, surface-type chondromyxoid fibroma would need to be considered in the differential when dealing with expansile surface diaphyseal lesions.

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References

  1. Jaffe HL, Lichtenstein L. Chondromyxoid fibroma of bone; a distinctive benign tumor likely to be mistaken especially for chondrosarcoma. Arch Pathol (Chic). 1948;45(4):541–51.

    CAS  Google Scholar 

  2. Wu CT, Inwards CY, O'Laughlin S, Rock MG, Beabout JW, Unni KK. Chondromyxoid fibroma of bone: a clinicopathologic review of 278 cases. Hum Pathol. 1998;29(5):438–46.

    Article  CAS  Google Scholar 

  3. Romeo S, Aigner T, Bridge J. Chondromyxoid fibroma. In: Fletcher CDM, Bridge JA, Hogendoorn PCW, Mertens F, editors. WHO classification of tumours of soft tissue and bone. 4th ed. Lyon: IARC; 2013. p. 255–6.

    Google Scholar 

  4. Wilson AJ, Kyriakos M, Ackerman LV. Chondromyxoid fibroma: radiographic appearance in 38 cases and in a review of the literature. Radiology. 1991;179(2):513–8.

    Article  CAS  Google Scholar 

  5. Baker AC, Rezeanu L, O'Laughlin S, Unni K, Klein MJ, Siegal GP. Juxtacortical chondromyxoid fibroma of bone: a unique variant: a case study of 20 patients. Am J Surg Pathol. 2007;31(11):1662–8.

    Article  Google Scholar 

  6. Ralph LL. Chondromyxoid fibroma of bone. J Bone Joint Surg Br. 1962;44-b:7–24.

    Article  CAS  Google Scholar 

  7. Feldman F, Hecht HL, Johnston AD. Chondromyxoid fibroma of bone. Radiology. 1970;94(2):249–60.

    Article  CAS  Google Scholar 

  8. Andrew T, Kenwright J, Woods C. Periosteal chondromyxoid fibroma of the tibia: a case report. Acta Orthop Scand. 1982;53(3):467–70.

    Article  CAS  Google Scholar 

  9. Bialik V, Kedar A, Ben-Arie Y, Kleinhaus U, Fishman J. Case report 315. Diagnosis: parosteal (periosteal, juxtacortical) chondromyxoid fibroma of the upper end of the femur. Skelet Radiol. 1985;13(4):323–6.

    CAS  Google Scholar 

  10. Schajowicz F. Chondromyxoid fibroma: report of three cases with predominant cortical involvement. Radiology. 1987;164(3):783–6.

    Article  CAS  Google Scholar 

  11. Kenan S, Abdelwahab IF, Klein MJ, Lewis MM. Case report 837: juxtacortical (periosteal) chondromyxoid fibroma of the proximal tibia. Skelet Radiol. 1994;23(3):237–9.

    CAS  Google Scholar 

  12. Park HR, Lee IS, Lee CJ, Park YK. Chondromyxoid fibroma of the femur: a case report with intra-cortical location. J Korean Med Sci. 1995;10(1):51–6.

    Article  CAS  Google Scholar 

  13. Marin C, Gallego C, Manjon P, Martinez-Tello FJ. Juxtacortical chondromyxoid fibroma: imaging findings in three cases and a review of the literature. Skelet Radiol. 1997;26(11):642–9.

    Article  CAS  Google Scholar 

  14. Park SH, Kong KY, Chung HW, Kim CJ, Lee SH, Kang HS. Juxtacortical chondromyxoid fibroma arising in an apophysis. Skelet Radiol. 2000;29(8):466–9.

    Article  CAS  Google Scholar 

  15. Fujiwara S, Nakamura I, Goto T, Motoi T, Yokokura S, Nakamura K. Intracortical chondromyxoid fibroma of humerus. Skelet Radiol. 2003;32(3):156–60.

    Article  Google Scholar 

  16. Estrada-Villasenor E, Cedillo ED, Martinez GR, Chavez RD. Periosteal chondromyxoid fibroma: a case study using imprint cytology. Diagn Cytopathol. 2005;33(6):402–6.

    Article  CAS  Google Scholar 

  17. Takenaga RK, Frassica FJ, McCarthy EF. Subperiosteal chondromyxoid fibroma: a report of two cases. Iowa Orthop J. 2007;27:104–7.

    PubMed  PubMed Central  Google Scholar 

  18. Jhala D, Coventry S, Rao P, Yen F, Siegal GP. Juvenile juxtacortical chondromyxoid fibroma of bone: a case report. Hum Pathol. 2008;39(6):960–5.

    Article  Google Scholar 

  19. Fernandez-Hernandez O, Ramos-Pascua L, Izquierdo-Garcia F. Intracortical chondromyxoid fibroma of the tibia. Musculoskelet Surg. 2013;97(2):177–81.

    Article  Google Scholar 

  20. Abdelwahab IF, Klein MJ. Surface chondromyxoid fibroma of the distal ulna: unusual tumor, site, and age. Skelet Radiol. 2014;43(2):243–6.

    Google Scholar 

  21. Soni R, Kapoor C, Shah M, Turakhiya J, Golwala P. Chondromyxoid fibroma: a rare case report and review of literature. Cureus. 2016;8(9):e803.

    PubMed  PubMed Central  Google Scholar 

  22. Han JS, Shim E, Kim BH, Choi JW. An intracortical chondromyxoid fibroma in the diaphysis of the metatarsal. Skelet Radiol. 2017;46(12):1757–62.

    Google Scholar 

  23. Harrington KA, Hoda S, La Rocca Vieira R. Surface-type chondromyxoid fibroma in an elderly patient: a case report and literature review. Skelet Radiol. 2019;48(5):823–30.

    Google Scholar 

  24. Brien EW, Mirra JM, Luck JV Jr. Benign and malignant cartilage tumors of bone and joint: their anatomic and theoretical basis with an emphasis on radiology, pathology and clinical biology. II. Juxtacortical cartilage tumors. Skelet Radiol. 1999;28(1):1–20.

    CAS  Google Scholar 

  25. Gholamrezanezhad A, Basques K, Kosmas C. Peering beneath the surface: Juxtacortical tumors of bone (part I). Clin Imaging. 2018;51:1–11.

    PubMed  Google Scholar 

  26. Gholamrezanezhad A, Basques K, Kosmas C. Peering beneath the surface: juxtacortical tumors of bone (part II). Clin Imaging. 2018;50:113–22.

  27. Kilpatrick S, Romeo S. Chondroblastoma. In: Fletcher CDM, Bridge JA, Hogendoorn PCW, Mertens F, editors. WHO classification of tumours of soft tissue and bone. 4th ed. Lyon: IARC; 2013. p. 262–3.

    Google Scholar 

  28. Folpe AL. Phosphaturic mesenchymal tumour. In: Fletcher CDM, Bridge JA, Hogendoorn PCW, Mertens F, editors. WHO classification of tumours of soft tissue and bone. 4th ed. Lyon: IARC; 2013. p. 211–2.

    Google Scholar 

  29. Sent-Doux KN, Mackinnon C, Lee JC, Folpe AL, Habeeb O. Phosphaturic mesenchymal tumor without osteomalacia: additional confirmation of the “nonphosphaturic” variant, with emphasis on the roles of FGF23 chromogenic in situ hybridization and FN1-FGFR1 fluorescence in situ hybridization. Hum Pathol. 2018;80:94–8.

    Article  CAS  Google Scholar 

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Delorme, JP., Purgina, B. & Jibri, Z. Subperiosteal chondromyxoid fibroma: a rare case involving the humeral diaphysis. Skeletal Radiol 50, 597–602 (2021). https://doi.org/10.1007/s00256-020-03581-y

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