Surface-type chondromyxoid fibroma in an elderly patient: a case report and literature review

  • Kate Anne HarringtonEmail author
  • Syed Hoda
  • Renata La Rocca Vieira
Case Report


Chondromyxoid fibroma (CMF) is a rare benign bone neoplasm that typically occurs in young adults. Juxtacortical or surface-type CMF are rarer still and we present the case of a surface-type CMF in a 78-year-old woman, with only one other case described in a patient of a similar age previously. This patient was an otherwise healthy woman who presented for evaluation of a palpable lump in the anterior proximal tibia. Initial radiographs obtained demonstrated a focal soft tissue fullness immediately anterior to the anterior cortex of the proximal tibia, which contained faint chondroid-like matrix internally. There was associated scalloping of the anterior tibial cortex. MRI confirmed the presence of a juxtacortical, enhancing lesion. Subsequent excisional biopsy was performed and histopathology demonstrated features, which was consistent with surface-type CMF. At a 6-month follow-up the patient remained free of recurrence. In a patient of this age, paraosteal chondrosarcoma should be excluded. Surface-type CMF, although rare, has been described in older patients and while it is unlikely to feature in a list of differential considerations on initial imaging, awareness of the entity is important.


Juxtacortical Surface type Chondromyxoid fibroma 



This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.


  1. 1.
    Unni K. Dahlin's bone tumors general aspects and data on 11,087 cases. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2010.Google Scholar
  2. 2.
    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.CrossRefGoogle Scholar
  3. 3.
    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.PubMedPubMedCentralGoogle Scholar
  4. 4.
    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.Google Scholar
  5. 5.
    Ralph LL. Chondromyxoid fibroma of bone. J Bone Joint Surg Br. 1962;44-B:7–24.CrossRefGoogle Scholar
  6. 6.
    Schajowicz F. Chondromyxoid fibroma: report of three cases with predominant cortical involvement. Radiology. 1987;164(3):783–6.CrossRefGoogle Scholar
  7. 7.
    Andrew T, Kenwright J, Woods C. Periosteal chondromyxoid fibroma of the tibia: a case report. Acta Orthop Scand. 1982;53(3):467–70.CrossRefGoogle Scholar
  8. 8.
    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.CrossRefGoogle Scholar
  9. 9.
    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.Google Scholar
  10. 10.
    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.CrossRefGoogle Scholar
  11. 11.
    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.CrossRefGoogle Scholar
  12. 12.
    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.CrossRefGoogle Scholar
  13. 13.
    Fujiwara S, Nakamura I, Goto T, Motoi T, Yokokura S, Nakamura K. Intracortical chondromyxoid fibroma of humerus. Skelet Radiol. 2003;32(3):156–60.CrossRefGoogle Scholar
  14. 14.
    Takenaga RK, Frassica FJ, McCarthy EF. Subperiosteal chondromyxoid fibroma: a report of two cases. Iowa Orthop J. 2007;27:104–7.PubMedPubMedCentralGoogle Scholar
  15. 15.
    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.CrossRefGoogle Scholar
  16. 16.
    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.CrossRefGoogle Scholar
  17. 17.
    Fernandez-Hernandez O, Ramos-Pascua L, Izquierdo-Garcia F. Intracortical chondromyxoid fibroma of the tibia. Musculoskelet Surg. 2013;97(2):177–81.CrossRefGoogle Scholar
  18. 18.
    Abdelwahab IF, Klein MJ. Surface chondromyxoid fibroma of the distal ulna: unusual tumor, site, and age. Skelet. Radiol. 2014;43(2):243–6.CrossRefGoogle Scholar
  19. 19.
    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.CrossRefGoogle Scholar
  20. 20.
    Levine SM, Lambiase RE, Petchprapa CN. Cortical lesions of the tibia: characteristic appearances at conventional radiography. RadioGraphics. 2003;23(1):157–77.CrossRefGoogle Scholar
  21. 21.
    Yamaguchi T, Dorfman HD. Radiographic and histologic patterns of calcification in chondromyxoid fibroma. Skelet Radiol. 1998;27(10):559–64.CrossRefGoogle Scholar
  22. 22.
    Klein JS, Braff S. Imaging evaluation of the solitary pulmonary nodule. Clin Chest Med. 2008;29(1):15–38 v.CrossRefGoogle Scholar
  23. 23.
    Seeger LL, Yao L, Eckardt JJ. Surface lesions of bone. Radiology. 1998;206(1):17–33.CrossRefGoogle Scholar
  24. 24.
    Gholamrezanezhad A, Basques K, Kosmas C. Peering beneath the surface: juxtacortical tumors of bone (part II). Clin Imaging. 2018;50:113–22.CrossRefGoogle Scholar
  25. 25.
    Gholamrezanezhad A, Basques K, Kosmas C. Peering beneath the surface: juxtacortical tumors of bone (part I). Clin Imaging. 2018;51:1–11.CrossRefGoogle Scholar
  26. 26.
    Schlesinger AE, Hernandez RJ. Intracapsular osteoid osteoma of the proximal femur: findings on plain film and CT. AJR Am J Roentgenol. 1990;154(6):1241–4.CrossRefGoogle Scholar
  27. 27.
    Chaabane S, Bouaziz MC, Drissi C, Abid L, Ladeb MF. Periosteal chondrosarcoma. AJR Am J Roentgenol. 2009;192(1):W1–6.CrossRefGoogle Scholar
  28. 28.
    Abdelwahab IF, Kenan S, Hermann G, Klein MJ, Lewis MM. Periosteal ganglia: CT and MR imaging features. Radiology. 1993;188(1):245–8.CrossRefGoogle Scholar
  29. 29.
    Zillmer DA, Dorfman HD. Chondromyxoid fibroma of bone: thirty-six cases with clinicopathologic correlation. Hum Pathol. 1989;20(10):952–64.CrossRefGoogle Scholar

Copyright information

© ISS 2018

Authors and Affiliations

  1. 1.Department of Musculoskeletal RadiologyNYU Langone HealthNew YorkUSA
  2. 2.Department of PathologyNYU Langone HealthNew YorkUSA

Personalised recommendations