Nonossifying fibroma

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Nonossifying fibroma
Other names: Not recommended: fibrous cortical defect, metaphyseal fibrous defect, benign fibrous histiocytoma.[1] Fibroxanthoma, nonosteogenic fibroma, cortical desmoid, fibromatosis[2]
NOF 1.jpg
X-ray of nonossifying fibroma of distal tibia.
SymptomsUsually none, fracture.
Diagnostic methodX-ray, MRI
PrognosisMost resolve without treatment

A nonossifying fibroma (NOF) is a noncancerous bone tumor.[1] It generally occurs in children and adolescents.[2][3]

Generally, there are no symptoms unless a bone breaks.[3] Diagnosis is by X-ray or MRI, usually when investigating a person for something else.[3] Imaging typically shows a well marginated radiolucent lesion, with a distinct multilocular appearance, sometimes looking like bubbles.[2][3]

Multiple nonossifying fibromas occur in Jaffe-Campanacci syndrome in combination with cafe-au-lait spots, mental retardation, hypogonadism, ocular and cardiovascular abnormalities.[2]

It has been seen to affect the jaw bone, but rarely.[4] A NOF was identified on the mandible of Qafzeh 9, an early anatomically modern human dated to 90–100 000 yrs B.P.[5]

Signs and symptoms

Most people with nonossifying fibroma have no symptoms. If the tumor is large, there may be pain over the affected area. An unexplained broken bone can occur.[1] Multiple NOFs occur in Jaffe-Campanacci syndrome in combination with cafe-au-lait spots, mental retardation, hypogonadism, ocular and cardiovascular abnormalities.[2]

Diagnosis

They are usually diagnosed by x-ray or MRI, when investigating another problem.[1] The tumor presents as a well defined radiolucent lesion, with a distinct multilocular appearance, sometimes looking like a "soap bubble".[2] If small and no symptoms, then biopsy is not needed.[1]

Mechanism

The cause is unknown.[1] The foci consist of collagen rich connective tissue, fibroblasts, histiocytes and osteoclasts. They originate from the growth plate, and are located in adjacent parts of the metaphysis and diaphysis of long bones, most often of the legs.[citation needed]

Treatment

Treatment is generally not required if the NOF is small, and the bone usually returns to normal. If more than half of the bone width is affected or the bone is broken, the NOF can be scraped out.[1]

Epidemiology

It is the most common tumor of bone, the exact incidence however, is unknown as most are too small to be known about.[1] Males are affected twice as much as females.[3] Studies of X-rays in children up to the age of 4 years, show that 22% of girls and 54% of boys have a NOF.[1] NOFs are rarely observed in adult X-rays.[1]

History

It has been seen to affect the jaw bone, but rarely.[4] The oldest case of nonossifying fibroma has been identified on the mandible of Qafzeh 9, an early anatomically modern human dated to 90–100 000 yrs B.P.[5]

See also

References

  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 WHO Classification of Tumours Editorial Board, ed. (2020). "Nonossifying fibroma". Soft Tissue and Bone Tumours: WHO Classification of Tumours. 3 (5th ed.). Lyon (France): International Agency for Research on Cancer. pp. 447–448. ISBN 978-92-832-4503-2.
  2. 2.0 2.1 2.2 2.3 2.4 2.5 Ahn, Leah; O'Donnell, Patrick. "Non-Ossifying Fibroma - Pathology - Orthobullets". www.orthobullets.com. Archived from the original on 5 May 2021. Retrieved 5 May 2021.
  3. 3.0 3.1 3.2 3.3 3.4 Murali, Sundaram; Ilaslan, Hakan; Holden, Darlene M. (2015). "2. An imaging approach to bone tumors". In Santini-Araujo, Eduardo; Kalil, Ricardo K.; Bertoni, Franco; Park, Yong-Koo (eds.). Tumors and Tumor-Like Lesions of Bone: For Surgical Pathologists, Orthopedic Surgeons and Radiologists. Springer. p. 15. ISBN 978-1-4471-6577-4.
  4. 4.0 4.1 Bowers, Leah M.; Cohen, Donald M.; Bhattacharyya, Indraneel; Pettigrew, James C.; Stavropoulos, Mary F. (25 September 2012). "The Non-ossifying Fibroma: A Case Report and Review of the Literature". Head and Neck Pathology. 7 (2): 203–210. doi:10.1007/s12105-012-0399-7. ISSN 1936-055X. PMC 3642261. PMID 23008139.
  5. 5.0 5.1 Coutinho Nogueira D, Dutour O, Coqueugniot H, Tillier A.-m., (2019) Qafzeh 9 mandible (ca 90–100 kyrs BP, Israel) revisited : μ-CT and 3D reveal new pathological conditions, International Journal of Paleopathology, Vol 26, pp.104-110, https://doi.org/10.1016/j.ijpp.2019.06.002

External links

Classification
External resources