Chondromyxoid fibroma. The experience at the Istituto Ortopedico Rizzoli.

Abstract

We reviewed the records of all patients with the diagnosis of chondromyxoid fibroma at the Bone Tumor Center of the Istituto Ortopedico Rizzoli. The records of twenty-seven patients were available for the study of clinical, radiographic, and pathological findings Surgical treatment was evaluated in twenty two patients with a follow-up of longer than two years; their average follow-up was 117 months (range, twenty-four to 380 months) Seventeen patients had been followed for at least five years. A questionnaire including a request for radiographs and questions pertaining directly to functional status was sent to the patients or their physicians Seventeen (77 per cent) of the patients responded, and two other patients were examined by us; the remaining three patients had died due to unrelated causes, with no evidence of tumor at the time of death. In our experience, the lesion was most commonly seen in the tibial metaphysis of adolescent boys. Symptoms of pain and swelling may precede detection of the lesion by years. Our results are similar to those reported by other authors. There was an over-all rate of recurrence of 27 per cent. With curettage alone there was an 80 per cent recurrence rate, but when curettage was combined with corticocancellous bone-grafting the recurrence rate decreased to 7 per cent. Two of the recurrences had been treated by amputation in the mistaken belief that the lesion was malignant The remaining recurrences were successfully treated by wide excision. The recurrence rate was not found to be dependent on the age of the patient or on an atypical histological appearance. On the basis of this experience, we believe that thorough curettage combined with corticocancellous bone-grafting remains the treatment of choice for patients with chondromyxoid fibroma.