J Pathol Transl Med.  2022 May;56(3):157-160. 10.4132/jptm.2021.12.15.

Juxtacortical chondromyxoid fibroma in the small bones: two cases with unusual location and a literature review

• Oh SJ
• Chung SH

• KMID: 2529807
• DOI: http://doi.org/10.4132/jptm.2021.12.15

Abstract

Chondromyxoid fibroma is a rare bone tumor of cartilaginous origin, representing less than 1% of all bone tumors. It preferentially arises in the eccentric location of the metaphysis of a long tubular bone. Juxtacortical locations are reported infrequently in the long bones and even more rarely in short tubular bones, with only three cases documented. Here we present two new cases of juxtacortical chondromyxoid fibroma in the small bones. One was an intracortical osteolytic lesion of the metatarsal bone of the foot with degenerative atypia that histologically should be differentiated from chondrosarcoma. The other was a phalangeal mass protruding into the interphalangeal joint of the hand, which had been labeled mistakenly as a soft tissue mass preoperatively. These cases illustrated that chondromyxoid fibromas have various the manifestations and should be included in the differential diagnosis of an osteolytic lesion or an exophytic mass in the small bones.

Keyword

Chondromyxoid fibroma; Small bones; Juxtacortical

Figure

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  Fig. 1 Radiologic images of the case 1. (A) Oblique radiograph of the foot shows an intracortical lytic lesion (arrow) in the right second metatarsal neck. (B) Sagittal magnetic resonance image shows a hyperintense mass (arrow) with an intact shell of cortical bone.

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  Fig. 2 Histologic findings of the case 1. (A) Low-power view of the tumor shows a prominent lobular patten. (B) The lobules consist of a hypocellular center with abundant myxoid matrix and condensation of tumor cells toward the periphery. (C) The tumor cells in the hypercellular periphery reveal degenerative features including bizarre nuclei, hyperchromasia, and vacuolization.

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  Fig. 3 Radiologic and histologic images of the case 2. (A) Lateral radiograph of the right index finger reveals a soft tissue mass (arrow) with calcification in the proximal interphalangeal joint. The lesion erodes the epiphysis of the mid phalanx. (B) Magnetic resonance image shows a protruding mass (arrow) with heterogeneous intensity. (C) Microphotographs show a characteristic lobular growth pattern. Spotty calcifications are scattered throughout the lesion. (D) Hypercellular area surrounding the hypocellular myxoid lobules occasionally contains multinucleated giant cells.

Reference

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