Chondromyxoid Fibroma

  • What is chondromyxoid fibroma?

    Chondromyxoid fibroma (CMF) is a rare, benign growth found most often in the long bones of the legs, arms, feet, hands, fingers and toes. In about 8 percent of cases, it can occur in the spine.

    While chondromyxoid fibroma has been diagnosed in children as young as 3 years old, typically it occurs the second and third decade of life (age 10-29). Chondromyxoid fibroma accounts for less than 1 percent of all bone tumors.

    Chondromyxoid fibroma has a high rate of recurrence — about one in every four patients with CMF will have their growths return. However, unlike some other benign tumors, recurrence does not increase the risk of the tumor becoming cancerous.

  • Cause of chondromyxoid fibroma

    It is not known why chondromyxoid fibromas form, but some studies have revealed a chromosomal abnormality in patients with CMF. Clinicians at The Children’s Hospital of Philadelphia are conducting research into this condition and its origins.

  • Symptoms of chondromyxoid fibroma

    Chondromyxoid fibroma symptoms include:

    • Pain
    • Swelling
    • Tenderness to palpation
    • Difficulty moving some joints
  • Diagnosing chondromyxoid fibroma

    At The Children’s Hospital of Philadelphia, our clinical experts use a variety of diagnostic tests to diagnose chondromyxoid fibroma in your child, including:

    • Magnetic resonance imaging (MRI), which uses a combination of large magnets, radiofrequencies and a computer to produce detailed images of organs and structures within the body.
    • Computed tomography (CT) scan, which uses a combination of X-rays and computer technology to produce cross-sectional images ("slices") of the body.
    • X-rays, which produce images of bones and internal organs on film.
    • Radioisotope bone scan, which can locate an area of abnormal tissue growth. 
    • EOS imaging, an imaging technology that creates 3-dimensional models from two planar images. Unlike a CT scan, EOS images are taken while the child is in an upright or standing position, enabling improved diagnosis due to weight-bearing positioning.

    In addition to imaging tests, a biopsy may also be necessary to confirm the diagnosis of chondromyxoid fibroma. A biopsy is a short procedure where a sample of the growth is surgically removed and then tested for malignant and benign cells.

  • Treating chondromyxoid fibroma

    Surgery is the recommended treatment for most chondromyxoid fibroma tumors in children.

    Though surgery for chondromyxoid fibroma is highly effective, we understand that any surgery can be a stressful experience for your child and family. At CHOP, we offer a wealth of resources about how to prepare your child for surgery and what to expect during surgery.

    Additionally, we employ numerous best practices before, during and after surgery to decrease the risk of infection and increase positive outcomes. See safety in surgery for details about safety protocols at The Children's Hospital of Philadelphia.

    Surgical options for chondromyxoid fibroma include:

    • Intralesional curettage, which involves scraping out the bone to completely remove the tumor and filling the space with material such as methyl methacrylate cement, phenol or liquid nitrogen.
    • Bone grafting, a surgical procedure to replace missing bone, most often completed with a piece of bone from another location on the person getting the graft, synthetic material or cadaver bone.
    • En bloc excision, which involves removal of the growth entirely through surgery.
  • Follow-up care of chondromyxoid fibroma

    Chondromyxoid fibroma tumors have a 25 percent chance of recurrence and can prevent or slow the growth of the affected bone. When chondromyxoid fibroma is on the spine, the condition is considered more aggressive. Either way, it is important for your child to continue to see a doctor after treatment.

    Your child will see the orthopedic surgeon about one to two weeks after surgery, then again at three and six months post-surgery. Annual monitoring by trained clinicians is strongly encouraged to monitor for possible recurrence of the growth.

    At The Children's Hospital of Philadelphia, we offer ongoing support and services for patients and families at our Main Campus and throughout our CHOP Care Network. Our team is committed to partnering with parents and referring physicians to provide the most current, comprehensive and specialized care possible for your child.

  • Long-term outcomes for chondromyxoid fibroma

    Along with possible recurrence, chondromyxoid fibroma can also affect your child’s leg length or cause angular deformities if the lesion is on a growth plate. Though troubling, these conditions can be surgically corrected in many cases.

Reviewed on May 19, 2014