Bone - Tissu Osseux

Cas 10100073

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  M 16 ans, fracture de la jambe: Curetage biopsique:   M 16 yo, fracture of the leg. Surgical curettings:  
     
     
     
     
 

Diagnostic proposé

 

 

 

 

 

 

 

Lacune osseuse métaphysaire (Fibrome non ossifiant)

 

Proposed diagnosis

 

 

 

 

 

 

 

Metaphyseal fibrous defect (Non ossifying fibroma)

 
  Arguments      

Metaphyseal fibrous defect (Non ossifying fibroma)

Metaphyseal fibrous defects are distinctive lesions of bone that occur in adolescents, most often in long tubular bones, particularly the upper or lower tibia or the lower femur. They are eccentric, sharply delimited lesions not too distant from the epiphysis and sometimes accompanied by epiphyseal disorders. When loose and associated with an intramedullary component, they have been designated as nonossifying or nonosteogenic fibromas. There has been a long-standing and still unresolved controversy regarding whether these lesions are neoplastic or whether they represent developmental aberration at the epiphyseal plate.

Grossly, the lesion is granular and brown or dark red. Microscopically, it consists of cellular masses of fibrous tissue often arranged in a storiform pattern. Scattered osteoclasts and collections of foamy and hemosiderin-laden macrophages are frequent. The microscopic appearance is very reminiscent of a benign fibrous histiocytoma and is designated as such by some authors, especially when it occurs in adult patients in places other than metaphyses of long bones.

Clinically, there are few or no symptoms except pain. The lesion is usually found incidentally on x-ray examination. Fractures can occur through the thinned cortex.