Fibrous cortical defect/nonossifying fibroma

Fibrous cortical defect/nonossifying fibroma
Updated: 07/01/2023
© Jun Wang, MD, PhD

General features
  • AKA metaphyseal fibrous defect
  • Often less than 1 cm
  • Called nonossifying fibroma if loose, > 5 cm and associated with intramedullary component
  • Affects teenagers
  • Usually resolves in a few years, replaced by cortical bone
  • Likely to be multiple
Clinical presentations
  • Usually incidental finding
  • Asymptomatic, possibly pain
Pathogenesis
  • Unclear, probably developmental defect
Most common sites
  • Metaphysis of distal femur, tibia
Key radiologic findings
  • Sharply demarcated radiolucency with zone of sclerosis
  • NO periosteal reaction
Key morphological features
  • Loose storiform pattern spindle cell proliferation
  • Scattered giant cells
Treatment
  • Surgery


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