Bone
Fibrous and Fibroosseous tumors of bone
Metaphyseal fibrous defect



Topic Completed: 01 August 2013

Revised: 27 December 2018

Copyright: (c) 2003-2018, PathologyOutlines.com, Inc.

PubMed Search: Metaphyseal fibrous defect
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Cite this page: Pernick N Metaphyseal fibrous defect. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/bonemetaphysealfibrousdefect.html. Accessed January 22nd, 2019.
Definition / general
  • Also called fibrous cortical defect
  • Called nonossifying fibroma if loose, > 5 cm and associated with intramedullary component
  • Distinctive lesions in teenagers, no gender preference
  • Benign; asymptomatic except for possibly pain
  • Probably a developmental defect (not neoplastic), usually resolves in a few years and is replaced by cortical bone
  • Sites: usually metaphysis of distal femur, tibia; 50% are multiple; often < 1 cm
Treatment
  • Usually none
  • Curettage and bone grafts if large and at risk for pathologic fracture
Case reports
Radiology description
  • Sharply demarcated radiolucencies surrounded by thin zone of sclerosis without a periosteal reaction
Radiology images

Contributed by Dr. Mark R. Wick

Nonossifying fibroma



Nonossifying fibroma


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Tibia

Gross description
  • Red-brown, granular, well circumscribed
Gross images

Contributed by Dr. Mark R. Wick

Non-ossifying fibroma

Microscopic (histologic) description
  • Storiform pattern of fibroblasts with scattered benign giant cells, foamy histiocytes, cholesterol crystals, hemosiderin
  • Mitotic figures common
  • Rarely has bizarre (degenerative) nuclear features
  • Resembles fibrous histiocytoma
Microscopic (histologic) images

Contributed by Dr. Mark R. Wick
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Non-ossifying fibroma


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Nonossifying fibroma



Images hosted on other servers:
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Spindle cells with storiform pattern and giant cells

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Quiz case

Differential diagnosis
Additional references