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A non-ossifying fibroma (NOF) is a benign bone tumor of the osteoclastic, giant cell-rich tumor type. [1] It generally occurs in the metaphysis of long bones in children and adolescents. [ 2 ] Typically, there are no symptoms unless there is a fracture . [ 2 ]
The most common bone tumor is a non-ossifying fibroma. [4] Average five-year survival in the United States after being diagnosed with bone and joint cancer is 67%. [5] The earliest known bone tumor was an osteosarcoma in a foot bone discovered in South Africa, between 1.6 and 1.8 million years ago. [6]
High magnification micrograph of giant cells in a giant-cell tumor of bone, H&E stain. The diagnosis of giant-cell tumors is based on biopsy findings. The key histomorphologic feature is, as the name of the entity suggests, (multinucleated) giant cells with up to a hundred nuclei that have prominent nucleoli.
Metaphyseal tumors or lesions include osteosarcoma, chondrosarcoma, fibrosarcoma, osteoblastoma, enchondroma, fibrous dysplasia, simple bone cyst, aneurysmal bone cyst, non-ossifying fibroma, and osteoid osteoma. [5] One of the clinical signs of rickets that doctors look for is cupping and fraying at the metaphyses when seen on X-ray.
The cystic fibroma (fibroma cysticum) has central softening or dilated lymphatic vessels. The myxofibroma (fibroma myxomatodes) is produced by liquefaction of the underlying soft tissue. The cemento-ossifying fibroma is hard and fibrous, most frequently seen in the jaw or mouth, sometimes in connection with a fracture or another type of injury.
Jaffe–Campanacci syndrome is one of the disorders associated with café au lait macules (CALMs). Presentations may include intellectual disability, disseminated non-ossifying fibromas of the long bones and jaw, hypogonadism or cryptorchidism, or giant cell granulomas of the jaw.
The most commonly affected bones are the proximal humerus, the distal radius, the distal femur, and the tibia, [37] following the basic premise "far from the elbow, close to the knee". Other sites include the ribs, the mandible, the spine, and the pelvis. Rarely, osteosarcoma may arise from soft tissues (extraskeletal osteosarcoma).
Giant-cell fibroma is a benign localized fibrous mass. It often mimics other fibroepithelial growths and can be distinguished by its histopathology . The exact cause of giant-cell fibromas is unknown however there is no evidence to show that it can be caused by irritation.