Manohar T H, Harshavardhan J K Giriraj, Menon P Gopinath
Department of Orthopaedic Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.
J Orthop Case Rep. 2020;10(2):106-108. doi: 10.13107/jocr.2020.v10.i02.1720.
Non-ossifying fibroma are is a common benign lesions found in children. Usually, they are found in cortical bone in metaphysis, but they can also be seen in cancellous bone. Theses lesions are known to regress spontaneously. Usually, it is asymptomatic and an incidental finding on radiograph. No intervention is required. Here, we are reporting a case of symptomatic non-ossifying fibroma of radius with unusual characteristics which required surgical intervention.
An 11-year-old skeletally immature girl presented to us two 2 years back with pain and swelling over the right forearm without any restriction of moments and other constitutional symptoms. She was diagnosed to have non-ossifying fibroma and had underwent surgery for the same 4years back. Radiographic and higher imaging studies suggested non-ossifying fibroma. Since the lesion was painful and the child had difficulty in carrying heavy objects, we decided to intervene. Tumour tissue was thoroughly curetted and the defect was filled with artificial bone substitute. Biopsy confirmed the diagnosis of non-ossifying fibroma and post-operative radiograph showed some residual tumour which was noted even at one 1-year follow-up X-ray. On 3-years follow-up,the patient was symptom-free with no residual lesion and complete incorporation of the artificial bone substitute.
Though Although most of the NOF regress completely without intervention, large and symptomatic lesions in unusual location require to be surgically treated. The natural history of the lesion - spontaneous regression also aids in the management.
非骨化性纤维瘤是儿童常见的良性病变。通常，它们位于干骺端的皮质骨中，但也可见于松质骨。这些病变已知会自发消退。通常，它无症状，是在放射照片上偶然发现的。无需干预。在此，我们报告一例具有不寻常特征的有症状的桡骨非骨化性纤维瘤病例，该病例需要手术干预。
一名11岁骨骼未成熟的女孩两年前前来就诊，右前臂疼痛肿胀，无任何活动受限及其他全身症状。她被诊断为非骨化性纤维瘤，4年前曾为此接受手术。放射学及更高分辨率影像学检查提示为非骨化性纤维瘤。由于病变疼痛且患儿搬运重物困难，我们决定进行干预。彻底刮除肿瘤组织，并用人工骨替代物填充缺损。活检证实为非骨化性纤维瘤，术后放射照片显示有一些残留肿瘤，甚至在1年随访X线检查时仍可见。在3年随访时，患者无症状，无残留病变，人工骨替代物完全融合。
尽管大多数非骨化性纤维瘤无需干预即可完全消退，但位于不寻常位置的大的有症状病变需要手术治疗。病变的自然史——自发消退也有助于治疗管理。
