Chondromyxoid fibroma of the maxilla. Electron microscopic findings and review of the literature

Unilocular anterior mandibular swelling

PURPOSE

To report a rare case of chondromyxoid fibroma, presenting as an unilocular anterior mandibular swelling, which is one of the least common tumours of bone comprising less than 1% of bone tumours and to review the differential diagnosis and literature for a better understanding of this disease as well as addressing the controversies in respect with its treatment.

MATERIALS AND METHODS

Previous reports about this lesion in literature were reviewed wherein data was recorded about the age, sex, race, location of pathology, presenting signs and symptoms, duration of pathology, size, radiographic findings, treatment and any recurrence on follow-up.

RESULTS

25 cases were studied and data compiled. Multisectional histopathological examination is advocated to differentiate it from osteosarcoma. Enucleation with or without curettage with long-term follow-up has been considered to be a satisfactory treatment modality.

CONCLUSION

The rarity of the lesion, limited data on the clinical presentation, histological dilemma and treatment options replete with controversies make it a tough predicament. A thorough understanding of the disease and treatment options is indispensable to treat such a case.

Chondromyxoid fibroma of the nasal septum: case report and review of literature

BACKGROUND

Chondromyxoid fibroma (CMF) is a rare bone tumor, accounting for less than 0.5% of all bone tumors, with a predilection for lower extremity bone metaphyses. Involvement of the head and neck is extremely rare, with only 3 cases reported in the nasal septum in world literature.

METHODS

This is a case report of a CMF in the nasal septum of a 49-year-old woman with a 6-month history of congestion. MRI showed a bilobed mass originating from the nasal septum. Histologic and immunoperoxidase staining as well as electron microscopic studies were performed. A literature review was performed.

RESULTS

The patient underwent a midface-degloving approach for surgical resection. The final pathology was prototypic of CMF. The patient was disease-free 16 months postoperatively.

CONCLUSIONS

CMF is a rare, benign neoplasm occasionally occurring in the head and neck. Surgical resection is often curative. CMF must be differentiated from chondrosarcoma, given the substantial differences in treatment.

Cell biology and matrix biochemistry of chondromyxoid fibroma

We studied matrix composition and gene expression pattern in chondromyxoid fibromas on the protein and the messenger RNA levels. We could clearly identify focal chondrocytic differentiation within chondromyxoid fibroma by the expression and deposition of type II collagen, which is a marker of chondrocytic cell differentiation. We also were able to show expression of collagen types I, III, and VI in the neoplasm. The major tumor portion was, however, characterized by the presence of hydrated proteoglycans and only minor amounts of collagens, a matrix composition responsible for the myxoid matrix appearance of most parts of these neoplasms. By analyzing cytoprotein expression, we found S-100 protein restricted to cells of the chondroid areas, suggesting S-100 protein staining to be of little help as a positive diagnostic marker for chondromyxoid fibroma. Our data show a specific matrix composition of chondromyxoid fibroma, not previously found in other mesenchymal neoplasms, including chondroblastoma, osteochondroma, enchondroma, and chondrosarcoma. This justifies chondromyxoid fibroma as a specific neoplastic entity, both clinically and biologically.

Chondromyxoid fibroma of the jaws. Case report and review of the literature

Chondromyxoid fibroma is a benign tumor of bone that is characterized by chondroid and myxoid differentiation and by ultrastructural and immunohistochemical evidence of chondral origin. It is rare in the jaws and skull bones, where only about 2% of all cases have been reported. A review of the 20 acceptable gnathic cases in the literature and of the current case revealed both a higher incidence in the mandible (76%) than in the maxilla (24%) and an equal sex distribution. The sites of occurrence in both jaws are compatible with origin from developmental cartilaginous remnants. The controversies regarding malignant transformation and therapeutic approach are addressed.

Endoscopic removal of chondromyxoid fibroma of the ethmoid sinus

The first case of the endoscopic intranasal excision of chondromyxoid fibroma as an outgrowth of the ethmoid bone is reported. This case appears to represent the second reported type of recurrence of CMF in the head and neck area and the second type of CMF originating in the ethmoid.

Chondromyxoid fibroma of the nasal bone with extension into the frontal and ethmoidal sinuses

Chondromyxoid fibroma is a rare benign tumour whose histological appearance may easily be misinterpreted as chondrosarcoma. It has a tendency to recur locally unless completely excised. A rare case of the tumour affecting the nasal bone with extension into the frontal and ethmoidal sinuses and impingement on the cribiform plate is presented. Complete excision was achieved by the craniofacial resection approach.

Unusual presentation of a chondromyxoid fibroma of the mandible. Report of a case and review of the literature

Chondromyxoid fibromas are uncommon central bone tumors that are most often found at the proximal metaphyses of long bones. Chrondromyxoid fibromas of the jaws are very rare with only 18 reported cases in the literature. This article reports on a recurrent chondromyxoid fibromas of the mandible in a 10-year-old boy. In addition, a literature review of the clinical and histologic features, as well as the diagnostic pitfalls and recommended modalities of treatment are presented.

Chondromyxoid fibroma of the mandible. Diagnostic image cytometry findings and review of the literature

A case of chondromyxoid fibroma in the mandible of a 12-year-old boy is reported. A review of the literature is presented with emphasis on flow and image cytometric analysis and evaluation of the radiologic and histologic differences between chondromyxoid fibroma and chondrosarcoma.

Chondromyxoid fibroma

Approximately 2% of chondromyxoid fibromas of bone present in the jaws, preponderantly in the mandible, where they must be distinguished from low-grade chondrosarcomas. A recurrence rate of 25% dictates careful complete removal of this histologically benign lesion.

Chondromyxoid fibroma of the maxilla

A case of chondromyxoid fibroma of the anterior maxilla arising in a 38-year-old Japanese woman is presented. Review of the literature reveals 16 cases of CMF of the jaws, of which only 3 were in the maxilla. Curettage and subsequent 5 year followup showed no evidence of recurrence.