Dahlin's Bone Tumors, Sixth Edition

[Classical osteosarcoma in children and adolescent]

Classical osteosarcoma is one of the most common primary malignant bone tumors in children and adolescents. It more frequently occurs in the areas of the highest growth plate proliferation: limb long bones particularly in the distal femur (30%), proximal tibia (15%), and proximal humerus (15%). In the long bones, the tumor is located usually in the metaphysis (90%), less frequently in the diaphysis (9%), and very rarely in the epiphysis. This paper considers the clinical, radiological, and histological diagnosis, and prognosis in this pathology.

[Non-ossifying fibroma (metaphyseal fibrous defect)]

Non-ossifying fibroma (NOF) or metaphyseal fibrous defect (MFD) is benign fibroblast proliferation with the presence of osteoclast-like multinucleated giant cells. The most cases of NOF/MFD occur in the metaphysis of the long tubular bones of the lower extremities, more commonly in the metaphysis of the femur and in the proximal metaphysis of the tibia. This lesion has a characteristic X-ray pattern and requires no surgical intervention, except for cases of a pathologic fracture or a risk for the latter. The paper analyzes 35 NOF/MFD cases in children and adolescents. It has been found that one and all patients have undergone surgery, suggesting the low awareness of this abnormality among radiodiagnosticians, pathologists, and surgeons.