CHONDROMYXOID FIBROMA (Greek chondros cartilage + myxa slime + eidos look; fibroma; a synonym a fibromiksoidny chondroma) — the benign tumor developing from cartilaginous tissue.
As the independent nosological form is described in 1948 to Jaffa (H. L. Jaffe) and JI. Likhtenstayn. Before X. t. considered as a myxoma or myxomatous option of an osteoblastoclastoma (see), quite often took for a chondrosarcoma (see).
According to Shayovich (F. Schajo-wizc, 1981), X. t. makes apprx. 1% of all tumors of a skeleton, comes to light at the age of 5 — 25 years (68% of patients) more often. The most frequent localization is the zone of a metaphysis of long tubular bones, especially lower extremities.
It is macroscopically usually presented by solid sites of a lobular look grayish-white or bluish, sometimes to the translucent fabric reminding a cartilage, separated from a surrounding bone by an accurate scalloped narrow zone of an osteosclerosis. Sometimes on a section in it the small cystous strips containing slime are visible. The most part of a tumor has quite dense consistence. In it the centers of calcification and sites of a softening can meet.
X. t. it is formed by the segments of irregular shape consisting of spindle-shaped and star-shaped cells without the accurate contours located in plentiful miksoidny or chondroid substance. In partitions between segments collagenic fibers, fibroblasts and almost constantly huge multinucleate cells are visible. In the majority of one-nuclear cells at a histochemical research find glybk of a glycogen, and in huge multinucleate cells — acid phosphatase. Sometimes in fabric of a tumor ugly hyperchromic cells meet, but lack of mitotic figures testifies against the diagnosis of a chondrosarcoma. Detection in chondromyxoid fibroma of the sites reminding hondroblasty (see) allows many researchers to consider that there is a communication between these tumors.
The wedge, symptoms are not specific — slowly increasing swelling, moderate pains is found. the % at the same time unlike a hondro-blastoma almost is never involved in process a nearby joint.
In diagnosis an important role is played by results rentgenol. researches. At damage of long tubular bones on the roentgenogram the characteristic zone of an enlightenment is found; it is located eccentric in a zone of a metaphysis with a tendency to move from an epiphyseal cartilage towards a diaphysis. The affected edges can look blown up on the roentgenogram. Sometimes in a zone of defeat the trabecular drawing comes to light and petrifikata are found (see).
Treatment operational — perform operations of a scraping (see) or resections (see) the block of a bone.
The forecast is favorable, however after operation of a scraping (curettage) in 12,5 — 25% of cases there is recurrence. The malignancy of a tumor comes extremely seldom.
Bibliography: In and N about r and d about in and T. P. Tumors of bones, page 62, M., 1973; Patologoapa-tomichesky diagnosis of tumors of the person, under the editorship of N. A. Krayevsky, etc., page 408, M., 1982; Sh and y about in and the p F. and d river. Histologic classification of bone tumors, page 36, Geneva, WHO, 1974; J a f-f e H. L. a. Lichtenstein L. Chon-dromyxoid fibroma of bone, distinctive benign tumor likely to be mistaken especially for chondrosarcoma, Arch. Path., v. 45, p. 541, 1948; SchajowizcF. Tumors and tumorlike lesions of bone and joints, p. 148, N. Y. a. o., 1981. BB. H. Nightingales.