What is chondromyxoid fibroma?
Chondromyxoid fibroma (CMF) is a rare, benign bone tumor found most often in the bones of the legs, arms, feet, hands, fingers and toes.
Chondromyxoid fibroma typically occurs in children and young adults between the ages of 10 and 30, and accounts for less than 1 percent of all bone tumors.
Cause
It is not known why chondromyxoid fibromas form.
Signs and symptoms
Chondromyxoid fibroma symptoms include:
- Pain
- Swelling
- Tenderness
- Stiffness or difficulty moving joints near the affected bone
- A growth or bump under the skin
Testing and diagnosis
At Children’s Hospital of Philadelphia (CHOP), our clinical experts use a variety of diagnostic tests to diagnose chondromyxoid fibroma in your child, including:
- X-rays, which produce images of bones.
- Magnetic resonance imaging (MRI), which uses a combination of large magnets, radiofrequencies and a computer to produce detailed images of organs, soft tissues, muscles, ligaments and other structures within the body. Your child is exposed to no radiation during an MRI.
- Computed tomography (CT) scan, which uses a combination of X-rays and computer technology to examine bones and produces cross-sectional images ("slices") of the body.
- EOS imaging, an imaging technology that creates 3-dimensional models from two flat images. Unlike a CT scan, EOS images are taken while the child is in an upright or standing position, enabling improved diagnosis due to weight-bearing positioning.
- Needle biopsy, which is a procedure where a doctor places a small needle through the skin and into the lesion to withdraw a small sample of the abnormal tissue. The tissue is analyzed to confirm any findings.
Treatment
There are many treatment options available for bone and soft tissue tumors, and some children will need a combination of these therapies. At CHOP, experts at the Bone and Soft Tissue Tumor Program take a team approach to treatment. Orthopedic, cancer and other specialists collaborate to provide your child with individualized care and the best possible outcomes.
Our program is led by Kristy L. Weber, MD, and Alexandre Arkader, MD, nationally renowned surgeons who specialize in treating bone and soft tissues tumors, limb-sparing surgery and reconstructive surgery.
Surgery is the recommended treatment for a chondromyxoid fibroma.
Surgical treatment may include:
- Intralesional curettage, which involves scraping out the bone to completely remove the tumor
- Intraoperative adjuvants — such as cryotherapy (liquid nitrogen), phenol (a chemical) or cauterization (burning the tumor bed) — which are used to remove microscopic tumor cells
- Bone grafting, a surgical procedure to replace missing bone with artificial graft material or cadaver bone
Depending on the size and location of chondromyxoid fibroma removed, your child may be able to return home that day or may spend one night in the Hospital.
Surgical safety
Though surgery for tumors is highly effective, we understand that any surgery can be a stressful experience for children and families. At CHOP, we offer a wealth of resources about how to prepare your child for surgery and what to expect during surgery.
Additionally, we employ numerous best practices before, during and after surgery to decrease the risk of infection and increase positive outcomes. For more details about safety protocols at Children's Hospital of Philadelphia, see safety in surgery.
Follow-up care
There is a 10-20 percent risk of recurrence of chondromyxoid fibroma after treatment, so it’s important for your child to continue to see her surgeon.
Your child will see the orthopedic surgeon about one to two weeks after surgery, then again every three to four months for two years to monitor for possible recurrence of the growth.
At Children's Hospital of Philadelphia, we offer ongoing support and services for patients and families at our Main Campus and throughout our CHOP Care Network. Our team is committed to partnering with parents and referring physicians to provide the most current, comprehensive and specialized care possible for your child.
During follow-up visits, X-rays and other diagnostic testing of the tumor site are recommended to closely monitor your child’s health, check the reconstruction, and make sure there is no recurrence.
If the chondromyxoid fibroma returns, surgeons will treat the recurrence with intralesional curettage, intraoperative adjuvants, and bone grafting.
In most cases, a chondromyxoid fibroma will not recur more than two years after surgery.
If your child needs continued monitoring into adulthood, she can continue to see some of the same doctors who treated her. CHOP’s Bone and Soft Tissue Tumor Program works closely with Penn Medicine. For families who live farther away and need continued monitoring, our clinical professionals will help your child transition to adult care near home.
Resources to help
Bone and Soft Tissue Tumor Program Resources
We have compiled web, video and other resources to help you find answers to your questions and help you feel more confident in the care you are providing your child.
Meet our team
Your child’s care team may include experts from several areas of medicine, including pediatric orthopedic surgery, oncology, diagnostic and interventional radiology, radiation oncology and more.
Reviewed by Alexandre Arkader, MD