Presentation
Motorcycle accident. Midshaft deformity of the lower leg.
Patient Data
Knee radiographs revealed an eccentrical metaphyseal multiloculated lucent lesion with a sclerotic rim. It measures 38 mm across its greater diameter.
There is no periosteal reaction, the sclerotic rim touches the cortical without breaching it.
These characteristics are highly suggestive of a non-ossifying fibroma.
Case Discussion
Non-ossifying fibromas are common non-neoplastic bone lesions, usually seen in children and adolescents.
They have a typical appearance of a multiloculated lucent lesion with a sclerotic rim. They are commonly located eccentrically in the metaphyses of long bones. Lesions with this appearance but <3 cm are referred to as fibrous cortical defects.
Due to their characteristic appearance and outcome, most of them require neither treatment nor biopsy. Because of this, non-ossifying fibromas are one of the "don't touch" lesions.
These lesions are mostly asymptomatic and found incidentally, which happened in this case. The patient had a tibia shaft fracture and the non-ossifying fibroma was an incidental finding of the knee radiographs.
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