Desmoplastic fibroma in the proximal femur: A case report with long-term follow-up

Abstract

Desmoplastic fibroma of the bone is an extremely rare primary benign tumor. The present study reports a case of desmoplastic fibroma of the bone with the longest published follow-up. A 21-year-old female presented to The First Hospital of Jilin University (Changchun, Jilin, China) with thigh pain. Radiography demonstrated a lytic expansile lesion in the proximal femur. Curettage was performed, followed by use of an allogeneic graft. One month later, the patient suffered a pathological fracture and was treated with an open reduction and internal fixation. There was no recurrence of the tumor over a 28-year follow-up period. In conclusion, desmoplastic fibroma in the proximal femur is rare and an intralesional resection is strongly recommended to prevent recurrence. The disease may be misdiagnosed as a bone cyst, so the diagnosis should be confirmed with a histological examination.

Keywords: bone; desmoplastic fibroma of the bone; fibromatosis.

Figure 1.

Radiography showing a lytic, cystic, low-density lesion of the proximal femur and femoral neck. The lesion was expansile and the cortex was slight eroded. The lesion exhibited intact, well defined sclerotic margins.

Figure 2.

Histological examination revealing sparse spindle-shaped cells with low mitotic activity, surrounded and separated from one another by abundant collagenous tissue, and no necrosis.

Figure 3.

Radiographic findings associated with the fall the patient suffered one month after curettage. (A) Pathological fracture. (B) Following open reduction and internal fixation of the fracture. (C) The healed fracture eight months later.