Osteofibrous dysplasia arising in the humerus: A case report

Abstract

Osteofibrous dysplasia is a benign fibro-osseous lesion of bone which is most commonly occurred in cortical bone of anterior mid-shaft of the tibia of infancy and childhood. This study reported a case of osteofibrous dysplasia arising in the humerus of adult, resulting in good prognosis after a surgical treatment. A 34-year-old male had felt left upper arm pain and was suspected as having a bone tumor at the humeral shaft by X-ray pictures. The tumor was suspected as the osteofibrous dysplasia of the humerus by a core needle biopsy. Intralesional curettage, intraoperative anhydrous ethanol therapy, and artificial bone graft were performed. Surgical specimens showed fibro-osseous lesion, which strongly indicated osteofibrous dysplasia. Seven years after the surgery, he has lived without any local recurrence and complaints. It is important to recognize that osteofibrous dysplasia can arise in the humerus of an older patient for appropriate diagnosis.

Keywords: Osteofibrous dysplasia; anhydrous ethanol; humerus; ossifying fibroma.

Figure 1.

Image analyses of the humerus and histological appearance of the tumor: Plain radiograph of (a) anteroposterior view and (b) lateral view shows an osteolytic lesion with slight marginal sclerosis in the anterior cortical bone of the distal part of the humeral shaft. (c) Computed tomography image revealed calcifications as well as marginal sclerosis in the lesion. The lesion protruded to the anterior side without breaking the anterior cortical wall of the humerus. Magnetic resonance imaging images show (d) intermediate signal intensity on T1-weighted images and (e) high signal intensity on T2-weighted images of the lesion. (f) The lesion was well enhanced with T1 fat suppression with an injection of gadolinium, axial image. Hematoxylin and eosin stained surgical specimen (g: 100×, h: 200×) shows fibro-osseous lesion with irregular fragments of woven bone rimmed by osteoblasts (*). Many spindle-shaped osteoblasts are observed in the fibrous component (**). Zonal architecture and storiform pattern were not detected. Arrow heads indicate the tumor. Scale bar = 200 µm.

Figure 2.

Plain radiograph of the humerus in 7 years after operation: Plain radiograph of (a) anteroposterior view and (b) lateral view shows no osteolytic lesion that shows recurrence.