Non-ossifying fibroma

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Non-ossifying fibroma
Synonyms Metaphyseal fibrous defect, fibrous cortical defect
Pronounce N/A
Specialty N/A
Symptoms Usually asymptomatic, may cause pain or fracture if large
Complications Pathological fracture
Onset Typically in children and adolescents
Duration Often resolves spontaneously
Types N/A
Causes Unknown, possibly developmental
Risks None known
Diagnosis X-ray, CT scan, MRI
Differential diagnosis Fibrous dysplasia, Osteosarcoma, Chondromyxoid fibroma
Prevention N/A
Treatment Observation, surgical curettage if symptomatic
Medication N/A
Prognosis Excellent, often resolves without treatment
Frequency Common in children, especially males
Deaths N/A


A benign bone tumor


Non-ossifying fibroma (NOF) is a benign bone tumor that typically occurs in the metaphysis of long bones in children and adolescents. It is one of the most common benign bone lesions and is often discovered incidentally on X-rays taken for other reasons.

Pathophysiology[edit]

Non-ossifying fibromas are composed of fibrous tissue and are considered a type of fibrous cortical defect. They are characterized by a proliferation of spindle-shaped fibroblasts and histiocytes, often with scattered multinucleated giant cells. The lesion is typically well-circumscribed and located in the cortex of the bone.

Clinical Presentation[edit]

Most non-ossifying fibromas are asymptomatic and are found incidentally. However, larger lesions may cause pain or pathological fractures, especially if they weaken the structural integrity of the bone.

Diagnosis[edit]

Diagnosis is primarily made through imaging studies. On X-ray, non-ossifying fibromas appear as well-defined, eccentric, lytic lesions with a sclerotic margin. They are often located in the metaphysis of long bones such as the femur or tibia. Advanced imaging techniques such as CT scan or MRI can be used to further characterize the lesion. On CT, a mature non-ossifying fibroma may show a well-defined, cortically based lesion with a sclerotic rim.

Mature non-ossifying fibroma CT

Treatment[edit]

In most cases, non-ossifying fibromas do not require treatment and are monitored with periodic imaging. If the lesion is large or symptomatic, surgical intervention may be necessary. This can include curettage and bone grafting to stabilize the bone and prevent fracture.

Prognosis[edit]

The prognosis for non-ossifying fibroma is excellent. These lesions often spontaneously regress as the child grows, and they rarely cause long-term complications. Malignant transformation is extremely rare.

See also[edit]

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