![]() Histopathological features of desmoplastic fibroma: A, Desmoplastic fibroma–spindled cells with bland small nuclei, evenly dispersed in the collagenous stroma (low power). CT ( Figure 3) showed a lytic lesion with well-defined margins, high-grade endosteal scalloping, and posterior cortical buckling. Magnetic resonance imaging of the right hip ( Figure 2, A–C) demonstrated a hypointense T1-weighted, hyperintense T2-weighted lesion in the proximal femur with postcontrast heterogeneous enhancement. There appears to be a groundglass matrix so that a benign fibro-osseous tumor is a reasonable thought. The margin has a narrow zone of transition and medially and, to a lesser extent, superiorly, has a fine sclerotic rim. On admission, AP and lateral right hip radiographs demonstrated ( Figure 1) a pathological intertrochanteric femur fracture associated with a radiolucent lesion measuring 5.4 × 5.6 cm and varus angulation. At the time, an ultrasonography failed to identify any pathology. Medical history was normal, except for the presence of right groin pain approximately 4 to 6 months ago. The rest of the examination was noncontributory. The right lower extremity had intact skin, and no distal neurovascular compromise was detected. Physical examination showed tenderness to palpation of the right proximal thigh area. On admission, the patient complained of excruciating right hip pain followed by occasional numbness and tingling in the right lower extremity. He reported feeling a sudden, inaudible “pop” immediately after the hit. ![]() Case ReportĪ previously healthy 18-year-old man presented to our emergency department with right hip pain and was unable to ambulate following a low-energy impact while playing basketball. ![]() The patient was informed that data concerning this case would be submitted for publication and he provided consent. Our study presents the case of an 18-year-old otherwise healthy man who consulted to our musculoskeletal oncology service after being diagnosed with a pathological fracture of the right proximal femur undergoing a functional and oncological treatment approach. Physicians must choose an intervention that balances the oncological and functional outcomes, 7 considering the possibility of recurrence and a need for subsequent surgeries. 6 Treatment strategies for this patient cohort are variable, and the optimal approach is still unclear. ![]() When located in the femur, an infrequent location, most patients manifest slowly progressive pain, and only a small minority present with a pathological fracture. 1, 2 Although histologically benign, this tumor is locally aggressive, recurs often, and rarely undergoes malignant transformation. Most affected patients are young, and the tumor is most commonly located in the jaw and the metaphysis of long bones. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.ĭesmoplastic fibroma (DF) is a rare primary intraosseous tumor that represents 0.3% of benign bone tumors and 0.06% of all bone neoplasms. None of the following authors or any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Rosenberg) and the Department of Orthopaedics, Division of Musculoskeletal Oncology, University of Miami Miller School of Medicine, Miami, FL (Dr. Subhawong) the Department of Bone and Soft Tissue Pathology, Miami Miller School of Medicine (Dr. Bryce-Alberti) the Department of Radiology, Division of Musculoskeletal Radiology, University of Miami Miller School of Medicine (Dr. From the Facultad de Medicina Universidad Peruana Cayetano Heredia, Lima, Peru (Dr.
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