Non-Ossifying Fibroma A Non-ossifying Fibroma (NOF) is one Asymptomatic and usually discovered as an of the most common benign bone tumors found incidental finding after a child has a minor in 30 to 40% of children between 8 to 20 years injury and a plain x-ray is taken in the ER. of age. They typically are non-cancerous, or History of pain at a nearby joint rather than life-threatening and do not spread to other areas at the lesion, and symptoms fit a sprain or of the body. strain injury. A NOF is a result from failure of the If there was pain before the injury that bone to properly close at its outer shell. They seems to arise from the lesion, the diagnosis tend to persist or increase in size as the child of NOF is highly suspect. grows but decrease in size or close once growth ends. What is the treatment? The most common complication of a Where do non-ossifying fibromas commonly NOF is a fracture to the bone from increased occur? stress related to injury or lesions that occupy more than 50% of the bones diameter. Immobilization in a cast is the treatment of choice with close observation by an Orthopaedic doctor. These fractures heal well with a normal amount of callous but the NOF may or may not resolve. Surgery is recommended for those patients who do not properly heal with a cast, or are likely to re- break the bone again.
Treatment options Non-surgical: Most lesions tend to heal spontaneously by being replaced with normal bone as the child becomes skeletally mature.
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Patient Guide to Unicameral Bone Cyst The location of the cysts tends to be in the upper arm (proximal humerus) or thighbone (proximal femur). Less common locations include the pelvis, ankle (talus) or heel Los Angeles Orthopaedic Medical (calcaneus). Center 2501 S. Hope St. Los Angeles, CA 90007
A unicameral (simple) bone cyst is a cavity found How are UBC’s diagnosed? within a bone that is filled with straw coloredPlain X-rays: show a hollow cavity in themetaphyseal portion of the bone with a well-defined cortical rim. Surgical option #2: UBC in a structurally compromising location may need surgery including scraping the inside of the bone (curettage). The hole left following this mayComputed tomography (CT) scan: ordered require donor bone or a bone graft substitute towhen the UBC is not typical in it appearance to fill the defect. Depending on the size and locationhelp determine the architecture of the bone. of the cyst, treatment with an internal fixation device may also be needed.
Patient Guide toTreatment Options Bone TumorsNon-Surgical: A UBC without pain or othersymptoms that the doctor discovers whenevaluating another problem can be watched withrepeated X-rays and routine doctor exams.Pathologic fractures occasionally incite a healingprocess not requiring surgical intervention. Los Angeles Orthopaedic Medical Center 2501 S. Hope St. Los Angeles, CA 90007Surgical option #1: The doctor may treat it bydraining the cyst (aspiration) and injecting it with Descriptiona steroid or with demineralized bone from thebone bank, supplemented occasionally with bone A tumor is a lump or mass of abnormal tissue andmarrow from the person's pelvis. This method of may be benign or rarely malignant (cancerous). Fortreatment may require more than one most bone tumors, the cause is unknown. A growingaspiration/injection. tumor may replace healthy tissue with abnormaltissue and may weaken the bone, causing it to break. examine other parts of your body to rule out cancersAggressive tumors can lead to disability or death, that can spread to bone.particularly if signs and symptoms are ignored. How are bone tumors diagnosed?
Most patients with a bone tumor will experience: You may need more imaging studies to furtherMost common types of malignant bone cancer in evaluate some tumors. These may include MRIchildren are: • Pain in the area of the tumor. The pain is (magnetic resonance imaging) or CT (computed generally described as dull and achy. It may or tomography). • Osteosarcoma is the second most common may not get worse with activity. The pain often bone cancer. It occurs in two or three new awakens the patient at night. Blood and or urine tests. If these tests are not people per million people each year. Most • Although tumors are not caused by trauma, adequate to diagnose your tumor, you may require a cases occur in teenagers. Most tumors occur occasionally injury can cause a tumor to start biopsy. around the knee. Other common locations hurting. Injury can cause a bone weakened by include the hip and shoulder. tumor to break, which often leads to severe Biopsy: Involves removing a sample of tissue from pain. the tumor. The tissue sample is examined under a • Ewing's sarcoma most commonly occurs • Some tumors can also cause fevers and night microscope. There are two basic methods of doing a between age 5 and 20. The most common sweats biopsy. locations are the upper and lower leg, • Many patients will not experience any pelvis, upper arm and ribs. symptoms, but will instead note a painless mass. • Needle biopsy: The doctor inserts a needle into the tumor to remove some tissue. This may be done while you are under local anesthesia in the doctor's office. Or aMost common types of benign bone tumors. radiologist may do it, using an X-ray Medical history and physical exam: machine or CT or MRI scanner to help • Non-ossifying fibroma direct the needle to the tumor. Tell the doctor your complete medical history. This • Unicameral (simple) bone cyst includes any medications you take, details about any • Osteochondroma • Open biopsy: The doctor uses surgery to previous tumors or cancers that you or your family • Giant cell tumor, members may have had, and symptoms you are remove tissue. This is generally done • Enchondroma experiencing. Your doctor will physically examine through a small incision while you are • Osteoid osteoma you. The focus is on the tumor mass, tenderness in under general anesthesia in an operating • Fibrous dysplasia. room. bone and any impact on joints and/or range of motion. In some cases, the doctor may want toTreatment metallic implant (prosthesis) or bone transplant.Benign tumors: In many cases, benign tumors just • Amputation removes all or part of an armneed to be watched. Some can be treated effectively or leg when the tumor is large and/or nerveswith medication. Some benign tumors will disappear and blood vessels are involved.over time; this is particularly true for some benign • Radiation therapy uses high-dose X-rays.tumors that occur in children. Certain benign tumors This kills cancer cells and shrinks tumors.can spread or become cancerous (metastasize). • Systemic treatment (chemotherapy) isSometimes your doctor may recommend removing often used to kill tumor cells when theythe tumor (excision) or using other treatment have spread into the blood stream buttechniques to reduce the risk of fracture and cannot yet be detected on tests and scans.disability. Some tumors may come back--even Chemotherapy is generally used whenrepeatedly--after appropriate treatment. cancerous tumors have a very high chance of spreading.Malignant tumors: If you are diagnosed with amalignant bone tumor, you might want to get a After Treatmentsecond opinion to confirm it. If you have bonecancer, your treatment team may include several When treatment for a bone tumor is finished, youspecialists. These may include an orthopaedic may need more X-rays and other imaging studies.oncologist, a medical oncologist, a radiation These can confirm that the tumor is actually gone.oncologist, a radiologist and a pathologist. You may need to have regular doctor visits and testsTreatment goals include curing the cancer and every few months. When the tumor disappears, it ispreserving the function of your body. To treat important to monitor your body for its possiblemalignant bone tumors, doctors often combine return (relapse).several methods. Treatment depends upon variousfactors including whether the cancer has spread.