# Assessing Treatment Outcomes of Chondromyxoid Fibroma: A Case Series

## TL;DR

This study examines different treatment approaches for a rare bone tumor called chondromyxoid fibroma and finds that non-surgical monitoring can be effective in some cases.

## Contribution

The first documented case series showing successful nonoperative management of chondromyxoid fibroma with serial imaging.

## Key findings

- All surgical patients remained free of tumor recurrence regardless of the surgical method used.
- Conservative management with serial imaging was successful in two asymptomatic patients over long-term follow-up.
- Two patients who underwent en bloc resection required revision surgery due to complications.

## Abstract

Background: Chondromyxoid fibroma (CMF) is a rare, benign, and locally aggressive bone tumor. It presents diagnostic challenges due to its radiologic similarity to other lesions and variable recurrence rates following surgical treatment. Current literature lacks standardized treatment guidelines, and nonoperative management strategies have not been previously described.

Methods: We conducted a retrospective review of patients diagnosed with CMF at our institution between 2010 and 2024. Eight patients met the inclusion criteria, with treatment modalities including en bloc resection (n=2), intralesional curettage with adjuvants (n=4), and conservative management with serial imaging (n=2). Demographic, clinical, and treatment-related data were collected, and outcomes were analyzed.

Results: The cohort consisted of three males and five females, with a mean age of 55.3 ± 11.8 years and an average follow-up of 41.7 ± 28.5 months (range: eight to 104 months). Lesions were located in the distal femur (n=3), pelvis (n=2), clavicle (n=1), great toe (n=1), and T3 vertebral body (n=1). All surgical patients remained free of tumor recurrence, regardless of treatment modality. Two patients (25%) treated with en bloc resection experienced surgical complications requiring revision arthroplasty. Conservative management with serial imaging was successful in two asymptomatic patients (25%), with no evidence of disease progression over eight and 104 months, respectively.

Conclusion: This case series demonstrates that en bloc resection, intralesional curettage with adjuvants, and conservative management with serial imaging are viable options for managing CMF, depending on patient-specific factors. Notably, to the best of our knowledge, this is the first series to document successful nonoperative management of CMF with serial imaging in carefully selected asymptomatic patients. Our results add to the limited literature on CMF and propose that serial imaging could be a potential management strategy in select patients with CMF.