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Latest revision as of 16:35, 30 April 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rohan A. Bhimani, M.B.B.S., D.N.B., M.Ch.[2]

Synonyms and keywords:

Overview

Chondromyxoid fibroma is a rare benign bone tumor accounting for approximately 1% of all benign bone tumors. Chondromyxoid fibroma affects all age groups. It is more commonly seen during the second and third decades of life. Men are more commonly affected than women. Chondromyxoid fibroma arising from the physeal remnant is the commonly proposed theory in the pathogenesis of this tumor. It is predominantly found in the metaphyses of the long bones. The bones involved include tibia, distal femur, pelvis, feet and hands. Chromosome 6 appears to be involved in chondromyxoid fibroma. Over expression of the glutamate receptor gene GRM1 in patients with chondromyxoid fibroma via promoter swapping and gene fusion has been observed. The hallmark of chondromyxoid fibroma is pain, swelling, and pathological fracture. The mainstay of treatment for chondromyxoid fibroma is surgery (curettage and bone grafting).

Historical Perspective

In 1948, Jaffe and Lichtenstein described chondromyxoid fibroma for the first time.^[1]

Classification

Chondromyxoid fibroma can be classified based on imaging findings.

Enneking (MSTS) Staging System

The Enneking surgical staging system (also known as the MSTS system) for benign musculoskeletal tumors is based on radiographic characteristics of the tumor host margin.^[2]
It is widely accepted and routinely used classification.

Stages	Description

1	Latent: Well demarcated borders
2	Active: Indistinct borders
3	Aggressive: Indistinct borders

Pathophysiology

The exact etiology of chondromyxoid fibroma is unknown.^[3]
Chondromyxoid fibroma arising from the physeal remnant is the commonly proposed theory in the pathogenesis of chondromyxoid fibroma.^[4]
It is predominantly found in the metaphyses of the long bones.^[5]
The bones involved by chondromyxoid fibroma includes tibia, distal femur, pelvis, feet and hands.^[6]

Genetics

Chromosome 6 appears to be involved in chondromyxoid fibroma.^[5]^[7]
The non-random clonal abnormalities involves 6p25, 6q13 and 6q23.^[5]
Whole-genome mate-pair sequencing and RNA sequencing showed over expression of the glutamate receptor gene GRM1 in patients with chondromyxoid fibroma via promoter swapping and gene fusion.^[8]

Causes

There are no established causes of chondromyxoid fibroma.^[9]

Differentiating Chondromyxoid Fibroma from Other Diseases

Chondromyxoid fibroma must be differentiated from the following bone disorders:^[10]

Disease	Bubbly lytic lesion on x-ray	Lakes of Blood on histology	Diagnosis	Treatment is curretage and bone grafting
Chondromyxoid Fibroma	-	-	Radiology and biopsy	+
Unicameral bone cyst	+	-	Radiology and biopsy	-
Non ossifying fibroma	+	-	Radiology and biopsy	-
Giant cell tumor	-	-	Radiology and Biopsy	+
Chondroblastoma	-	-	Biopsy	+
Aneurysmal bone cyst	+	+	Radiology and biopsy	+
Osteoblastoma	-	-	Radiology and biopsy	+
Telangiectatic osteosarcoma	-	+	Radiology and biopsy	-

Epidemiology and Demographics

Chondromyxoid fibroma is a rare benign bone tumor accounting for approximately 1% of all benign bone tumors.^[11]
Chondromyxoid fibroma affects all age groups.
It is more commonly seen during the second and third decades of life.
Men are more commonly affected than women.
There is no racial predilection to chondromyxoid fibroma.

Risk Factors

There are no established risk factors for chondromyxoid fibroma.

Screening

There is insufficient evidence to recommend routine screening for chondromyxoid fibroma.

Natural History, Complications, and Prognosis

Common complications of chondromyxoid fibroma include:

Pathological fracture
Premature epiphyseal closure
Limb-length discrepancy
Angular deformity

Prognosis is generally good for chondromyxoid fibroma.

Prognostic variables include:
- Children
- When the Tumor is more lobulated with abundant myxoid material

Diagnosis

Histology of chondromyxoid fibroma showing stellate cells in a myxoid stroma..Source: Case courtesy of Sarahkayb [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0), from Wikimedia Commons]

Diagnostic Study of Choice

Biopsy is the diagnostic study of choice for chondromyxoid fibroma.
Biopsy findings under low and high power fields are given below:^[12]^[13]

Under Low Power field:

It has a biphasic appearance
It has lobules and pseudolobules of fibromyxoid tissue with hypercellular area.
The cells are spindle-shaped or stellate-shaped and contain hyperchromatic nuclei.
Multinucleated giant cells and fibrovascular tissue may be present between the lobules.
Hypocellular area with chondroid material is seen.

Under High Power Field:

The tumor shows myxoid stroma mixed with stellate cells.
In addition, an area of pleiomorphic cells with bizarre nuclei may be seen.

History and Symptoms

The majority of patients with chondromyxoid fibroma have a positive history of:

X-ray of ulna showing chondromyxoid fibroma.Source: Case courtesy of A.Prof Frank Gaillard, Radiopaedia.org, rID: 6172

Physical Examination

Common physical examination findings of chondromyxoid fibroma include:

Deformity

Swelling
Decreased range of motion
Warmth over the affected area

Laboratory Findings

There are no diagnostic laboratory findings associated with chondromyxoid fibroma.

Electrocardiogram

There are no ECG findings associated with chondromyxoid fibroma.

X-ray

X-ray findings include:^[14]^[15]

The tumor appears as a lytic, eccentric metaphyse al lesion.

Size of the lesion may vary from 2 to 10 cm.
It has a sharply demarcated border from the adjacent bone.

CT of proximal ulna showing chondromyxoid fibroma.Source: Case courtesy of A.Prof Frank Gaillard, Radiopaedia.org, rID: 6172

It may show scalloped and sclerotic rim
Calcification is usually not seen
The tumor may show cortical expansion.

Echocardiography or Ultrasound

There are no echocardiography/ultrasound findings associated with chondromyxoid fibroma.

CT scan

CT scan confirms the x-ray findings.^[16]
It is superior to x-ray for analyzing the expansion of the lesion and cortical breach.

MRI

MRI findings of chondromyxoid fibroma include:^[17]^[18]

MRI of proximal ulna showing chondromyxoid fibroma.Source: Case courtesy of A.Prof Frank Gaillard, Radiopaedia.org, rID: 6172

T1 image: Chondroid and myxoid tissues produce low signals.
T2 image: Chondroid and myxoid tissues produce high signals.

Other Imaging Findings

Bone Scan

Increased uptake is seen in chondromyxoid fibroma.

Other Diagnostic Studies

There are no other diagnostic studies associated with chondromyxoid fibroma.

Treatment

Medical Therapy

There is no treatment for chondromyxoid fibroma; the mainstay of therapy is surgery.

Surgery

Surgery is the mainstay of treatment for chondromyxoid fibroma.^[19]^[20]

Types

1. Intralesional Curettage

It is the mainstay of treatment for chondromyxoid fibroma.^[20]
The defect is filled with bone graft or bone cement in form of polymethlymethacrylate(PMMA).

2. En Bloc Excision

It usually reserved for recurrent cases.^[21]

Recurrence Rate

The recurrence rate is about 25% for chondromyxoid fibroma.^[22]

Primary Prevention

There are no established measures for the primary prevention of chondromyxoid fibroma.

Secondary Prevention

There are no established measures for the secondary prevention of chondromyxoid fibroma.

References

↑ JAFFE HL, LICHTENSTEIN L (1948). "Chondromyxoid fibroma of bone; a distinctive benign tumor likely to be mistaken especially for chondrosarcoma". Arch Pathol (Chic). 45 (4): 541–51. PMID 18891025.
↑ Jawad MU, Scully SP (2010). "In brief: classifications in brief: enneking classification: benign and malignant tumors of the musculoskeletal system". Clin Orthop Relat Res. 468 (7): 2000–2. doi:10.1007/s11999-010-1315-7. PMC 2882012. PMID 20333492.
↑ Peabody, Terrance (2014). Orthopaedic oncology : primary and metastatic tumors of the skeletal system. Cham: Springer. ISBN 9783319073224.
↑ Brien EW, Mirra JM, Kerr R (1997). "Benign and malignant cartilage tumors of bone and joint: their anatomic and theoretical basis with an emphasis on radiology, pathology and clinical biology. I. The intramedullary cartilage tumors". Skeletal Radiol. 26 (6): 325–53. PMID 9229417.
↑ ^5.0 ^5.1 ^5.2 Cuvelier CA, Roels HJ (1979). "Cytophotometric studies of the nuclear DNA content in cartilaginous tumors". Cancer. 44 (4): 1363–74. PMID 498016.
↑ Halbert AR, Harrison WR, Hicks MJ, Davino N, Cooley LD (1998). "Cytogenetic analysis of a scapular chondromyxoid fibroma". Cancer Genet Cytogenet. 104 (1): 52–6. PMID 9648559.
↑ Buddingh EP, Naumann S, Nelson M, Neffa JR, Birch N, Bridge JA (2003). "Cytogenetic findings in benign cartilaginous neoplasms". Cancer Genet Cytogenet. 141 (2): 164–8. PMID 12606137.
↑ Nord KH, Lilljebjörn H, Vezzi F, Nilsson J, Magnusson L, Tayebwa J; et al. (2014). "GRM1 is upregulated through gene fusion and promoter swapping in chondromyxoid fibroma". Nat Genet. 46 (5): 474–7. doi:10.1038/ng.2927. PMID 24658000.
↑ Gherlinzoni F, Rock M, Picci P (1983). "Chondromyxoid fibroma. The experience at the Istituto Ortopedico Rizzoli". J Bone Joint Surg Am. 65 (2): 198–204. PMID 6337162.
↑ Bergman S, Madden CR, Geisinger KR (2009). "Fine-needle aspiration biopsy of chondromyxoid fibroma: an investigation of four cases". Am J Clin Pathol. 132 (5): 740–5. doi:10.1309/AJCPFJZ8AKMFUAFP. PMID 19846816.
↑ Pintor F, Bahamondes C, Campos O, Zivov A (2015). "Chondromyxoid fibroma of zygoma in an elderly patient: A rare presentation". Ann Maxillofac Surg. 5 (2): 244–8. doi:10.4103/2231-0746.175755. PMC 4772571. PMID 26981481.
↑ Tallini G, Dorfman H, Brys P, Dal Cin P, De Wever I, Fletcher CD; et al. (2002). "Correlation between clinicopathological features and karyotype in 100 cartilaginous and chordoid tumours. A report from the Chromosomes and Morphology (CHAMP) Collaborative Study Group". J Pathol. 196 (2): 194–203. doi:10.1002/path.1023. PMID 11793371.
↑ Desai SS, Jambhekar NA, Samanthray S, Merchant NH, Puri A, Agarwal M (2005). "Chondromyxoid fibromas: a study of 10 cases". J Surg Oncol. 89 (1): 28–31. doi:10.1002/jso.20113. PMID 15612014.
↑ Marin C, Gallego C, Manjón P, Martinez-Tello FJ (1997). "Juxtacortical chondromyxoid fibroma: imaging findings in three cases and a review of the literature". Skeletal Radiol. 26 (11): 642–9. PMID 9428071.
↑ Merine D, Fishman EK, Rosengard A, Tolo V (1989). "Chondromyxoid fibroma of the fibula". J Pediatr Orthop. 9 (4): 468–71. PMID 2732329.
↑ Cappelle S, Pans S, Sciot R (2016). "Imaging features of chondromyxoid fibroma: report of 15 cases and literature review". Br J Radiol: 20160088. doi:10.1259/bjr.20160088. PMC 5124884. PMID 27226218.
↑ Kim HS, Jee WH, Ryu KN, Cho KH, Suh JS, Cho JH; et al. (2011). "MRI of chondromyxoid fibroma". Acta Radiol. 52 (8): 875–80. doi:10.1258/ar.2011.110180. PMID 21835889.
↑ Campanacci M. Bone and soft tissue tumours. 2nd edn. Wien, Austria: Springer; 1999. pp. 265–71.
↑ Zillmer DA, Dorfman HD (1989). "Chondromyxoid fibroma of bone: thirty-six cases with clinicopathologic correlation". Hum Pathol. 20 (10): 952–64. PMID 2793160.
↑ ^20.0 ^20.1 Dürr HR, Lienemann A, Nerlich A, Stumpenhausen B, Refior HJ (2000). "Chondromyxoid fibroma of bone". Arch Orthop Trauma Surg. 120 (1–2): 42–7. PMID 10653103.
↑ Dey B, Deshpande AH, Brar RK, Ray A (2018). "Chondromyxoid Fibroma of the Metatarsal Bone: A Diagnosis Using Fine Needle Aspiration Biopsy". J Cytol. 35 (1): 67–68. doi:10.4103/JOC.JOC_48_17. PMC 5795736. PMID 29403178.
↑ Wu CT, Inwards CY, O'Laughlin S, Rock MG, Beabout JW, Unni KK (1998). "Chondromyxoid fibroma of bone: a clinicopathologic review of 278 cases". Hum Pathol. 29 (5): 438–46. PMID 9596266.

Template:WikiDoc Sources

[pmid18891025-1] JAFFE HL, LICHTENSTEIN L (1948). "Chondromyxoid fibroma of bone; a distinctive benign tumor likely to be mistaken especially for chondrosarcoma". Arch Pathol (Chic). 45 (4): 541–51. PMID 18891025.

[pmid20333492-2] Jawad MU, Scully SP (2010). "In brief: classifications in brief: enneking classification: benign and malignant tumors of the musculoskeletal system". Clin Orthop Relat Res. 468 (7): 2000–2. doi:10.1007/s11999-010-1315-7. PMC 2882012. PMID 20333492.

[3] Peabody, Terrance (2014). Orthopaedic oncology : primary and metastatic tumors of the skeletal system. Cham: Springer. ISBN 9783319073224.

[pmid9229417-4] Brien EW, Mirra JM, Kerr R (1997). "Benign and malignant cartilage tumors of bone and joint: their anatomic and theoretical basis with an emphasis on radiology, pathology and clinical biology. I. The intramedullary cartilage tumors". Skeletal Radiol. 26 (6): 325–53. PMID 9229417.

[pmid498016-5] 5.0 ^5.1 ^5.2 Cuvelier CA, Roels HJ (1979). "Cytophotometric studies of the nuclear DNA content in cartilaginous tumors". Cancer. 44 (4): 1363–74. PMID 498016.

[pmid9648559-6] Halbert AR, Harrison WR, Hicks MJ, Davino N, Cooley LD (1998). "Cytogenetic analysis of a scapular chondromyxoid fibroma". Cancer Genet Cytogenet. 104 (1): 52–6. PMID 9648559.

[pmid12606137-7] Buddingh EP, Naumann S, Nelson M, Neffa JR, Birch N, Bridge JA (2003). "Cytogenetic findings in benign cartilaginous neoplasms". Cancer Genet Cytogenet. 141 (2): 164–8. PMID 12606137.

[pmid24658000-8] Nord KH, Lilljebjörn H, Vezzi F, Nilsson J, Magnusson L, Tayebwa J; et al. (2014). "GRM1 is upregulated through gene fusion and promoter swapping in chondromyxoid fibroma". Nat Genet. 46 (5): 474–7. doi:10.1038/ng.2927. PMID 24658000.

[pmid6337162-9] Gherlinzoni F, Rock M, Picci P (1983). "Chondromyxoid fibroma. The experience at the Istituto Ortopedico Rizzoli". J Bone Joint Surg Am. 65 (2): 198–204. PMID 6337162.

[pmid19846816-10] Bergman S, Madden CR, Geisinger KR (2009). "Fine-needle aspiration biopsy of chondromyxoid fibroma: an investigation of four cases". Am J Clin Pathol. 132 (5): 740–5. doi:10.1309/AJCPFJZ8AKMFUAFP. PMID 19846816.

[pmid26981481-11] Pintor F, Bahamondes C, Campos O, Zivov A (2015). "Chondromyxoid fibroma of zygoma in an elderly patient: A rare presentation". Ann Maxillofac Surg. 5 (2): 244–8. doi:10.4103/2231-0746.175755. PMC 4772571. PMID 26981481.

[pmid11793371-12] Tallini G, Dorfman H, Brys P, Dal Cin P, De Wever I, Fletcher CD; et al. (2002). "Correlation between clinicopathological features and karyotype in 100 cartilaginous and chordoid tumours. A report from the Chromosomes and Morphology (CHAMP) Collaborative Study Group". J Pathol. 196 (2): 194–203. doi:10.1002/path.1023. PMID 11793371.

[pmid15612014-13] Desai SS, Jambhekar NA, Samanthray S, Merchant NH, Puri A, Agarwal M (2005). "Chondromyxoid fibromas: a study of 10 cases". J Surg Oncol. 89 (1): 28–31. doi:10.1002/jso.20113. PMID 15612014.

[pmid9428071-14] Marin C, Gallego C, Manjón P, Martinez-Tello FJ (1997). "Juxtacortical chondromyxoid fibroma: imaging findings in three cases and a review of the literature". Skeletal Radiol. 26 (11): 642–9. PMID 9428071.

[pmid2732329-15] Merine D, Fishman EK, Rosengard A, Tolo V (1989). "Chondromyxoid fibroma of the fibula". J Pediatr Orthop. 9 (4): 468–71. PMID 2732329.

[pmid27226218-16] Cappelle S, Pans S, Sciot R (2016). "Imaging features of chondromyxoid fibroma: report of 15 cases and literature review". Br J Radiol: 20160088. doi:10.1259/bjr.20160088. PMC 5124884. PMID 27226218.

[pmid21835889-17] Kim HS, Jee WH, Ryu KN, Cho KH, Suh JS, Cho JH; et al. (2011). "MRI of chondromyxoid fibroma". Acta Radiol. 52 (8): 875–80. doi:10.1258/ar.2011.110180. PMID 21835889.

[18] Campanacci M. Bone and soft tissue tumours. 2nd edn. Wien, Austria: Springer; 1999. pp. 265–71.

[pmid2793160-19] Zillmer DA, Dorfman HD (1989). "Chondromyxoid fibroma of bone: thirty-six cases with clinicopathologic correlation". Hum Pathol. 20 (10): 952–64. PMID 2793160.

[pmid10653103-20] 20.0 ^20.1 Dürr HR, Lienemann A, Nerlich A, Stumpenhausen B, Refior HJ (2000). "Chondromyxoid fibroma of bone". Arch Orthop Trauma Surg. 120 (1–2): 42–7. PMID 10653103.

[pmid29403178-21] Dey B, Deshpande AH, Brar RK, Ray A (2018). "Chondromyxoid Fibroma of the Metatarsal Bone: A Diagnosis Using Fine Needle Aspiration Biopsy". J Cytol. 35 (1): 67–68. doi:10.4103/JOC.JOC_48_17. PMC 5795736. PMID 29403178.

[pmid9596266-22] Wu CT, Inwards CY, O'Laughlin S, Rock MG, Beabout JW, Unni KK (1998). "Chondromyxoid fibroma of bone: a clinicopathologic review of 278 cases". Hum Pathol. 29 (5): 438–46. PMID 9596266.

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@@ Line 7: / Line 7: @@
 ==Overview==
+Chondromyxoid fibroma is a rare [[benign]] [[Bone tumors|bone tumor]] accounting for approximately 1% of all [[benign]] [[bone tumors]]. Chondromyxoid fibroma affects all age groups. It is more commonly seen during the second and third decades of life. [[Male|Men]] are more commonly affected than [[Female|women]]. Chondromyxoid fibroma arising from the [[Growth plate|physeal]] remnant is the commonly proposed theory in the [[pathogenesis]] of this [[tumor]]. It is predominantly found in the [[Metaphysis|metaphyses]] of the [[Long bone|long bones]]. The [[Bone|bones]] involved include [[tibia]], [[distal]] [[femur]], [[pelvis]], [[feet]] and [[hands]]. [[Chromosome 6]] appears to be involved in chondromyxoid fibroma. Over expression of the [[Glutamic acid|glutamate]] [[Receptor (biochemistry)|receptor]] [[gene]] GRM1 in [[Patient|patients]] with chondromyxoid fibroma via [[promoter]] swapping and [[Fusion gene|gene fusion]] has been observed. The [[hallmark]] of chondromyxoid fibroma is [[pain]], [[Edema|swelling]], and [[Bone fracture|pathological fracture]]. The mainstay of treatment for chondromyxoid fibroma is [[surgery]] ([[curettage]] and [[bone grafting]]).
 ==Historical Perspective==
@@ Line 12: / Line 13: @@
 ==Classification==
-Chondromyxoid fibromacan be classified based on imaging findings.
+Chondromyxoid fibroma can be [[Classification|classified]] based on [[imaging]] findings.
 ===Enneking (MSTS) Staging System===
-*The Enneking surgical staging system (also known as the MSTS system) for benign [[Musculoskeletal system|musculoskeletal]] [[Tumor|tumors]] based on [[radiographic]] characteristics of the tumor host margin.<ref name="pmid20333492">{{cite journal| author=Jawad MU, Scully SP| title=In brief: classifications in brief: enneking classification: benign and malignant tumors of the musculoskeletal system. | journal=Clin Orthop Relat Res | year= 2010 | volume= 468 | issue= 7 | pages= 2000-2 | pmid=20333492 | doi=10.1007/s11999-010-1315-7 | pmc=2882012 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20333492  }} </ref>
+*The Enneking [[Surgery|surgical]] [[Cancer staging|staging]] system (also known as the MSTS system) for [[benign]] [[Musculoskeletal system|musculoskeletal]] [[Tumor|tumors]] is based on [[radiographic]] characteristics of the [[tumor]] host margin.<ref name="pmid20333492">{{cite journal| author=Jawad MU, Scully SP| title=In brief: classifications in brief: enneking classification: benign and malignant tumors of the musculoskeletal system. | journal=Clin Orthop Relat Res | year= 2010 | volume= 468 | issue= 7 | pages= 2000-2 | pmid=20333492 | doi=10.1007/s11999-010-1315-7 | pmc=2882012 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20333492  }} </ref>
-*It is widely accepted and routinely used classification.
+*It is widely accepted and routinely used [[classification]].
 {| style="border: 0px; font-size: 90%; margin: 3px; width: 1000px" align="center"
@@ Line 36: / Line 35: @@
 ==Pathophysiology==
-*The exact etiology of chondromyxoid fibroma is unknown.<ref>{{cite book | last = Peabody | first = Terrance | title = Orthopaedic oncology : primary and metastatic tumors of the skeletal system | publisher = Springer | location = Cham | year = 2014 | isbn = 9783319073224 }}</ref>
+*The exact [[etiology]] of chondromyxoid fibroma is unknown.<ref>{{cite book | last = Peabody | first = Terrance | title = Orthopaedic oncology : primary and metastatic tumors of the skeletal system | publisher = Springer | location = Cham | year = 2014 | isbn = 9783319073224 }}</ref>
-*Chondromyxoid fibroma arises from the physeal remanant is the commonly proposed theory concerning the pathogenesis of chondromyxoid fibroma.<ref name="pmid9229417">{{cite journal| author=Brien EW, Mirra JM, Kerr R| title=Benign and malignant cartilage tumors of bone and joint: their anatomic and theoretical basis with an emphasis on radiology, pathology and clinical biology. I. The intramedullary cartilage tumors. | journal=Skeletal Radiol | year= 1997 | volume= 26 | issue= 6 | pages= 325-53 | pmid=9229417 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9229417  }} </ref>
+*Chondromyxoid fibroma arising from the [[Growth plate|physeal]] remnant is the commonly proposed theory in the [[pathogenesis]] of chondromyxoid fibroma.<ref name="pmid9229417">{{cite journal| author=Brien EW, Mirra JM, Kerr R| title=Benign and malignant cartilage tumors of bone and joint: their anatomic and theoretical basis with an emphasis on radiology, pathology and clinical biology. I. The intramedullary cartilage tumors. | journal=Skeletal Radiol | year= 1997 | volume= 26 | issue= 6 | pages= 325-53 | pmid=9229417 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9229417  }} </ref>
-*It is predominantly found in the metaphyses of the long bones.<ref name="pmid498016">{{cite journal| author=Cuvelier CA, Roels HJ| title=Cytophotometric studies of the nuclear DNA content in cartilaginous tumors. | journal=Cancer | year= 1979 | volume= 44 | issue= 4 | pages= 1363-74 | pmid=498016 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=498016  }} </ref>
+*It is predominantly found in the [[Metaphysis|metaphyses]] of the [[Long bone|long bones]].<ref name="pmid498016">{{cite journal| author=Cuvelier CA, Roels HJ| title=Cytophotometric studies of the nuclear DNA content in cartilaginous tumors. | journal=Cancer | year= 1979 | volume= 44 | issue= 4 | pages= 1363-74 | pmid=498016 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=498016  }} </ref>
-*The bones involved by chondromyxoid fibroma includes tibia, distal femur, pelvis, feet and hands.<ref name="pmid9648559">{{cite journal| author=Halbert AR, Harrison WR, Hicks MJ, Davino N, Cooley LD| title=Cytogenetic analysis of a scapular chondromyxoid fibroma. | journal=Cancer Genet Cytogenet | year= 1998 | volume= 104 | issue= 1 | pages= 52-6 | pmid=9648559 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9648559  }} </ref>
+*The bones involved by chondromyxoid fibroma includes [[tibia]], [[Anatomical terms of location|distal]] [[femur]], [[pelvis]], [[feet]] and [[Hand|hands]].<ref name="pmid9648559">{{cite journal| author=Halbert AR, Harrison WR, Hicks MJ, Davino N, Cooley LD| title=Cytogenetic analysis of a scapular chondromyxoid fibroma. | journal=Cancer Genet Cytogenet | year= 1998 | volume= 104 | issue= 1 | pages= 52-6 | pmid=9648559 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9648559  }} </ref>
 ===Genetics===
-*Chromosome 6 appears to be involved with chondromyxoid fibroma.<ref name="pmid498016" /><ref name="pmid12606137">{{cite journal| author=Buddingh EP, Naumann S, Nelson M, Neffa JR, Birch N, Bridge JA| title=Cytogenetic findings in benign cartilaginous neoplasms. | journal=Cancer Genet Cytogenet | year= 2003 | volume= 141 | issue= 2 | pages= 164-8 | pmid=12606137 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12606137  }} </ref>
+*[[Chromosome 6]] appears to be involved in chondromyxoid fibroma.<ref name="pmid498016" /><ref name="pmid12606137">{{cite journal| author=Buddingh EP, Naumann S, Nelson M, Neffa JR, Birch N, Bridge JA| title=Cytogenetic findings in benign cartilaginous neoplasms. | journal=Cancer Genet Cytogenet | year= 2003 | volume= 141 | issue= 2 | pages= 164-8 | pmid=12606137 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12606137  }} </ref>
 *The non-random clonal abnormalities involves 6p25, 6q13 and 6q23.<ref name="pmid498016">{{cite journal| author=Cuvelier CA, Roels HJ| title=Cytophotometric studies of the nuclear DNA content in cartilaginous tumors. | journal=Cancer | year= 1979 | volume= 44 | issue= 4 | pages= 1363-74 | pmid=498016 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=498016  }} </ref>
-*whole-genome mate-pair sequencing and RNA sequencing showed over expression of the glutamate receptor gene GRM1 in patients with chondromyxoid fibroma  via promoter swapping and gene fusion.<ref name="pmid24658000">{{cite journal| author=Nord KH, Lilljebjörn H, Vezzi F, Nilsson J, Magnusson L, Tayebwa J et al.| title=GRM1 is upregulated through gene fusion and promoter swapping in chondromyxoid fibroma. | journal=Nat Genet | year= 2014 | volume= 46 | issue= 5 | pages= 474-7 | pmid=24658000 | doi=10.1038/ng.2927 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24658000  }} </ref>
+*[[Shotgun sequencing|Whole-genome mate-pair sequencing]] and [[RNA]] sequencing showed over expression of the [[glutamate receptor]] [[gene]] GRM1 in [[Patient|patients]] with chondromyxoid fibroma via [[promoter]] swapping and [[Fusion gene|gene fusion]].<ref name="pmid24658000">{{cite journal| author=Nord KH, Lilljebjörn H, Vezzi F, Nilsson J, Magnusson L, Tayebwa J et al.| title=GRM1 is upregulated through gene fusion and promoter swapping in chondromyxoid fibroma. | journal=Nat Genet | year= 2014 | volume= 46 | issue= 5 | pages= 474-7 | pmid=24658000 | doi=10.1038/ng.2927 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24658000  }} </ref>
 ==Causes==
-There are no established causes for chondromyxoid fibroma.<ref name="pmid6337162">{{cite journal| author=Gherlinzoni F, Rock M, Picci P| title=Chondromyxoid fibroma. The experience at the Istituto Ortopedico Rizzoli. | journal=J Bone Joint Surg Am | year= 1983 | volume= 65 | issue= 2 | pages= 198-204 | pmid=6337162 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6337162  }} </ref>
+There are no established causes of chondromyxoid fibroma.<ref name="pmid6337162">{{cite journal| author=Gherlinzoni F, Rock M, Picci P| title=Chondromyxoid fibroma. The experience at the Istituto Ortopedico Rizzoli. | journal=J Bone Joint Surg Am | year= 1983 | volume= 65 | issue= 2 | pages= 198-204 | pmid=6337162 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6337162  }} </ref>
 ==Differentiating Chondromyxoid Fibroma from Other Diseases==
-Aneurysmal bone cyst must be differentiated from following bone disorders:
+Chondromyxoid fibroma must be differentiated from the following [[bone]] disorders:<ref name="pmid19846816">{{cite journal| author=Bergman S, Madden CR, Geisinger KR| title=Fine-needle aspiration biopsy of chondromyxoid fibroma: an investigation of four cases. | journal=Am J Clin Pathol | year= 2009 | volume= 132 | issue= 5 | pages= 740-5 | pmid=19846816 | doi=10.1309/AJCPFJZ8AKMFUAFP | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19846816  }} </ref>
 {|
 ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Disease
@@ Line 64: / Line 63: @@
 | align="center" style="background:#F5F5F5;" + | +
 |-
-! align="center" style="background:#DCDCDC;" + |Unicameral bone cyst
+! align="center" style="background:#DCDCDC;" + |[[Unicameral bone cyst]]
 | align="center" style="background:#F5F5F5;" + | +
 | align="center" style="background:#F5F5F5;" + | -
@@ Line 70: / Line 69: @@
 | align="center" style="background:#F5F5F5;" + | -
 |-
-! align="center" style="background:#DCDCDC;" + |Non ossifying fibroma
+! align="center" style="background:#DCDCDC;" + |[[Non ossifying fibroma]]
 | align="center" style="background:#F5F5F5;" + | +
 | align="center" style="background:#F5F5F5;" + | -
@@ Line 76: / Line 75: @@
 | align="center" style="background:#F5F5F5;" + | -
 |-
-! align="center" style="background:#DCDCDC;" + |Giant cell tumor
+! align="center" style="background:#DCDCDC;" + |[[Giant cell tumor of bone|Giant cell tumor]]
 | align="center" style="background:#F5F5F5;" + | -
 | align="center" style="background:#F5F5F5;" + | -
@@ Line 82: / Line 81: @@
 | align="center" style="background:#F5F5F5;" + | +
 |-
-! align="center" style="background:#DCDCDC;" + |Chondroblastoma
+! align="center" style="background:#DCDCDC;" + |[[Chondroblastoma]]
 | align="center" style="background:#F5F5F5;" + | -
 | align="center" style="background:#F5F5F5;" + | -
@@ Line 88: / Line 87: @@
 | align="center" style="background:#F5F5F5;" + | +
 |-
-! align="center" style="background:#DCDCDC;" + |Aneurysmal bone cyst
+! align="center" style="background:#DCDCDC;" + |[[Aneurysmal bone cyst]]
 | align="center" style="background:#F5F5F5;" + | +
 | align="center" style="background:#F5F5F5;" + | +
@@ Line 94: / Line 93: @@
 | align="center" style="background:#F5F5F5;" + | +
 |-
-! align="center" style="background:#DCDCDC;" + |Osteoblastoma
+! align="center" style="background:#DCDCDC;" + |[[Osteoblastoma]]
 | align="center" style="background:#F5F5F5;" + | -
 | align="center" style="background:#F5F5F5;" + | -
@@ Line 100: / Line 99: @@
 | align="center" style="background:#F5F5F5;" + | +
 |-
-! align="center" style="background:#DCDCDC;" + |Telangiectatic osteosarcoma
+! align="center" style="background:#DCDCDC;" + |Telangiectatic [[osteosarcoma]]
 | align="center" style="background:#F5F5F5;" + | -
 | align="center" style="background:#F5F5F5;" + | +
@@ Line 108: / Line 107: @@
 ==Epidemiology and Demographics==
-The incidence/prevalence of [disease name] is approximately [number range] per 100,000 individuals worldwide.
+*Chondromyxoid fibroma is a rare [[benign]] [[Bone tumors|bone tumor]] accounting for approximately 1% of all [[benign]] [[bone tumors]].<ref name="pmid26981481">{{cite journal| author=Pintor F, Bahamondes C, Campos O, Zivov A| title=Chondromyxoid fibroma of zygoma in an elderly patient: A rare presentation. | journal=Ann Maxillofac Surg | year= 2015 | volume= 5 | issue= 2 | pages= 244-8 | pmid=26981481 | doi=10.4103/2231-0746.175755 | pmc=4772571 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26981481  }} </ref>
+*Chondromyxoid fibroma affects all age groups.
-OR
+*It is more commonly seen during the second and third decades of life.
+*[[Male|Men]] are more commonly affected than [[Female|women]].
-In [year], the incidence/prevalence of [disease name] was estimated to be [number range] cases per 100,000 individuals worldwide.
+*There is no racial predilection to chondromyxoid fibroma.
-OR
-In [year], the incidence of [disease name] is approximately [number range] per 100,000 individuals with a case-fatality rate of [number range]%.
-Patients of all age groups may develop [disease name].
-OR
-The incidence of [disease name] increases with age; the median age at diagnosis is [#] years.
-OR
-[Disease name] commonly affects individuals younger than/older than [number of years] years of age.
-OR
-[Chronic disease name] is usually first diagnosed among [age group].
-OR
-[Acute disease name] commonly affects [age group].
-There is no racial predilection to [disease name].
-OR
-[Disease name] usually affects individuals of the [race 1] race. [Race 2] individuals are less likely to develop [disease name].
-[Disease name] affects men and women equally.
-OR
-[Gender 1] are more commonly affected by [disease name] than [gender 2]. The [gender 1] to [gender 2] ratio is approximately [number > 1] to 1.
-The majority of [disease name] cases are reported in [geographical region].
-OR
-[Disease name] is a common/rare disease that tends to affect [patient population 1] and [patient population 2].
 ==Risk Factors==
-There are no established risk factors for [disease name].
+There are no established [[Risk factor|risk factors]] for chondromyxoid fibroma.
-OR
-The most potent risk factor in the development of [disease name] is [risk factor 1]. Other risk factors include [risk factor 2], [risk factor 3], and [risk factor 4].
-OR
-Common risk factors in the development of [disease name] include [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].
-OR
-Common risk factors in the development of [disease name] may be occupational, environmental, genetic, and viral.
 ==Screening==
-There is insufficient evidence to recommend routine screening for [disease/malignancy].
+There is insufficient evidence to recommend routine [[Screening (medicine)|screening]] for chondromyxoid fibroma.
-OR
-According to the [guideline name], screening for [disease name] is not recommended.
-OR
-According to the [guideline name], screening for [disease name] by [test 1] is recommended every [duration] among patients with [condition 1], [condition 2], and [condition 3].
 ==Natural History, Complications, and Prognosis==
-If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
+Common [[Complication (medicine)|complications]] of chondromyxoid fibroma include:
+*[[Bone fracture|Pathological fracture]]
-OR
+*[[Premature]] [[Epiphyseal plate|epiphyseal]] closure
+*Limb-length discrepancy
-Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
+*Angular deformity
+[[Prognosis]] is generally good for chondromyxoid fibroma.
-OR
+*[[Prognostic]] variables include:
+**[[Children]]
-Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
+**When the [[Tumor]] is more lobulated with abundant myxoid material
 ==Diagnosis==
+{| align="right"
+|
+[[File:CMF HISTO.jpg|300px|thumb|Histology of chondromyxoid fibroma showing stellate cells in a myxoid stroma..[https://upload.wikimedia.org/wikipedia/commons/0/05/Bone_ChondromyxoidFibroma_MP3_CTR.jpg Source: Case courtesy of Sarahkayb [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0)], from Wikimedia Commons]]]
+|}
 ===Diagnostic Study of Choice===
-The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
+*[[Biopsy]] is the [[diagnostic study of choice]] for chondromyxoid fibroma.
+*[[Biopsy]] findings under low and high power fields are given below:<ref name="pmid11793371">{{cite journal| author=Tallini G, Dorfman H, Brys P, Dal Cin P, De Wever I, Fletcher CD et al.| title=Correlation between clinicopathological features and karyotype in 100 cartilaginous and chordoid tumours. A report from the Chromosomes and Morphology (CHAMP) Collaborative Study Group. | journal=J Pathol | year= 2002 | volume= 196 | issue= 2 | pages= 194-203 | pmid=11793371 | doi=10.1002/path.1023 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11793371  }} </ref><ref name="pmid15612014">{{cite journal| author=Desai SS, Jambhekar NA, Samanthray S, Merchant NH, Puri A, Agarwal M| title=Chondromyxoid fibromas: a study of 10 cases. | journal=J Surg Oncol | year= 2005 | volume= 89 | issue= 1 | pages= 28-31 | pmid=15612014 | doi=10.1002/jso.20113 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15612014  }} </ref>
-OR
+====== Under Low Power field: ======
+*It has a biphasic appearance
+*It has [[lobules]] and pseudolobules of fibromyxoid [[Tissue (biology)|tissue]] with hypercellular area.
+*The [[Cell (biology)|cells]] are [[spindle]]-shaped or [[Stellate cell|stellate]]-shaped and contain [[Hyperchromicity|hyperchromatic]] [[Cell nucleus|nuclei]].
+*[[Multinucleate|Multinucleated]] [[giant cells]] and fibrovascular [[Tissue (biology)|tissue]] may be present between the [[lobules]].
+*Hypocellular area with chondroid material is seen.
-The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
+====== Under High Power Field: ======
+*The [[tumor]] shows [[Stroma|myxoid stroma]] mixed with [[Stellate cell|stellate cells]].
-OR
+*In addition, an area of [[Pleomorphism|pleiomorphic]] [[Cell (biology)|cells]] with bizarre [[Cell nucleus|nuclei]] may be seen.
-The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
-OR
-There are no established criteria for the diagnosis of [disease name].
 ===History and Symptoms===
-The majority of patients with [disease name] are asymptomatic.
+*The majority of [[Patient|patients]] with chondromyxoid fibroma have a positive history of:
+**[[Pain]]
-OR
+**[[Swelling]]
+**[[Stiffness]]
-The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3]. Common symptoms of [disease] include [symptom 1], [symptom 2], and [symptom 3]. Less common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
+**[[Bone fracture|Pathological fracture]]
+{| align="right"
+|
+[[File:XRAY CMF.gif|300px|thumb|X-ray of ulna showing chondromyxoid fibroma.[https://radiopaedia.org/cases/chondromyxoid-fibroma-ulna?lang=us Source: Case courtesy of A.Prof Frank Gaillard, Radiopaedia.org, rID: 6172]]]
+|}
 ===Physical Examination===
-Patients with [disease name] usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].
+Common [[physical examination]] findings of chondromyxoid fibroma include:
+* [[Deformity]]
-OR
-Common physical examination findings of [disease name] include [finding 1], [finding 2], and [finding 3].
-OR
-The presence of [finding(s)] on physical examination is diagnostic of [disease name].
-OR
-The presence of [finding(s)] on physical examination is highly suggestive of [disease name].
+*[[Swelling]]
+*Decreased [[range of motion]]
+*[[Warmth receptors|Warmth]] over the affected area
 ===Laboratory Findings===
-An elevated/reduced concentration of serum/blood/urinary/CSF/other [lab test] is diagnostic of [disease name].
+There are no [[Diagnosis|diagnostic]] [[Medical laboratory|laboratory]] findings associated with chondromyxoid fibroma.
-OR
-Laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].
-OR
-[Test] is usually normal among patients with [disease name].
-OR
-Some patients with [disease name] may have elevated/reduced concentration of [test], which is usually suggestive of [progression/complication].
-OR
-There are no diagnostic laboratory findings associated with [disease name].
 ===Electrocardiogram===
-There are no ECG findings associated with [disease name].
+There are no [[The electrocardiogram|ECG]] findings associated with chondromyxoid fibroma.
-OR
-An ECG may be helpful in the diagnosis of [disease name]. Findings on an ECG suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
 ===X-ray===
-There are no x-ray findings associated with [disease name].
+[[X-rays|X-ray]] findings include:<ref name="pmid9428071">{{cite journal| author=Marin C, Gallego C, Manjón P, Martinez-Tello FJ| title=Juxtacortical chondromyxoid fibroma: imaging findings in three cases and a review of the literature. | journal=Skeletal Radiol | year= 1997 | volume= 26 | issue= 11 | pages= 642-9 | pmid=9428071 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9428071  }} </ref><ref name="pmid2732329">{{cite journal| author=Merine D, Fishman EK, Rosengard A, Tolo V| title=Chondromyxoid fibroma of the fibula. | journal=J Pediatr Orthop | year= 1989 | volume= 9 | issue= 4 | pages= 468-71 | pmid=2732329 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2732329  }} </ref>
+* The [[tumor]] appears as a [[lytic]], eccentric [[Metaphyseal|metaphyse]]<nowiki/>[[Metaphyseal|a]]<nowiki/>l [[lesion]].
-OR
+*Size of the [[lesion]] may vary from 2 to 10 cm.
+*It has a sharply demarcated border from the adjacent [[bone]].
-An x-ray may be helpful in the diagnosis of [disease name]. Findings on an x-ray suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
+{| align="right"
+|
-OR
+[[File:CT CMF.gif|thumb|CT of proximal ulna showing chondromyxoid fibroma.[https://radiopaedia.org/cases/chondromyxoid-fibroma-ulna?lang=us Source: Case courtesy of A.Prof Frank Gaillard, Radiopaedia.org, rID: 6172]]]
+|}
-There are no x-ray findings associated with [disease name]. However, an x-ray may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
+*It may show scalloped and [[Sclerosis|sclerotic]] rim
+*[[Calcification]] is usually not seen
+*The [[tumor]] may show [[Cortical bone|cortical expansion.]]
 ===Echocardiography or Ultrasound===
-There are no echocardiography/ultrasound  findings associated with [disease name].
+There are no [[echocardiography]]/[[ultrasound]]  findings associated with chondromyxoid fibroma.
-OR
-Echocardiography/ultrasound  may be helpful in the diagnosis of [disease name]. Findings on an echocardiography/ultrasound suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
-OR
-There are no echocardiography/ultrasound  findings associated with [disease name]. However, an echocardiography/ultrasound  may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
 ===CT scan===
-There are no CT scan findings associated with [disease name].
+*[[Computed tomography|CT scan]] confirms the [[X-rays|x-ray]] findings.<ref name="pmid27226218">{{cite journal| author=Cappelle S, Pans S, Sciot R| title=Imaging features of chondromyxoid fibroma: report of 15 cases and literature review. | journal=Br J Radiol | year= 2016 | volume=  | issue=  | pages= 20160088 | pmid=27226218 | doi=10.1259/bjr.20160088 | pmc=5124884 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27226218  }} </ref>
+*It is superior to [[X-rays|x-ray]] for analyzing the expansion of the [[lesion]] and [[Cortical bone|cortical]] breach.
-OR
-[Location] CT scan may be helpful in the diagnosis of [disease name]. Findings on CT scan suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
-OR
-There are no CT scan findings associated with [disease name]. However, a CT scan may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
 ===MRI===
-There are no MRI findings associated with [disease name].
+[[MRI]] findings of chondromyxoid fibroma include:<ref name="pmid21835889">{{cite journal| author=Kim HS, Jee WH, Ryu KN, Cho KH, Suh JS, Cho JH et al.| title=MRI of chondromyxoid fibroma. | journal=Acta Radiol | year= 2011 | volume= 52 | issue= 8 | pages= 875-80 | pmid=21835889 | doi=10.1258/ar.2011.110180 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21835889  }} </ref><ref>Campanacci M. Bone and soft tissue tumours. 2nd edn. Wien, Austria: Springer; 1999. pp. 265–71.</ref>
+{| align="right"
-OR
+|
+[[File:MRI CMF.gif|thumb|MRI of proximal ulna showing chondromyxoid fibroma.[https://radiopaedia.org/cases/chondromyxoid-fibroma-ulna?lang=us Source: Case courtesy of A.Prof Frank Gaillard, Radiopaedia.org, rID: 6172]]]
+|}
-[Location] MRI may be helpful in the diagnosis of [disease name]. Findings on MRI suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
+*T1 image: Chondroid and myxoid [[Tissue (biology)|tissues]] produce low signals.
+*T2 image: Chondroid and myxoid [[tissues]] produce high signals.
-OR
-There are no MRI findings associated with [disease name]. However, a MRI may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
 ===Other Imaging Findings===
-There are no other imaging findings associated with [disease name].
-OR
-[Imaging modality] may be helpful in the diagnosis of [disease name]. Findings on an [imaging modality] suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
+===Bone Scan===
+*Increased uptake is seen in chondromyxoid fibroma.
 ===Other Diagnostic Studies===
-There are no other diagnostic studies associated with [disease name].
+There are no other [[Diagnosis|diagnostic]] studies associated with chondromyxoid fibroma.
-OR
-[Diagnostic study] may be helpful in the diagnosis of [disease name]. Findings suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
-OR
-Other diagnostic studies for [disease name] include [diagnostic study 1], which demonstrates [finding 1], [finding 2], and [finding 3], and [diagnostic study 2], which demonstrates [finding 1], [finding 2], and [finding 3].
 ==Treatment==
 ===Medical Therapy===
-There is no treatment for [disease name]; the mainstay of therapy is supportive care.
+There is no treatment for chondromyxoid fibroma; the mainstay of therapy is [[surgery]].
-OR
-Supportive therapy for [disease name] includes [therapy 1], [therapy 2], and [therapy 3].
-OR
-The majority of cases of [disease name] are self-limited and require only supportive care.
-OR
-[Disease name] is a medical emergency and requires prompt treatment.
-OR
-The mainstay of treatment for [disease name] is [therapy].
-OR
-The optimal therapy for [malignancy name] depends on the stage at diagnosis.
-OR
-[Therapy] is recommended among all patients who develop [disease name].
-OR
-Pharmacologic medical therapy is recommended among patients with [disease subclass 1], [disease subclass 2], and [disease subclass 3].
-OR
-Pharmacologic medical therapies for [disease name] include (either) [therapy 1], [therapy 2], and/or [therapy 3].
-OR
-Empiric therapy for [disease name] depends on [disease factor 1] and [disease factor 2].
-OR
-Patients with [disease subclass 1] are treated with [therapy 1], whereas patients with [disease subclass 2] are treated with [therapy 2].
 ===Surgery===
-Surgical intervention is not recommended for the management of [disease name].
+[[Surgery]] is the mainstay of treatment for chondromyxoid fibroma.<ref name="pmid2793160">{{cite journal| author=Zillmer DA, Dorfman HD| title=Chondromyxoid fibroma of bone: thirty-six cases with clinicopathologic correlation. | journal=Hum Pathol | year= 1989 | volume= 20 | issue= 10 | pages= 952-64 | pmid=2793160 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2793160  }} </ref><ref name="pmid10653103">{{cite journal| author=Dürr HR, Lienemann A, Nerlich A, Stumpenhausen B, Refior HJ| title=Chondromyxoid fibroma of bone. | journal=Arch Orthop Trauma Surg | year= 2000 | volume= 120 | issue= 1-2 | pages= 42-7 | pmid=10653103 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10653103  }} </ref>
-OR
-Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either [indication 1], [indication 2], and [indication 3]
-OR
-The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either [indication 1], [indication 2], and/or [indication 3].
-OR
-The feasibility of surgery depends on the stage of [malignancy] at diagnosis.
+'''Types'''
-OR
+'''1. Intralesional Curettage'''
+*It is the mainstay of treatment for chondromyxoid fibroma.<ref name="pmid10653103">{{cite journal| author=Dürr HR, Lienemann A, Nerlich A, Stumpenhausen B, Refior HJ| title=Chondromyxoid fibroma of bone. | journal=Arch Orthop Trauma Surg | year= 2000 | volume= 120 | issue= 1-2 | pages= 42-7 | pmid=10653103 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10653103  }} </ref>
+*The defect is filled with [[bone graft]] or [[bone cement]] in form of polymethlymethacrylate(PMMA).
+'''2. En Bloc Excision'''
+*It usually reserved for recurrent cases.<ref name="pmid29403178">{{cite journal| author=Dey B, Deshpande AH, Brar RK, Ray A| title=Chondromyxoid Fibroma of the Metatarsal Bone: A Diagnosis Using Fine Needle Aspiration Biopsy. | journal=J Cytol | year= 2018 | volume= 35 | issue= 1 | pages= 67-68 | pmid=29403178 | doi=10.4103/JOC.JOC_48_17 | pmc=5795736 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29403178  }} </ref>
-Surgery is the mainstay of treatment for [disease or malignancy].
+'''Recurrence Rate'''
+*The recurrence rate is about 25% for chondromyxoid fibroma.<ref name="pmid9596266">{{cite journal| author=Wu CT, Inwards CY, O'Laughlin S, Rock MG, Beabout JW, Unni KK| title=Chondromyxoid fibroma of bone: a clinicopathologic review of 278 cases. | journal=Hum Pathol | year= 1998 | volume= 29 | issue= 5 | pages= 438-46 | pmid=9596266 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9596266  }} </ref>
 ===Primary Prevention===
-There are no established measures for the primary prevention of [disease name].
+There are no established measures for the [[Prevention (medical)|primary prevention]] of chondromyxoid fibroma.
-OR
-There are no available vaccines against [disease name].
-OR
-Effective measures for the primary prevention of [disease name] include [measure1], [measure2], and [measure3].
-OR
-[Vaccine name] vaccine is recommended for [patient population] to prevent [disease name]. Other primary prevention strategies include [strategy 1], [strategy 2], and [strategy 3].
 ===Secondary Prevention===
-There are no established measures for the secondary prevention of [disease name].
+There are no established measures for the [[Prevention (medical)|secondary prevention]] of chondromyxoid fibroma.
-OR
-Effective measures for the secondary prevention of [disease name] include [strategy 1], [strategy 2], and [strategy 3].
 ==References==