J Pathol Transl Med.  2021 Jan;55(1):75-78. 10.4132/jptm.2020.10.08.

Fibrocartilaginous mesenchymoma with an unusual location in the rib

• Oh SJ

• KMID: 2511516
• DOI: http://doi.org/10.4132/jptm.2020.10.08

Abstract

Fibrocartilaginous mesenchymoma is a rare bone tumor, with fewer than 35 cases reported in the literature since 1984. This tumor usually occurs in the long bones of children and adolescents. In the current case, the tumor affected a rib. A 17-year-old boy presented with a mass in the right fifth rib. Radiologic findings revealed an osteolytic mass with cortical destruction and calcification; en bloc resection was performed. The tumor showed three distinct histologic features: bland spindle cell proliferation, benign cartilage nodules, and epiphyseal plate-like enchondral ossification. The pathologic diagnosis was fibrocartilaginous mesenchymoma. The patient remains free of disease 1 year after the surgery. Pathological diagnosis of fibrocartilaginous mesenchymoma can be challenging, especially when the tumor occurs in an unusual site. When any fibro-osseous lesion with a cartilaginous component is encountered, the possibility of fibrocartilaginous mesenchymoma should be considered because of its locally aggressive behavior.

Keyword

Fibrocartilaginous mesenchymoma; Fibrocartilaginous dysplasia; Enchondral ossification

Figure

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  Fig. 1 Computed tomography shows an osteolytic lesion (arrow) with calcification and juxtacortical extension at the posterolateral side of the right 5th rib.

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  Fig. 2 Histologic findings. (A) Gross examination reveals an ill-defined, eccentrically-located, hard mass with multifocal glistening bluish grey nodules corresponding to cartilage tissue. The cortex had been partially destroyed. (B) The tumor consists of multiple cartilage islands with a fibrocollagenous area (asterisk) and well-formed new bone trabeculae (arrows). (C) Epiphyseal plate-like enchondral ossification is observed at the periphery of the cytologically bland cartilage nodules. (D) A hypocellular fibrocollagenous lesion consisting of spindle and stellate cells without nuclear pleomorphism or mitosis is noted. Reactive woven bone formation with osteoblastic rimming is observed.

Reference

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