What is a non-ossifying fibroma ?
A non-ossifying fibroma, also known as a cortical fibrous lesion, is a benign tumor that affects the bones. This benign lesion is usually made up of fibrous tissue and is often diagnosed in children and adolescents, although adults can also be affected.
What are the causes ?
The exact causes of non-ossifying fibroids are still unknown, but certain factors are thought to play a role in the development of these benign bone tumors. Researchers believe that non-ossifying fibroids may be caused by a disruption in the normal regulation of bone growth and function.
Studies have shown that non-ossifying fibroids have a slightly more frequent predisposition to develop in growing children and adolescents, suggesting that growth hormone and calcium levels may play a role in their appearance.
Some theories also suggest that trauma and injury to the bones may contribute to the formation of non-ossifying fibroids, although this has not been conclusively proven.
What are the symptoms ?
Non-ossifying fibroids may sometimes have no symptoms. However, when symptoms do occur, they can vary depending on the size and location of the tumor. Here are some common symptoms associated with non-ossifying fibroids:
Bone pain: Patients with non-ossifying fibroids may experience bone pain in the affected area, which may be intermittent or constant.
Swelling: Swelling (swelling) may appear in the affected area where the non-ossifying fibroid is located. This can happen if the fibroid is located under the periosteum, the thin membrane that covers the bones.
Alterations in function: Non-ossifying fibroids can cause impaired function or limitation of movement in the area affected.
Bone fractures: If non-ossifying fibroma progresses or develops to an advanced stage, it can weaken the bone and increase the risk of fractures.
Lame Gait: Lame gait may occur in patients with non-ossifying fibroids located near the joints, due to pain or impaired function.
Nausea, vomiting, or loss of appetite: these symptoms are not exclusive to non-ossifying fibroids but can occur if the tumor becomes very large or spreads into delicate areas of bone.
How to diagnose ?
Diagnosis of non-ossifying fibroids usually involves a series of examinations and tests to confirm the presence of the tumor and assess its size and location. The following tests can be used to diagnose a non-ossifying fibroid:
X-rays: X-rays are often the first test done to diagnose a non-ossifying fibroma. X-rays show the lesion and help determine its size and location.
MRI (Magnetic Resonance Imaging): MRI uses a magnetic field and radio waves to create a detailed image soft tissues and bones. MRI is useful for evaluating the tumor and determining if it is active or has resolved.
Scanner: The scanner can be used to assess the tumor and determine its state of activity.
Bone biopsy: If the lesion is suspected of being cancerous, a bone biopsy may be recommended to take a sample of tissue for laboratory analysis.
What are the treatment options ?
Non-ossifying fibroids are usually benign tumors that do not require surgery or active treatment. However, treatment options may be offered depending on the size and location of the lesion or if the pain is severe.
Monitoring: Regular monitoring is recommended for asymptomatic non-ossifying fibroids to monitor changes in size and thickness. tumor condition.
Analgesics: Analgesics may be prescribed to control mild pain associated with the tumour.
Conservative treatment: Radiation therapy may be used to reduce tumor size and relieve pain, particularly if the lesion is very painful, to relieve pain.
Surgery: In cases where the tumor has progressed and is very symptomatic, surgery may be required. The surgery aims to remove the tumor and prevent complications such as a fracture. However, surgery can lead to complications such as bone fractures, infections, or impaired function.
How is the surgery performed ?
Surgery may be a treatment option for patients with non-ossifying fibroids, particularly if the tumor is very symptomatic or has progressed. Here is how surgery for non-ossifying fibroids is usually performed:
Anesthesia: The patient will be anesthetized, either locally or generally, prior to surgery.
Incision: The surgeon will make an incision in the skin to access the tumor.
Tumor Removal: The surgeon will remove the tumor depending on its location and size. In some cases, part of the bone may also be removed to ensure complete tumor removal.
Bone Repair: If part of the bone is removed, the surgeon will make repairs to restore the bone function and avoid complications such as fractures.
Closure: The surgeon will close the incision with sutures or staples.
Post-operative follow-up: Patients should undergo follow-up consultations to monitor their recovery and rehabilitation.
What is the recovery period ?
The recovery period after surgery for non-ossifying fibroids can vary with each patient and many factors such as the size of the tumor, its location, and the extent of the surgery.
Immediately after the surgery, the patient will be monitored for several hours to ensure that their vital signs are stable. If necessary, he can be hospitalized for a few days.
Recovery time will depend on the bone affected and the extent of the surgery. In cases of minor surgery, the patient can return to normal activity within weeks of surgery. However, full recovery can take up to 6 months in more complex cases.
During the recovery period, the patient may experience pain, discomfort, stiffness and limitation of movement. There may also be swelling and blueness around the operated area. The surgeon may recommend painkillers and other medications to help relieve pain and symptoms.
Rehabilitation and physiotherapy may be recommended to help restore function and strength to the operated bone. Patients should follow the doctor's instructions for post-operative care to help reduce the risk of complications and recurrence.
What are the advantages ?
Surgery for non-ossifying fibroids can offer significant benefits for patients with symptomatic or progressive tumor. Here are some of the advantages of surgery for non-ossifying fibroids:
Tumor removal: Surgery completely removes the tumor, which helps reduce the risk of complications and recurrence.
Pain relief: Surgery can also relieve pain associated with the tumor.
Restoration of function: Surgery restores function to the affected bone, which can help improve the quality of life of patients.
Reduced risk of fracture: By removing the tumor and restoring the affected bone, surgery can also help reduce the risk of fracture.
Improved mobility: By restoring bone function, surgery can improve patients' mobility.
Improved quality of life: By removing the tumor and relieving pain, surgery can improve the quality of overall patient life.
What are the risks and complications ?
Surgery for non-ossifying fibroids, like any surgery, has risks and complications. It is important to understand that each case is unique and complications can vary depending on many factors, including the location of the tumor and the size of the resection. Here are some of the possible complications of surgery for non-ossifying fibroids:
Infection: Infection may occur after surgery. The risk of infection can be reduced by following post-operative instructions and taking prescribed antibiotics.
Bleeding: During or immediately after surgery, bleeding may occur. Bone resection surgery can cause significant bleeding. Doctors will use special techniques to minimize bleeding.
Pain: Pain is a common complication of surgery and can result in a prolonged rehabilitation period.
Anesthesia-related complications: Patients may experience reactions to anesthesia during surgery.
Fractures: When the tumor is located near a joint, a fracture may occur during surgery or after .
Nerve damage: Nerves near the tumor can be affected during surgery, which can lead to loss of sensation or movement in the affected area.
Implant Complications: In some cases, implants such as screws or plates may be needed to stabilize the 'bone. Possible complications with these implants may include rupture or migration.
In conclusion, non-ossifying fibroids are benign tumors located in the bone. Although they don't often require active treatment, in some cases surgery may be needed to remove the tumor and relieve symptoms.
Treatment options include monitoring, pain medication, radiation therapy, and surgery. Surgery can provide many benefits, including complete tumor removal, pain relief, restoration of bone function, reduced fracture risk, improved mobility, and improved quality of overall life. However, surgery also comes with risks and complications, including infection, bleeding, pain, anesthesia-related complications, fractures, nerve damage, and complications from implants.
Ultimately, most patients with non-ossifying fibroids do not need active treatment and can be monitored regularly. However, in some cases, surgery can offer significant benefits for patients with symptomatic tumor or progression.