PMC6236643_01
Image analyses of the humerus and histological appearance of the tumor: Plain
radiograph of (a) anteroposterior view and (b) lateral view shows an
osteolytic lesion with slight marginal sclerosis in the anterior cortical
bone of the distal part of the humeral shaft. (c) Computed tomography image
revealed calcifications as well as marginal sclerosis in the lesion. The
lesion protruded to the anterior side without breaking the anterior cortical
wall of the humerus. Magnetic resonance imaging images show (d) intermediate
signal intensity on T1-weighted images and (e) high signal intensity on
T2-weighted images of the lesion. (f) The lesion was well enhanced with T1
fat suppression with an injection of gadolinium, axial image. Hematoxylin
and eosin stained surgical specimen (g: 100x, h: 200x) shows fibro-osseous
lesion with irregular fragments of woven bone rimmed by osteoblasts (*).
Many spindle-shaped osteoblasts are observed in the fibrous component (**).
Zonal architecture and storiform pattern were not detected. Arrow heads
indicate the tumor. Scale bar = 200 microm.
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Plain X-ray images showed an osteolytic lesion with slight marginal sclerosis in the anterior cortical bone of the distal part of the humeral shaft (Figure 1(a) and (b)). Although the lesion protruded to the anterior side, it did not break the anterior cortical wall of the humerus and there was no invasion of the soft tissues (Figure 1(c)). T1-weighted magnetic resonance imaging (MRI) images and high signal intensity on T2-weighted images, and was enhanced by an injection of gadolinium (Figure 1(d)-(f)). The differential diagnosis was OFD, FD, classic adamantinoma, OFD-like adamantinoma, and non-ossifying fibroma (NOF). There were many spindle-shaped osteoblasts in the fibrous component (Figure 1(g) and (h)), which strongly indicated OFD.
Plain radiograph of the humerus in 7 years after operation: Plain radiograph
of (a) anteroposterior view and (b) lateral view shows no osteolytic lesion
that shows recurrence.
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Seven years later, he has had no recurrence or symptoms (Figure 2(a) and (b)).