A 13-Year-Old Boy With Recurrent Lower Leg Pain

Prasenjit Das, MD, MBBS; Elanthenral Sigamani, MD

Disclosures

June 13, 2017

The prognosis in cases of CMF is usually excellent, even with recurrence.[5] Treatment of the lesion includes curettage or en bloc excision with bone grafting. Radiation therapy is contraindicated because it causes dedifferentiation and malignancy. In cases of multiple recurrence, radiation therapy may be of some help.[9]

Recurrence has been reported in 3%-22% of cases, especially within the first 2 years of surgery, but it has been reported 30 years after surgery as well.[10] Recurrence is more frequently seen in patients younger than 15 years who have a more myxoid tumor with nuclear atypia. Some reports have not found any correlation between the histologic findings and recurrence in CMF. Metastasis has never been reported.[5] All of these facts point to the need for long-term follow-up in these patients.[11]

In the patient in this case, curettage of the lesion with bone grafting was performed. Local extension of the lesion into the articular cartilage and the scant yield of the preintervention biopsy dictated the decision to opt for curettage, followed by fracture fixation. Care should be taken to curette the whole lesion, because incomplete curettage is one of the important factors leading to local tumor recurrence. The patient has had two monthly follow-up examinations over 8 months, with no recurrence detected.

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