Abstract
Fibrocartilaginous mesenchymoma (FM) is a rare bone tumor mimicking other fibrocartilaginous lesions on imaging and histologically. Hence, it is difficult to diagnose this entity especially on small biopsies. In this article, we report a case of FM mimicking desmoplastic fibroma on biopsy. A 36-year-old male presented with pain in the left hip. Imaging showed a large expansile lytic lesion involving the acetabulum and pubis. The differential diagnosis was suggestive of giant cell tumor, aneurysmal bone cyst, intraosseous desmoplastic fibroma, and chondrosarcoma. Biopsy revealed a low-grade spindle cell lesion with no evidence of osteoid or chondroid matrix. The lack of cartilaginous nodules in the biopsy prompted a preoperative diagnosis of desmoplastic fibroma. The excised mass showed bland spindle cell proliferation, benign cartilage nodules, and epiphyseal plate-like enchondral ossification suggestive of fibrocartilaginous mesenchymoma. Negative immunostaining for SATB2, CDK4, and MDM2 ruled out low-grade central osteosarcoma. Though GNAS mutations were not performed in this case, rimming of the bony trabeculae at the periphery of the epiphyseal growth plate-like cartilaginous nodule ruled out fibrous dysplasia. The absence of cartilaginous component misleads the diagnosis preoperatively in small biopsies.
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Monalisa Hui: manuscript preparation and literature search. Shantveer G. Uppin: concept, definition of intellectual content, data analysis, manuscript review, and supervision. Ramakrishna Narayanan: manuscript review; K Nageshwara Rao: manuscript review and supervision. B. Aravind Kumar: manuscript review.
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Hui, M., Uppin, S.G., Narayanan, R. et al. Fibrocartilaginous mesenchymoma of pelvis—a potential diagnostic pitfall. Skeletal Radiol 52, 791–795 (2023). https://doi.org/10.1007/s00256-022-04167-6
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DOI: https://doi.org/10.1007/s00256-022-04167-6