Successful Treatment of a Massive Desmoplastic Fibroma of the Ilium without Surgery: A Case Report with Long-Term Follow-Up

Desmoplastic fibroma of the bone (DFB) is a notably rare, lytic, locally aggressive but nonmetastatic, primary benign bone tumor in patients less than 30 years old. As the recommended primary treatment for DFB, wide resection is preferred to curettage from the perspective of recurrence but wide rese...

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Main Authors: Hideyuki Kinoshita, Takeshi Ishii, Hiroto Kamoda, Yoko Hagiwara, Toshinori Tsukanishi, Sumihisa Orita, Kazuhide Inage, Naoya Hirosawa, Seiji Ohtori, Tsukasa Yonemoto
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Case Reports in Orthopedics
Online Access:http://dx.doi.org/10.1155/2020/5380598
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author Hideyuki Kinoshita
Takeshi Ishii
Hiroto Kamoda
Yoko Hagiwara
Toshinori Tsukanishi
Sumihisa Orita
Kazuhide Inage
Naoya Hirosawa
Seiji Ohtori
Tsukasa Yonemoto
author_facet Hideyuki Kinoshita
Takeshi Ishii
Hiroto Kamoda
Yoko Hagiwara
Toshinori Tsukanishi
Sumihisa Orita
Kazuhide Inage
Naoya Hirosawa
Seiji Ohtori
Tsukasa Yonemoto
author_sort Hideyuki Kinoshita
collection DOAJ
description Desmoplastic fibroma of the bone (DFB) is a notably rare, lytic, locally aggressive but nonmetastatic, primary benign bone tumor in patients less than 30 years old. As the recommended primary treatment for DFB, wide resection is preferred to curettage from the perspective of recurrence but wide resection of DFB in the pelvis such as in the acetabulum could result in greater functional loss, suggesting the need for conservative treatments. However, there is no report on long-term follow-up following conservative treatment for DFB. The present case involved a 21-year-old woman with right hip pain. Radiological evaluation revealed a massive lesion throughout the right ilium and acetabulum with partial osteolysis, cortical destruction, marginal sclerosis, slight pseudotrabeculation, and bone expansion. Open biopsy from the ilium showed the proliferation of spindle cells in an abundant collagenous matrix without atypia and mitosis, suggesting a diagnosis of DFB. Conservative treatment was selected considering the risk of greater functional loss following wide ilium resection. An evaluation 10 years after follow-up showed a partially sclerotic lesion of the ilium and the absence of pain. The current case demonstrates that conservative therapy may be effective even in some cases of aggressive DFB.
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spelling doaj-art-c2d2efdca3dd4552b1c0b5820b62059a2025-08-20T03:23:15ZengWileyCase Reports in Orthopedics2090-67492090-67572020-01-01202010.1155/2020/53805985380598Successful Treatment of a Massive Desmoplastic Fibroma of the Ilium without Surgery: A Case Report with Long-Term Follow-UpHideyuki Kinoshita0Takeshi Ishii1Hiroto Kamoda2Yoko Hagiwara3Toshinori Tsukanishi4Sumihisa Orita5Kazuhide Inage6Naoya Hirosawa7Seiji Ohtori8Tsukasa Yonemoto9Department of Orthopedic Surgery, Chiba Cancer Center, 666-2 Nitonacho, Chuo-ku, Chiba 260-8717, JapanDepartment of Orthopedic Surgery, Chiba Cancer Center, 666-2 Nitonacho, Chuo-ku, Chiba 260-8717, JapanDepartment of Orthopedic Surgery, Chiba Cancer Center, 666-2 Nitonacho, Chuo-ku, Chiba 260-8717, JapanDepartment of Orthopedic Surgery, Chiba Cancer Center, 666-2 Nitonacho, Chuo-ku, Chiba 260-8717, JapanDepartment of Orthopedic Surgery, Chiba Cancer Center, 666-2 Nitonacho, Chuo-ku, Chiba 260-8717, JapanDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, JapanDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, JapanDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, JapanDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, JapanDepartment of Orthopedic Surgery, Chiba Cancer Center, 666-2 Nitonacho, Chuo-ku, Chiba 260-8717, JapanDesmoplastic fibroma of the bone (DFB) is a notably rare, lytic, locally aggressive but nonmetastatic, primary benign bone tumor in patients less than 30 years old. As the recommended primary treatment for DFB, wide resection is preferred to curettage from the perspective of recurrence but wide resection of DFB in the pelvis such as in the acetabulum could result in greater functional loss, suggesting the need for conservative treatments. However, there is no report on long-term follow-up following conservative treatment for DFB. The present case involved a 21-year-old woman with right hip pain. Radiological evaluation revealed a massive lesion throughout the right ilium and acetabulum with partial osteolysis, cortical destruction, marginal sclerosis, slight pseudotrabeculation, and bone expansion. Open biopsy from the ilium showed the proliferation of spindle cells in an abundant collagenous matrix without atypia and mitosis, suggesting a diagnosis of DFB. Conservative treatment was selected considering the risk of greater functional loss following wide ilium resection. An evaluation 10 years after follow-up showed a partially sclerotic lesion of the ilium and the absence of pain. The current case demonstrates that conservative therapy may be effective even in some cases of aggressive DFB.http://dx.doi.org/10.1155/2020/5380598
spellingShingle Hideyuki Kinoshita
Takeshi Ishii
Hiroto Kamoda
Yoko Hagiwara
Toshinori Tsukanishi
Sumihisa Orita
Kazuhide Inage
Naoya Hirosawa
Seiji Ohtori
Tsukasa Yonemoto
Successful Treatment of a Massive Desmoplastic Fibroma of the Ilium without Surgery: A Case Report with Long-Term Follow-Up
Case Reports in Orthopedics
title Successful Treatment of a Massive Desmoplastic Fibroma of the Ilium without Surgery: A Case Report with Long-Term Follow-Up
title_full Successful Treatment of a Massive Desmoplastic Fibroma of the Ilium without Surgery: A Case Report with Long-Term Follow-Up
title_fullStr Successful Treatment of a Massive Desmoplastic Fibroma of the Ilium without Surgery: A Case Report with Long-Term Follow-Up
title_full_unstemmed Successful Treatment of a Massive Desmoplastic Fibroma of the Ilium without Surgery: A Case Report with Long-Term Follow-Up
title_short Successful Treatment of a Massive Desmoplastic Fibroma of the Ilium without Surgery: A Case Report with Long-Term Follow-Up
title_sort successful treatment of a massive desmoplastic fibroma of the ilium without surgery a case report with long term follow up
url http://dx.doi.org/10.1155/2020/5380598
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