Nonossifying fibroids are noncancerous tumors that occur in children and adolescents near the end of long bones, causing little pain but increasing the risk of bone fractures. Surgery is only necessary for large fibroids causing severe pain or fractures. The cause is unknown, but it is believed to be a developmental defect. Symptoms are rare, and treatment depends on the size and discomfort caused by the fibroid. Surgery involves removing the fibroid and inserting donor bone, with a good prognosis and a low chance of recurrence.
A nonossifying fibroid is a nonmalignant tumor that occurs in adolescents and children. The fibroid is always found near the end of the long bones, usually those in the legs. Although a fibroid causes little or no pain, large fibroids increase the chance of a bone fracture, especially if the teenager participates in a physical activity such as sports. Only large fibroids that cause severe pain or fractures need to be surgically removed. In most cases, however, a fibroid disappears as the teenager continues to grow.
It is still unclear why some teenagers develop this condition. One theory is that while a baby is developing in the womb, blood flow within the long bones is misdirected. Although other theories try to explain the root cause, the medical community agrees that the condition is caused by a developmental defect. Because a nonossifying fibroid takes time to develop, it’s not possible to test for the condition immediately after birth.
Symptoms of a nonossifying fibroid are rare or nonexistent. Most teenagers who have a fibroid never know it, although in some cases a teenager may complain of a painful sensation in a joint. With a large fibroid, the most common symptom is breaking the bone during physical activity. A post-fracture X-ray can confirm the presence of this type of fibroid.
Treatment of a nonossifying fibroid depends on both the adolescent’s current health and the nature of the fibroid. If the fibroid is small and causes little discomfort, a doctor may decide to do nothing and let the teen grow. Surgery is needed, however, when a fibroid causes significant discomfort, structural bone weakening, or fracture.
Surgery consists of both curettage and bone grafting. A surgeon will remove the fibroid, creating a space in the bone. Pieces of donor bone are inserted into the gap. During the six-week period that the leg is in a cast, the donor bone fuses with the adolescent’s natural bone. In six months, the teenager will be fully able to participate in all physical activities.
The prognosis for the future is also excellent in cases where a teenager undergoes surgery. Unlike malignant tumors, there is little chance that a nonossifying fibroid will reappear. Although parents of teenagers who have had corrective surgery may want to check their child for other fibroids, the chances of having two or more large fibroids are statistically insignificant and only occur in rare conditions that have other major symptoms.
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