Chondromyxoid fibroma is a rare, nonmalignant lesion that typically arises in the metaphyses of the long bones of the lower extremity. The literature has sporadic reports of a chondromyxoid fibroma in the spine. We describe the first case of a chon-dromyxoid fibroma of the lumbar spine in a pediatric patient, along with a literature review with emphasis on recurrence rates and malignant transformation.
An 8-year-old boy initially presented with mild lower back pain. Plain radiographs showed a right-sided lumbar curve. Magnetic resonance imaging (MRI) and computed tomography (CT) scan showed an expansile, lobulated mass in the posterior elements of L3. A CT-guided biopsy led to the diagnosis of chondro-myxoid fibroma.
An L2 laminotomy was performed to assess the L2 nerve root. We then removed the inferior facet of L3 and the superior facet of L4. Once the L2 and L3 nerve roots were identified and found to be free of the mass, the mass was transected near the pedicle and excised. With the mass excised, the L3 pedicle was completely removed. Using a pedicle screw construct, a posterior spinal fusion was performed from L2 to L4.
This patient has done well postoperatively and has recently been seen for his 13-month follow-up. Postoperative CT scan as well as MRI at this point have both been negative for recurrence.