Epidemiology
Very common in children and adolescents; often discovered on an X-ray taken for another reason. Its size relative to the bone's diameter helps estimate the fracture risk and decide whether observation is enough while the child grows. When there are several non-ossifying fibromas in different bones, it is worth checking for café-au-lait spots or other signs of neurofibromatosis type 1, or for the uncommon picture known as Jaffe-Campanacci syndrome.
Basic features
A fibrous lesion of the metaphysis, generally without symptoms. If large, it can weaken the bone.
Usual treatment
When it is typical and symptom-free it needs no treatment or follow-up: most ossify and disappear on their own as the child grows. Surgery (curettage with grafting or stabilization) is reserved for large lesions at risk of fracture or for an established fracture.
Outcomes and prognosis
It tends to fill in or become sclerotic with growth and has no malignant potential. The outlook is very favorable, with recurrence being exceptional.