In children, Nonossifying fibromas (NOFs) are the most common bone lesions that are benign. The Non-ossifying fibromas are not aggressive and mainly occur as fibrous (scar) tissue. Many people confuse these tumors as birthmarks’ in the bone.


Mainly, Nonossifying fibromas occur in the tibia (shin bone) and femur (thigh bone), but they may also exist in the upper arm bone (humerus). Both boys and girls can have these lesions.


As per the research, people who are younger than 20 years have a greater incidence of developing this tumor. At least, one non-ossifying fibroma is present in 20 percent of people belonging to such an age group.


When the child grows fully, the non-ossifying fibroma will resolve. Thus, most of them will require no treatment. Nonossifying fibromas have other names as well, such as cortical desmoids and fibrous cortical defects.



There is no known exact cause for Nonossifying fibromas. Besides this, researchers know no risk factors. Thus, the risk factors like the environment, genetics, or traumatic injury do not contribute to your risk of developing Nonossifying fibromas, apparently.



Symptoms of Nonossifying fibromas (NOFs):

Nonossifying fibromas show no symptoms. A lot of children don’t even know that they have this benign lesion in the body. It is by chance on an x-ray for some another problem that your doctor discovers this.

However, some people experience the following symptoms:

  • Mildsoreness or swelling present in the tumor area.
  • Bones may break because of Non-ossifying fibromas, at least partly if not wholly. This occurs because of weakening and reducing the overall strength of a bone.
  • Pain in the area where a tumor is present. This may even occur during periods of inactivity.
  • A higher number of fractures in people who have a large non-ossifying fibroma.

How your doctor will examine the tumor?


Before going for the main imaging tests, your doctor will ask for your medical history. Then, he/she will perform a complete physical examination. When the physical signs and symptoms are present, then your doctor will order imaging tests_ specifically x-rays.


Imaging tests

Your doctor will order the x-rays as soon as he/she detects some physical signs. This technique will provide a clear image of dense structures of the body, such as bone.

Nonossifying fibromas will appear dark in an x-ray with a white rim surrounding them.


Other imaging tests: To further test and confirm the tumor, your doctor may order a magnetic resonance imaging (MRI) scan, computerized tomography (CT) scan, or bone scan.

A CT scan or an MRI can show the changes in the appearance of a tumor over time. Although not necessary, it can also depict the exact size of a tumor. Moreover, these images can also show how thin the rigid outer part of the bone is in the area of the Nonossifying fibroma (cortical integrity).

Further, it can also show a pathological fracture, if any.  To see if there is more than one tumor, a bone scan becomes helpful sometimes.

Treatment for Nonossifying fibromas:

Nonsurgical Treatment: In many cases, Nonossifying fibromas requires no treatment other than a simple observation. The tumor stops growing when the child finishes growing if the tumor is left as such. Eventually, the bone will fill the tumor over time.

By the time a person reaches the age of 20, most Nonossifying fibromas disappear by that time. Until this period, your healthcare provider may order some periodic x-rays.

Surgical Treatment: If the non-surgical treatment doesn’t world, then your doctor may recommend you surgical treatment. Your doctor will suggest this when the Nonossifying fibromas are very large. Furthermore, having severe symptoms and a lot of time to grow, it is better to remove the tumor surgically.

The presence of symptoms or the larger size means that the bone is likely to fracture. This occurs due to the weakening of the bone. In rare cases of surgical management, your doctor may do the following:


Curettage: This is the surgical procedure that your doctor may use to treat Nonossifying fibroma. Your surgeon will scrap the tumor out of the bone by using special instruments. This can cure your fibroma.

Bone graft: After performing the surgery, your doctor will fill the hole that forms during Curettage. This helps stabilize the bone by filling it with a bone graft. Further, your doctor may take the bone graft from another bone of your body (autograft) or a donor (allograft). Afterward, to fill the hole, your doctor may use a bone cement mixture.



After surgery, most of the patients return to their normal life after 3 to 6 months. However, many factors influence the recovery of patients. These factors include the size of Nonossifying fibroma, how quickly bones of a patient heal, and the type of bone graft that your doctor uses.

You should regularly visit your doctor and have an x-ray regularly. This way you can make sure if the tumor does not come or grow back.

The treatment in the patients works well. This is because the tumor not so much aggressive and responds well to the drugs. Cancer will rarely recur if your doctor performs surgery. Furthermore, they do not become cancerous or resolves with skeletal maturity.


Coping and support 


When you get diagnosed with Non-Ossifying fibroma, it could be frightening for you. The condition will be no different for your family.

However, you may learn to cope with the uncertainty and distress related to cancer with time.  Thus, you need to follow these instructions until then;


Call on for medical support:

Various things are going to help you. For instance, the knowledge and understanding of a medical social worker, or any other mental health professional is necessary. They will help you in understanding your cancer.

Furthermore, if your child or other family member suffers from cancer, you need to ask health care professionals for advice. They will provide you with options for medical health support. This will also provide you with emotional and social support.

In addition to this, you can check various online services that will provide you support to combat cancer.


  • Gain more knowledge about Non-Ossifying fibroma to make decisionsabout control and care:

Ask your doctor about various treatment options related to Non-Ossifying fibroma. Little knowledge is dangerous. Therefore, more confidence in understanding and making decisions about treatment options will be there with you. So you should always learn more about the disease.

Ask the health care team for guidance if your child has cancer. Therefore, get more and more information for appropriately caring for the patient.


Be close to your friends and family:

A close and strong relationship with your family and friends is necessary. It will help you deal with Non-Ossifying fibroma.

You need practical support, moral support from your friends and relatives. Thus, someone should be there for you to look after the family. Emotional support from them is going to matter most. Thus, a healthy and happy person will ultimately efficiently fight the disease.


Prepare for your appointment


You are likely to start making an appointment with your primary care doctor if some signs and symptoms worry you. Ask for a referral to an experienced specialist if your doctor suspects Non-Ossifying fibroma.


A team of specialists typically can treat Non-Ossifying fibroma. For instance;

Orthopedic surgeons or orthopedic oncologists who have specialization in operating bone cancers.

Doctors who have a specialization in treating cancers with systemic medications or chemotherapy.

Pathologists diagnose the specific type of cancer by analyzing a tissue.

Rehabilitation specialists who after surgery help in the recovery of a tumor.


What you should expect from your doctor:


You will face several questions from your doctor. Thus, you should be ready to answer these. So, give more time to your doctor to address them. Your doctor may ask;


What signs and symptoms concern you more?


Have your symptoms been occasional or continuous?


When did you start to notice the symptoms?

The severity of your symptoms?


Is there anything that improves your symptoms?


Is there anything that worsens your symptoms?


Do you have any family or personal history of cancer?