Pseudoanaplastic chondromyxoid fibroma

A 19-year-old man presented with a chondromyxoid fibroma of the distal phalanx of the great toe that was originally diagnosed as osteosarcoma rather than "dedifferentiated" chondrosarcoma. Radiographs showed a large, expansive, and calcified tumor of the distal phalanx. Although the tumor had the architectural and matrix patterns of a chondromyxoid fibroma, high-power examination demonstrated that the lesion had such severe nuclear pleomorphism that it was mistaken for high-grade sarcoma. The purpose of this report is to present the criteria used to differentiate a benign pseudoanaplastic chondromyxoid fibroma from chondrogenic high-grade sarcomas.