Updated: 6/21/2021

Fibrosarcoma of Bone

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https://upload.orthobullets.com/topic/8031/images/Case C - femur - xray b - Parsons_moved.gif
https://upload.orthobullets.com/topic/8031/images/Case C - femur - MRI - Parsons_moved.png
https://upload.orthobullets.com/topic/8031/images/Case C - femur - bone scan - Parsons_moved.gif
https://upload.orthobullets.com/topic/8031/images/Histology A - high power_moved.jpg
https://upload.orthobullets.com/topic/8031/images/Histology C - Parsons_moved.jpg
https://upload.orthobullets.com/topic/8031/images/Histology B - medium power - Parsons_moved.jpg
  • SUMMARY
    • Fibrosarcoma of Bone is a malignant, high-grade, fibrogenic tumor of bone that usually occurs in patients > 50 years of age who presents with regional pain and swelling. 
    • Diagnosis is made with a biopsy and histology showing atypical spindle cells in a herringbone pattern.
    • Treatment is usually wide surgical resection and multiagent chemotherapy.
  • Prognosis
    • Prognosis is poor
      • high grade has 30% survival at 5 years
        • majority are high-grade
      • low grade has 80% survival at 10 years
  • PRESENTATION
    • Symptoms
      • pain and swelling
  • Imaging
    • Radiographic characteristics
      • purely lytic lesion with bone destruction in a permeative pattern
      • ill defined features
      • looks like osteosarcoma
    • Bone scan
      • is very hot
  • STUDIES
    • Histology
      • Same as soft tissue sarcoma
        • atypical spindle cells
        • herringbone pattern
        • variable levels of collagen production
  • Treatment
    • Operative
      • wide surgical resection and multiagent chemotherapy
        • indications
          • all malignant cases
        • chemotherapy
          • multiagent chemotherapy only if high grade (most cases)

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