Updated: 10/4/2016

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/Histology A - high power_moved.jpg
https://upload.orthobullets.com/topic/8031/images/Case C - femur - bone scan - Parsons_moved.gif
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
Introduction
  • MFH and fibrosarcoma are now considered the same entity
  • malignant fibrogenic tumor of the bone that usually affects older patients (> 50 yrs), although it may occur in all age groups
    • the majority are high grade
  • Prognosis is poor
    • high grade has 30% survival at 5 years
    • low grade has 80% survival at 10 years
Symptoms
  • Presentation
    • 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 
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)
 
  Location
Xray
Xray
CT
B. Scan
MRI
MRI
Histo(1)
Case A distal tibia
Case A femur
Case A tibia
 
(1) - histology does not always correspond to case
 

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