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Fibrosarcoma of the bone

Dr Yair Glick ◉ and Dr Matt Skalski et al.

Fibrosarcoma of the bone is a rare malignant bone tumor which may occur as a primary lesion, or secondarily after radiation treatment, dedifferentiation from other tumors ³ or pathologies such as Paget disease, bone infarction, or chronic osteomyelitis.

On this page:

Article:

Terminology
Epidemiology
Pathology
Radiographic features
Related articles
References

Terminology

It is a distinct entity from but similar to malignant fibrous histiocytoma²(pleomorphic undifferentiated sarcoma) that may also rarely occur in bone, causing confusion in terminology, as the term "fibrosarcoma" has in the past encompassed a multitude of distinct histologic diseases.

Epidemiology

Fibrosarcoma occurs primarily in 30-60-year-olds, with a slight male predominance. It constitutes <5% of primary bone tumors. Infantile fibrosarcoma is also rarely encountered in bone.

Pathology

Cells are fibroblastic in appearance with a somewhat uniform spindle shape. They may be arranged in fascicles creating a herringbone pattern. The degree of differentiation is variable, however, and therefore distinguishing features from other spindle cell neoplasm should be sought. Extracellular collagen fibrils are typical.

Radiographic features

Plain radiograph

Typically highly destructive with a wide zone of transition, and occasionally expansile. Periosteal reaction is uncommon, but if seen is usually laminated, spiculated or Codman triangles. The lesion usually has no matrix mineralization, but may have areas of sequestered bone. These tumors are often associated with a large soft tissue mass extending from the bone ¹.

MRI

MRI is useful in defining intraosseous spread and the extent of extension into the soft tissues. Descriptions of the appearance of intraosseous fibrosarcoma on MR are few.

Signal characteristics

The signal intensity pattern is nonspecific:

T1: isointense to muscle
T2: hyperintense to muscle
T1C+: avid contrast enhancement (may be uniform or heterogeneous)

References

Bone tumours

The differential diagnosis for bone tumors is dependent on the age of the patient, with a very different set of differentials for the pediatric patient.

bone tumors
- bone-forming tumors
- cartilage-forming tumors
- fibrous bone lesions
- bone marrow tumors
- other bone tumors or tumor-like lesions
- skeletal metastases
  - morphology
  - location
  - impending fracture risk
    - Harrington criteria
    - Mirel classification
- staging
  - AJCC staging of musculoskeletal tumors
  - Enneking surgical staging system

Article information

rID: 27312

System: Musculoskeletal

Tag: cases

Synonyms or Alternate Spellings:

Fibrosarcoma of bone
Fibrosarcoma (bone)
Osseous fibrosarcoma

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