Malignant change secondary to fibrous dysplasia

Abstract

The sites of the lesions were tibia (2 cases), femur (1 case), and rib (1 case). The forms of FD were monostotic in one case and polyostotic in three cases. Radiologically, plain films and computed tomography (CT) showed osteolytic lesions with poorly delineated margins within and/or near areas having a ground-glass appearance. In the osteolytic lesions, simple cystic changes associated with old FD could be excluded by enhanced magnetic resonance imaging (MRI). Histopathologically, two cases were osteosarcoma, one case was malignant fibrous histiocytoma (MFH), and one case was fibrosarcoma. The management of this disease should be decided according to the type of primary high-grade bone sarcoma. One patient, with MFH, was dead of lung metastasis 13 months after surgery. The others are alive without disease.

Malignant Fibrous Histiocytoma of the Head and Neck: CT and MR Imaging Findings

“…Although rare, fibrous dysplasia is known for the potential for malignant change, with the estimated frequency of 0.5% for monostotic type and 4% for McCuneAlbright syndrome. 24 The associated sarcomas include osteosarcoma, fibrosarcoma, chondrosarcoma, and MFH. Early diagnosis of an associated malignancy with cross-sectional imaging gives a better chance for a cure.…”

“…Early diagnosis of an associated malignancy with cross-sectional imaging gives a better chance for a cure. 24 MFH has also been reported to occur secondary to irradiation, trauma, Paget disease, osteonecrosis, chronic osteomyelitis, and benign bone tumors such as enchondroma and giant cell tumor. 10,22,23,25 Compared with the tumors that arise de novo, secondary MFHs are reported to be more aggressive with a poorer prognosis.…”

Prognosis for craniofacial fibrous dysplasia after incomplete resection: age and serum alkaline phosphatase

“…It also has the potential to compress the optic nerve 17 . Malignant transformation is rare but may occur, most likely after radiation therapy with sarcomas being the most common histological type 9,16 .…”

McCune-Albright Syndrome Mimicking Malignancy: an Endocrine Disease From Oncologist’s Perspective

“…Thus, FD possesses the potential for malignant change. Although very rare, its frequency was estimated to be 0.5% for monostotic FD and 4% for MAS (4). Several reports have documented the presence of thyroid, breast, pituitary and adrenocortical tumors in patients with MAS (16).…”

“…Bone lesions observed in MAS and FD can mimic malignant processes (3). Besides, coexisting neoplasia is a rare but probable occurrence and malignant transformation develops in 0.5-4% of the cases of FD/MAS (4). Computerized tomography (CT) and conventional radiographic findings demonstrate the characteristics of FD.…”