Postradiation Malignant Fibrous Histiocytoma of Bone

Spindle cell sarcoma of bone arising from a non-ossifying fibroma: A case report

“…In these cases is very difficult to understand if it was a sarcoma from the onset because the differential diagnosis between a low-grade fibrosarcoma and a desmoplastic fibroma is a challenge even for experienced pathologists. According to Huvos et al, 1 the commonest secondary osseous malignant fibrous histiocytoma is due to radiation therapy (15.4%). The latent period between irradiation and the appearance of the bone sarcoma ranged from 4 to 47 years with a mean of 16.5 years.…”

“…Less frequently, they may be secondary to other conditions like radiation therapy, bone pathologies like Paget's disease, bone infarct, aseptic necrosis and many benign tumors or tumor like bone conditions like metaphyseal fibrous defect (MFD), giant cell tumor (GCT), osteochondroma, chondroma and others. 1 This work describes a very rare case of sarcoma of bone arisen in the same area of a benign lesion, diagnosed occasionally ten years ago, which has not undergone previously medical, radiotherapic or surgical treatment.…”

Primary osseous malignant fibrous histiocytoma involving a rib

“…Clinically, features are similar to other primary malignant bone tumors, with pain, swelling, and/or an enlarging mass being present in the majority of patients [1,2,4,5,8,10]. Radiologically, MFH is most frequently purely osteolytic, with no evidence of matrix production or internal trabeculation [1,2,[4][5][6][8][9][10]. The area of bony destruction is typically permeative and is associated with cortical destruction and a soft tissue mass.…”

“…Periosteal reaction is infrequent [1,2,[4][5][6][8][9][10]. Pathologic fractures can occur [1,2,[4][5][6][8][9][10] and occasionally tumor calcification may be present [4][5][6]9]. In the long bones it is typically metaphyseal in location [1,4].…”

“…Review of the six largest series [1,2,4,6,8,10] revealed a total of 183 primary cases. From this total, nine were believed to arise from the rib, although two of these cases [10] were multicentric in nature.…”