Imaging findings, prevalence and outcome of de novo and secondary malignant fibrous histiocytoma of bone.
OBJECTIVE
To evaluate the radiographic and magnetic resonance (MR) imaging features of primary and secondary malignant fibrous histiocytoma in bone and determine the demographics, prevalence and outcome of patients with this tumor.


METHODS
A retrospective search of files from two institutions identified 28 patients with malignant fibrous histiocytoma (MFH) of bone. Microscope slides were reviewed to confirm diagnosis and identify any pre-existing lesions. Medical records were reviewed with respect to patients' demographic characteristics and outcomes.


RESULTS
Radiographic features demonstrated an aggressive osteolytic lesion with a permeative pattern of bone destruction. Periosteal reaction was seen in three of 13 lesions. T1-weighted images (T1WIs) demonstrated signal intensity iso- to slightly hyperintense to muscle. T2-weighted images (T2WIs) demonstrated mildly higher signal intensity than that of muscle. The 5-year survival rate was 53%. The tumor arose secondarily in pre-existing lesions in 43% of patients. Metastases occurred in 46% of patients during the course of the disease, with pulmonary and osseous metastases being the most common.


CONCLUSIONS
Secondary MFH of bone was slightly less common than primary MFH and had a prognosis similar to that of primary MFH of bone. MR imaging showed variable and somewhat unusual low to intermediate T2 signal characteristics for a radiographically malignant osteolytic lesion.
Koplas
Monica C
MC
Imaging Institute/A21, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44120, USA. koplasm@ccf.org
Lefkowitz
Robert A
RA
Bauer
Thomas W
TW
Joyce
Michael J
MJ
Ilaslan
Hakan
H
Landa
Jonathan
J
Sundaram
Murali
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology / Q000556:secondary; D005260:Female; D051677:Histiocytoma, Malignant Fibrous / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology / Q000556:secondary; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010014:Osteolysis / Q000000981:diagnostic imaging; D015995:Prevalence; D011859:Radiography; D012189:Retrospective Studies