Medullary fibrosarcoma of bone

✍ Scribed by Myles P. Cunningham; Myron Arlen

• Publisher: John Wiley and Sons
• Year: 1968
• Tongue: English
• Weight: 488 KB
• Volume: 21
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/1097-0142(196801)21:1<31::aid-cncr2820210107>3.0.co;2-8

✦ Synopsis

Twenty-seven cases of medullary fibrosarcoma of the bone are reviewed in detail. They span a broad age range with a median age in the ~O ' S , show a mild sex preference for men, tend to be clustered towards the end of long bones but may be found almost anywhere in the axial and appendicular skeleton. They are similar to soft tissue fibrosarcomas in their clinical presentation but are more lethal, having a 5-year survival of 29.6%. The most significant factor relating to survival is the degree of histologic differentiation, lowgrade tumors having a favorable prognosis and anaplastic lesions an extremely poor one. Appropriate amputation is the treatment of choice.

IBROSARCOMA ARlSlNC IN BONE OWES ITS

F recognition as a separate and distinct pathologic entity to the work of Budd and Mac-Donald2 and to Phemister.13 Some authorities deny that it is anything more than an undifferentiated chondrosarcoma or osteogenic sar-coma14 or a manifestation of parosteal or soft tissue fibrosarcoma invading bone.4 More recent investigations5~ $-Q seem to have established that fibrosarcoma of endosteal origin (medullary fibrosarcoma) deserves separate consideration.

We have been interested in the natural history of this uncommon tumor, especially in determining whether it behaves like osteogenic sarcoma or rather like soft-part sarcomas. Since this lesion is infrequently encountered we felt it would be worthwhile to carefully analyze our experience with a relative large and well defined group of such cases.

MATERIAL

T h e medical records of the Memorial and James Ewing Hospitals were culled for all available cases between 1934 to 1963. Only those cases in which complete follow-up data was available were included, thus eliminating some case records from the 1920's and 1930's in which data was either incomplete or inadequate. Only proven primary bone fibrosarcomas of medullary origin were included. No cases of fibrosarcoma occurring in the From the Bone Service of the Memorial Sloan-