|Print Date:||May 25, 2013, 10:23 am|
|Text||History: 52 yo female with right shoulder pain
Findings: Plain films and CT show an aggressive lytic lesion in the right humeral head and metaphysis with wide transition zone, cortical destruction, no significant periostitis, and dystrophic calcification but no significant tumor matrix. MRI shows the mass to be enhancing.
Differential: Aggressive neoplasms such as malignant fibrous histiocytoma, plasmacytoma, metastasis, fibroblastic osteosarcoma and fibrosarcoma.
Discussion: Fibrosarcomas are rare aggressive tumor that tend to occur in the 3rd to 6th decade of life. They occur equally in males and females. They may be de novo or a secondary tumor in patients with history of Pagetâ€™s, osteonecrosis, or history of irradiation and prior chondrosarcomas. Distribution favors metaphyseal and long tubular bones with femur(40%) and humerus (10%).
Radiographic appearance is as described with aggressive lytic features. Usually little periostitis and tumor matrix is seen. They may have pseudocapsules and if very large have necrotic areas.
Clinically, they tend to be aggressive tumors that reoccurs and behaves much like malignant fibrous histiocytomas.
This patient under went resection and began chemotherapy.
|References:||REF: 1. D Resnick, Diagnosis of Bone and Joint Disorders, 4th ed, 2002, pp 3934-3937.
2. BJ Manaster, Musculoskeletal Imaging, 2nd ed, 2002, pp 72-73
|Contributor||Chun W Chen (National Capital Consortium)|
|Peer Reviewer||Philip A Dinauer (Civilian Medical Center)|
|Record Number||: 5699|
|Category:||Neoplasm, malignant (NOS)|
|Location:||MSK - Musculoskeletal|
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