Chondroblastoma is a benign bone tumor arising most often in the epiphyses of long bones. Nearly 90% occurred in patients between the ages of 5 and 25 years, but tumors were found in later adulthood and even in old age. A few chondroblastomas were predominantly cystic, and some contained zones that were indistinguishable microscopically from aneurysmal bone cysts. Conservative surgical removal, nearly always effective, should be thorough so as to minimize the risk of the occasional troublesome recurrence. Late sarcomatous change has been reported in a few cases whether radiation therapy was employed or not. Atypical sarcomas, especially chondrosarcomas, mimic chondroblastoma in rare instances, but there is no convincing evidence for a primarily malignant chondroblastoma. The one metastasizing benign chondroblastoma that was documented is a pathologic rarity. The tumor may respond favorably to radiation therapy, which should be employed only for surgically inaccessible tumors, and it may be curative.
A retrospective study of 167 patients with soft-tissue malignant fibrous histiocytoma of the trunk, extremities, and retroperitoneal region revealed twice as many deeply situated tumors as superficial tumors. Malignant fibrous histiocytoma may be subclassified into fibrous, giant-cell, myxoid, and inflammatory variants. The fibrous variant accounted for two-thirds of the lesions. The prognosis is no different among the histologic subtypes. The depth of the tumor significantly affects survival, and three important groups were identified: superficial tumors, superficial tumors that recur in deep locations, and deeply situated tumors. The group with superficial tumors that subsequently did not recur in deep locations had a significantly better 4-year survival rate than did the other two groups (65% versus 34% and 40%, respectively). Patients with distally located tumors had a better 5-year survival rate than did patients with proximally located tumors (73% versus 28%). Local recurrence was found in 51% of patients who had a "complete" excision. Patients with superficial tumors had a higher local recurrence rate (71%) than did those with deep tumors (41%). Few patients with retroperitoneal tumors were long-term survivors; the 5-year survival rate was 14%. Cancer 45167-178. 1980. ALIGNANT FIBROUS HISTIOCYTOMA is one of a
A study of 76 chondromyxoid fibromas affirms that it is a benign tumor, apparently of cartilaginous derivation, that is most likely to occur in adolescents and young adults. Although a wide skeletal distribution has been observed, the lesion most often affects major limb bones, especially the tibia. The characteristic but somewhat complex histologic range of this lesion, coupled with its benign appearance on roentgenograms, allows ready distinction from other tumors, most importantly chondrosarcoma. The lesion is somewhat more aggressive and considerably more likely to recur in young patients, but adequate local resection nearly always can forestall such recurrence. Malignant transformation is extremely improbable.
The clinical courses of 60 patients with hemangiopericytoma of the somatic soft tissues are summarized in this retrospective study. The tumors were subjected to a comparative histologic review and classified as benign (12 lesions), borderline malignant (16 lesions), and malignant (32 lesions). Tumors with 1 mitotic figure per 10 high‐power fields and slight cellular anaplasia or 1 mitotic figure per 20 high‐power fields and moderate cellular anaplasia may be expected to follow a malignant clinical course. Six of the 16 tumors with these microscopic features (borderline lesions) metastasized (37.5%), and 6 exhibited local recurrences after excision. Of the 32 malignant tumors, 25 (78%) metastasized. Twenty‐three patients with malignant tumors were followed for more than 5 years or until death from tumor, and only one patient was alive and free of disease. Fifteen of the 23 patients experienced one of more local recurrences. None of the benign tumors metastasized. Surgical ablation of hemangiopericytoma is, in our experience, the only satisfactory method of treatment. Amputation of an extremity need be done only when the location of the lesion precludes a wide local excision. Local recurrent tumor was experienced by 22 patients after an inadequate local excision. Long‐term follow‐up is recommended because metastasis became apparent in 11% of patients with malignant tumors and 7% with borderline tumors after 5 “disease‐free” years.
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