Malignant Fibrous Histiocytoma of Bone and Soft Tissue – Two Different Tumor Entities? A Retrospective Study of 45 Cases

Abstract

Background: Malignant fibrous histiocytoma (MFH) can arise as primary bone or soft-tissue sarcoma. Primary MFH of bone and soft tissue are histopathologically indistinguishable. The aim of the study was to assess the clinical course and oncological outcome of MFH of bone and soft tissue. Methods: 45 patients with a confirmed diagnosis of MFH (25 primary bone MFH, 20 primary soft-tissue MFH) were seen between 1974 and 1993 in our institution. Patient records, pathology, and operation reports were assessed for staging and oncological outcome with respect to differences in clinical behavior and response to chemo- and radiotherapy. Follow-up was more than 36 months in 33 patients. Results: MFH of bone metastasizes more frequently and earlier and responds better to chemotherapy than MFH of soft tissue. Soft-tissue MFH has a higher local recurrence rate, and local control can only be achieved by adequate resection margins. 3-year tumor-free survival in our series is 21 % for bone and 57% for soft-tissue MFH. Conclusion: With respect to clinical behavior MFH of bone and MFH of soft tissue can be considered as 2 different tumorentities. The reason forthis remains unclear. In the authors opinion MFH of bone should be treated with chemotherapy and surgery.

Malignant fibrous histiocytoma of bone: A survival analysis from the National Cancer Database

“…Malignant fibrous histiocytoma (MFH), also reclassified as undifferentiated pleomorphic sarcoma (UPS), 1 is a rare high‐grade sarcoma that typically presents in soft tissues, but in rare cases, may also present as a primary bone tumor 2–6 . These sarcomas account for up to 2% of all primary bone tumors, with an overall 5‐year survival rate reported to range between 30% and 60% 7–11 . Due to the rarity of cancer, as well as limited literature based on single‐institution case series, 7–10 high‐quality/population‐based evidence regarding the prognosis and survival of MFH of bone is limited.…”

“…These sarcomas account for up to 2% of all primary bone tumors, with an overall 5‐year survival rate reported to range between 30% and 60% 7–11 . Due to the rarity of cancer, as well as limited literature based on single‐institution case series, 7–10 high‐quality/population‐based evidence regarding the prognosis and survival of MFH of bone is limited. Despite these limitations, prior reports have gone on to group MFH of bone and osteosarcoma into the same group, 12 even though these cancers having distinct clinico‐pathological profiles that may warrant different treatment protocols.…”