OrthoNet

MFH
Malignant Fibrous Histiocytoma (MFH of bone)

- malignant tumor occurring in metadiaphyseal region of long bones of adults
- thought to be derived from fibroblasts

Signs & Symptoms:
- pain & swelling associated with tender mass usu present for at least 6 mos

Xrays:
- lytic lesions with cortical destruction with minimal periosteal reaction
- may see soft tissue mass

Histology:
- spindle & histiocytoid cells with scattered multinucleated giant cells & lipid-laden histiocytes
- spindle cells arranged in storiform or cartwheel pattern where they form fascicles that intersect in a central hypocellular area
- varying degree of cell pleomorphism

Treatment:
- wide excision (amputation vs limb salvage)
- benefits of chemotherapy inconclusive
- radiation used postoperatively
- 5 yr survival = 50%