Secondary fibrosarcoma of bone can arise from benign bone lesions (Paget disease, bone infarction, fibrous dysplasia, chronic osteomyelitis, giant cell tumor), malignant bone lesions (e.g., chondrosarcoma), or irradiated bone. Fibrosarcomas occurring in the spine or the flat bones are usually secondary lesions.
Radiographs typically reveal a large aggressive lytic lesion with cortical destruction and soft tissue extension. The location is typically metaphyseal and extension into the diaphysis and epiphysis is common.
Differential considerations for high-grade fibrosarcomas include:
- Multiple myeloma:
- Malignant fibrous histiocytoma: