Fibrosarcoma and malignant fibrous histiocytoma of long bones: radiographic features and grading.

The salient radiological features of 102 cases of fibrosarcoma and of so-called malignant fibrous histiocytoma (MFH) of the long bones are presented. All cases registered with the Netherlands Committee on Bone Tumours in the period 1953-1976, were originally classified as fibrosarcoma. In a recent review of the pathological material approximately half of these tumours were reinterpreted as malignant fibrous histiocytoma. As the two neoplasms demonstrate no difference in their clinical picture, radiological appearance, and survival statistics, we did not study both groups separately. Favourable radiographic signs which suggest a longer survival rate included: a geographic type of bone destruction, eccentric location, and cortical destruction involving no more than two quadrants of the bone circumference. Based on these findings a grading system is presented which differs from that proposed by Lodwick et al. [21].