Home / Case Study / Case No. 22: Malignant Fibrous Histiocytoma

Case No. 22: Malignant Fibrous Histiocytoma

X-Ray Thigh (Lateral View)
CT Thigh (Soft Tissue Window)
CT Thigh (Bone Window)

Report Of Malignant Fibrous Histiocytoma:

A lateral radiograph reveals a large soft tissue mass in the posterior thigh with a pathologic fracture involving the midshaft of the femur.
A transaxial CT scan bone window clearly shows the extent of bone destruction and separation of the anterior cortex from the posterior cortex due to the pathologic fracture. Osseous debris is scattered throughout the soft tissues. Another transaxial CT scan, with a soft tissue window, obtained. Another transaxial CT scan, with a soft tissue window obtained after intravenous contrast administration, reveals a mixed attenuation within the soft tissues of the posterior thigh and communication of the large mass with the marrow cavity of the femur. Peripheral contrast enhancement is seen within the soft tissue mass.

Diagnosis:

Malignant Fibrous Histiocytoma.

Key Points:

44% of malignant fibrous histiocytomas involve the femur. Pathologic fracture in 30%-50% of cases. Metaphyseal location with frequent spread to epiphysis and diaphysis. Moth-eaten or permeative osteolysis, frequently resembling fibrosarcoma.

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