Malignant Fibrous Histiocytoma Of Bone Research Articles

Statistics of bone sarcoma in Japan: report from the population-based cancer registry in Japan.

No previous reports have characterized national bone sarcoma profiles overall. We examined the nationwide statistics for bone sarcoma in Japan using data from the National Cancer Registry (NCR), a population-based cancer registry. We identified 3,755 patients with bone sarcomas entered in the NCR during 2016-2019 using International Classification of Diseases-Oncology, Third Edition codes for cancer topography and morphology. We extracted data on patient demographics, tumor details (reason for diagnosis, tumor location, histology, extent of disease), hospital volume/type, treatment, and prognosis for each patient. Bone sarcoma showed a slight male preponderance. The age distribution peaked at ages 10-20 and 60-80; approximately 44% of patients were aged over 60years. Chordoma, chondrosarcoma, and malignant fibrous histiocytoma of bone peaked in the elderly, and Ewing's sarcoma peaked in children. Osteosarcoma had two peaks in Japan as well as in Western countries. The most frequent tumor locations were the limb (45%) and the pelvis (21%). Extent of disease was categorized as: "localized" (39%), "regional" (27%), and "distant" (11%). We found significant associations between overall survival and age, tumor location, facility type, hospital volume, histologic subtype, reason for diagnosis, and extent of disease. The latter had the poorest survival. This is the first study to outline the epidemiology, clinical features, treatment, prognosis, and significant factors affecting prognosis of bone sarcoma in Japan using the NCR. Documenting our data regarding elderly patients' outcomes is essential so other countries showing similar population-aging trends can learn from our experiences. Prognostic studies, Level III.

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

Malignant fibrous histiocytoma (MFH) of bone, now known as undifferentiated pleomorphic sarcoma of bone, is a rare neoplasm that accounts for less than 2% of all primary malignant bone tumors. The objective of the current study was to evaluate prognosis and survival for MFH of bone. The 2004 to 2016 National Cancer Database was queried to identify patients with a primary MFH of bone. Kaplan-Meier survival and Cox regression analyses were used to analyze overall survival and risk factors associated with overall mortality. The overall 5-year and 10-year survival rates were 38.3% and 30.5%, respectively. Increasing stage and metastatic disease at presentation were associated with poor overall survival (P < .001). Patients aged 18 to 50 years (hazard ratio [HR], 0.51), 51 to 75 years (HR, 0.61), and those undergoing surgery (HR, 0.39) had improved survival. Having Medicare insurance (HR, 1.48), residing in a low educated area (HR, 2.56), and positive surgical margins (HR, 1.80) were associated with poor survival. The overall prognosis of MFH of bone is poor with a reported 5-year survival rate of 38.3%. Undergoing surgery and younger age were associated with a better prognosis. Older age, having Medicare insurance, and positive surgical margins were predictors of mortality.

Clinical characteristics and prognostic factors of malignant fibrous histiocytoma of bone: a SEER population-based study.

BackgroundMalignant fibrous histiocytoma of bone (MFH-B) is an extremely rare type of bone tumor. We aimed to analyze the clinical characteristics of MFH-B and establish nomograms that predict the prognosis of patients with MFH-B based on prognostic factors.MethodsA total of 250 patients diagnosed with MFH-B were included from the Surveillance, Epidemiology, and End Results (SEER) database. Kaplan-Meier curves and log-rank tests were conducted. Potential prognostic factors were identified using univariate and multivariate Cox regression analysis. Nomograms that predict 3- and 5-year overall survival (OS) and cancer-specific survival (CSS) were further developed and internally validated.ResultsThe multivariate analysis suggested that OS of patients was associated with age ≥57 years [hazard ratio (HR), 1.916; 95% confidence interval (CI), 1.329–2.761; P<0.001], pelvic bones (HR, 1.742; 95% CI, 1.024–2.961; P=0.040) and other tumor sites (HR, 2.498; 95% CI, 1.515–4.120; P<0.001), Grade III/IV (HR, 1.750; 95% CI, 1.002–3.056; P=0.049), distant tumor stage (HR, 2.100; 95% CI, 1.351–3.263; P=0.001), tumor size ≥66 mm (HR, 2.629; 95% CI, 1.747–3.959; P<0.001) and no surgery (HR, 2.134; 95% CI, 1.380–3.300; P=0.001). We then developed nomograms based on the prognostic factors. The concordance index (C-index) of nomograms for OS and CSS were 0.74 (95% CI, 0.70–0.77) and 0.74 (95% CI, 0.70–0.78). Calibration plots suggested optimal concordance between the predictive outcomes of nomograms with the actual survival.ConclusionsThis is the first sizable study that analyzed clinical characteristics and prognostic factors of MFH-B. The nomograms we established for MFH-B were effective tools to predict prognosis of individual patients. These tools can also help doctors identify mortality risk.

Ultra-short stem anchorage in the proximal tibial epiphysis after intercalary tumor resections: analysis of reconstruction survival in four patients at a mean follow-up of 56 months.

Tumors localized in the proximal tibial meta-diaphysis often lead to osteoarticular resections. In this study, we retrospectively reviewed four patients who underwent intercalary tumor resection and reconstruction using an ultra-short stem in the proximal tibial epiphysis, a procedure that to our knowledge has not been reported in literature so far. At the time of operation, the mean patient age was 26.2 years. Three patients were male and one was female. Patients were diagnosed with osteosarcoma in two cases, Ewing's sarcoma and malignant fibrous histiocytoma of bone in one case each. In all cases, wide tumor resections were achieved (osteotomy 3-3.5cm below the tibia plateau joint surface, mean resection length of tibial bone 18cm) at a mean time of operation of 198.8min. Two superficial wound-healing disorders occurred, leading to one surgical revision in each case. One local tumor recurrence occurred 12 months after operation in a patient who discontinued his adjuvant chemotherapy. This patient died of disease, 31 months after operation. Three patients are alive with no evidence of disease at a mean follow-up of 56 months. Walking is not impaired and light sports activities have been reported in all cases. The mean MSTS score is 28/30. Therefore, we report this reconstruction technique to be considered for special indications where the functional outcome can be improved by preservation of the knee joint in tumors of the proximal meta-diaphyseal tibial region.

P0165 The management of head and neck sarcomas: 10-Year experience from a clinical institute in east China

Background We aimed to describe the incidence, type, treatment, outcomes and features of head and neck sarcomas in a major institute of east China. Methods Cases of head and neck soft tissue sarcoma (STS) and osteogenic sarcomas treated at Stomatology Hospital of Nanjing University from 2003 to 2013 were retrospectively analysed. Information regarding patient characteristics, site of the lesion, main presenting symptoms, treatment, histology, local recurrence, development of metastatic disease, duration of follow-up, and survival was obtained. Findings 63 patients were diagnosed with head and neck sarcomas (aged 3–83 years, mean 43.1 years). 27 (42.9%) cases were soft tissue sarcoma and 36 (57.1%) were osteogenic sarcoma. In the patients with soft-tissue sarcoma, common histologies were fibrosarcoma (9), malignant fibrous histiocytoma (6), rhabdomyosarcoma (3), leiomysarcoma (3), neurofibrosarcoma (2), angiosarcoma (1), synovial sarcoma (1), Kaposi’s sarcoma (1), and olfactory neuroblastoma (1). Of the 36 cases of osteogenic sarcoma, 26 had osteosarcoma, three cases were fibrosarcoma of bone, four were malignant fibrous histiocytoma of bone, and two were Ewing’s sarcoma. There was only one case of chondrosarcoma. Initial symptoms were local swelling (48, 76.2%) and pain (29, 46.0%). The latency period between first symptoms and clinical presentation was 4.5 months. The most common treatment was surgery. A radical resection was done in 56 patients. In 33 patients, resection and radiotherapy was used. Ten patients received resection, chemotherapy, and radiotherapy. Of these patients, 17 died within the observation period. Interpretation Surgery remains the mainstay treatment for head and neck sarcomas. According to our data, treatment should possibly include chemotherapy, radical resection, and irradiation.

Undifferentiated High-Grade Pleomorphic Sarcoma of Bone (Previously Called Malignant Fibrous Histiocytoma of Bone) Occurred in the Mandible: Report of Two Cases and Review of the Literature

Undifferentiated High-Grade Pleomorphic Sarcoma of Bone (Previously Called Malignant Fibrous Histiocytoma of Bone) Occurred in the Mandible: Report of Two Cases and Review of the Literature

(99)Tcm-MDP whole body bone scan for the ancillary diagnosis of malignant fibrous histiocytoma of bone

Objective To investigate the usefulness of 99Tcm-MDP whole body bone scan in bone malignant fibrous histiocytoma (BMFH).Methods Fifteen patients (11 males,4 females,age ranged from 23 to 60 years,average age (50.4±12.8) years) who had documented BMFH and underwent 99Tcm-MDP whole body bone scan were retrospectively analyzed.The appearance of increased uptake,decreased uptake or defect in radioactivity on bone was considered as positive.The typical scintigraphic manifestations of BMFH were summarized and compared to other radiological imaging data.Results All 15 patients showed positive results.The lesions involved femoral in 10 cases(66.7％),46.7％(7/15) of which was distal femur.The lesions also involved sacrum,tibia,humerus,radius each in 1 case and multiple lesions in 1 case.Among 27 lesions found,63.0％ (17/27) showed strong increased radioactivity together with reduced or defect area and 37.0％ (10/27) showed strong increased radioactivity only.X-ray found 20 lesions.Twelve cases underwent CT and 7 cases underwent MRI.Abnormal spots showed on CT and MRI were also positive on the whole body bone scan.Conclusions The most common site of BMFH is femur,especially distal femur.BMFH lesions are presented as strong increased radioactivity together with sparse and defect area on bone scan.The whole body bone scan may be an auxiliary examination to evaluate whether there are multiple bone lesions and bone metastasis. Key words: Bone neoplasms; Fibroma; Radionuclide imaging; MDP

Low-grade central osteosarcoma arising from bone infarct

Bone infarct-associated sarcoma is a rare sarcoma, accounting for less than 1% of all bone sarcomas. Its histology usually reflects a high-grade sarcoma, such as malignant fibrous histiocytoma of bone or conventional osteosarcoma. Low-grade sarcoma arising from bone infarct has not been described well in the literature. Here, we present a 17-year follow-up of a female patient with bone infarct in her right humerus, from which a low-grade central osteosarcoma developed during follow-up. A histologic diagnosis of low-grade central osteosarcoma was confirmed by immunohistochemical expression of MDM2 and CDK4. She underwent a wide resection surgery. As of 4 years after surgery, she has remained free of any evidence of recurrence or metastasis. Here, we present clinical and pathologic findings of our case in detail and discuss the differential diagnoses of this extremely rare condition.

Malignant Fibrous Histiocytoma of Maxilla

Malignant fibrous histiocytoma (MFH) is an aggressive soft tissue sarcoma occurring in the late adulthood. It may rarely arise as a primary neoplasm in bone, but usually in the long bones and accounts for less than 1% of the malignant tumors of bone. Its presentation in the facial bones and skull is extremely rare. Malignant fibrous histiocytoma of bone is a highly malignant tumor that recurs, metastasizes, and commonly results in death despite aggressive surgical therapy. This article documents the clinical, radiographic and pathologic features of malignant fibrous histiocytoma of maxilla in a 45-year-old female patient and discusses the considerations related to the diagnosis.

The outcomes of navigation-assisted bone tumour surgery

We evaluated the oncological and functional outcome of 18 patients, whose malignant bone tumours were excised with the assistance of navigation, and who were followed up for more than three years. There were 11 men and seven women, with a mean age of 31.8 years (10 to 57). There were ten operations on the pelvic ring and eight joint-preserving limb salvage procedures. The resection margins were free of tumour in all specimens. The tumours, which were stage IIB in all patients, included osteosarcoma, high-grade chondrosarcoma, Ewing's sarcoma, malignant fibrous histiocytoma of bone, and adamantinoma. The overall three-year survival rate of the 18 patients was 88.9% (95% confidence interval (CI) 75.4 to 100). The three-year survival rate of the patients with pelvic malignancy was 80.0% (95% CI 55.3 to 100), and of the patients with metaphyseal malignancy was 100%. The event-free survival was 66.7% (95% CI 44.9 to 88.5). Local recurrence occurred in two patients, both of whom had a pelvic malignancy. The mean Musculoskeletal Tumor Society functional score was 26.9 points at a mean follow-up of 48.2months (22 to 79). We suggest that navigation can be helpful during surgery for musculoskeletal tumours; it can maximise the accuracy of resection and minimise the unnecessary sacrifice of normal tissue by providing precise intra-operative three-dimensional radiological information.

Malignant fibrous histiocytoma and fibrosarcoma of bone: a re-assessment in the light of currently employed morphological, immunohistochemical and molecular approaches

Malignant fibrous histiocytoma (MFH) and fibrosarcoma (FS) of bone are rare malignant tumours and contentious entities. Sixty seven cases labelled as bone MFH (57) and bone FS (10) were retrieved from five bone tumour referral centres and reviewed to determine whether recent advances allowed for reclassification and identification of histological subgroups with distinct clinical behaviour. A panel of immunostains was applied: smooth muscle actin, desmin, h-caldesmon, cytokeratin AE1-AE3, CD31, CD34, CD68, CD163, CD45, S100 and epithelial membrane antigen. Additional fluorescence in situ hybridisation and immunohistochemistry were performed whenever appropriate. All cases were reviewed by six bone and soft tissue pathologists and a consensus was reached. Follow-up for 43 patients (median 42 months, range 6-223 months) was available. Initial histological diagnosis was reformulated in 18 cases (26.8 %). Seven cases were reclassified as leiomyosarcoma, six as osteosarcoma, three as myxofibrosarcoma and one each as embryonal rhabdomyosarcoma and interdigitating dendritic cell sarcoma. One case showed a peculiar biphasic phenotype with epithelioid nests and myofibroblastic spindle cells. Among the remaining 48 cases, which met the WHO criteria for bone FS and bone MFH, we identified five subgroups. Seven cases were reclassified as undifferentiated pleomorphic sarcoma (UPS) and 11 as UPS with incomplete myogenic differentiation due to positivity for at least one myogenic marker. Six were reclassified as spindle cell sarcoma not otherwise specified. Among the remaining 24 cases, we identified a further two recurrent morphologic patterns: eight cases demonstrated a myoepithelioma-like phenotype and 16 cases a myofibroblastic phenotype. One of the myoepithelioma-like cases harboured a EWSR1-NFATC2 fusion. It appears that bone MFH and bone FS represent at best exclusion diagnoses.

A Multifocal Malignant Fibrous Histiocytoma of the Bone Evolving From Fibrous Dysplasia

Fibrous Dysplasia (FD) is a focal bone lesion occurring sporadically and in hereditary syndromes caused by activating mutations of the G protein alpha subunit. It rarely undergoes malignant transformation. Malignant Fibrous Histiocytoma (MFH) is a sarcoma of soft tissues and may be found as primary sarcoma of the bone or multifocally. Until now only a few cases of malignant transformation of FD into MFH of the bone have been described. We report a case of a 38 year old female with polyostotic FD. Years after the first diagnosis of FD, pain with sudden onset and diminution of force in the left lower limb finally led to the diagnosis of a multifocal MFH of the bone. No response to different chemotherapy schemes was found and the patient deceased shortly after. This is the first described case of a polyostotic FD with malignant transformation into a multifocal MFH of bone. Due to the rarity of this entity and the lack of response to chemotherapy no treatment recommendations can be concluded.

Smooth muscle actin expression in primary bone tumours

Alpha isoform of smooth muscle actin (SMA) expression has been reported in giant cell tumour of bone (GCTB) and other benign and malignant bone tumours, but the pattern of SMA expression and the precise nature of SMA-expressing cells in these lesions is uncertain. We determined by immunohistochemistry the expression of SMA and other muscle and vascular markers in normal bone, GCTB and a wide range of primary benign and malignant bone tumours. Cultured stromal cells of GCTB, chondroblastoma (CB), and aneurysmal bone cyst (ABC) were also analysed for SMA expression. SMA was only noted in blood vessels in normal bone. SMA was expressed by mononuclear stromal cells (MSC) cultured from GCTB, ABC and CB. SMA was strongly and diffusely expressed by MSC in non-ossifying fibroma, fibrous dysplasia, and "brown tumour" of hyperparathyroidism. SMA expression was also noted in GCTB, ABC, CB, chondromyxoid fibroma, malignant fibrous histiocytoma of bone and osteosarcoma. Little or no SMA was noted in Langerhans cell histiocytosis, simple bone cyst, Ewing's sarcoma, osteoblastoma, osteoid osteoma, enchondroma, osteochondroma, chondrosarcoma, myeloma, lymphoma, chordoma and adamantinoma. Our findings show that there is differential SMA expression in primary bone tumours and that identifying the presence or absence of SMA is useful in the differential diagnosis of these lesions. The nature of SMA-expressing cells in bone tumours is uncertain but they are negative for desmin and caldesmon and could represent either myofibroblasts or perivascular cells, such as pericytes.

Primär maligne Knochentumoren

Among human neoplasms, primary malignant bone tumors are fairly rare. They present an incidence rate of roughly 10 cases per 1 million inhabitants per year. During childhood (<15 years), the percentage of malignant bone tumors amounts to 6% of all infantile malignancies. Only leukemia and lymphoma show a higher incidence in adolescence. Of all primary malignant bone tumors, 60% affect patients younger than 45 years and the peak incidence of all bone tumors occurs between 15 and 19 years. The most common primary malignant bone tumors are osteosarcoma (35%), chondrosarcoma (25%), and Ewing's sarcoma (16%). Less frequently (≤ 5%) occurring tumors are chordoma, malignant fibrous histiocytoma of bone, and fibrosarcoma of bone. Vascular primary malignant tumors of bone and adamantinoma are very rare. Staging of the lesion is essential for systemic therapeutic decision-making and includes complete imaging and histo-pathological confirmation of the suspected entity. In most cases, this is established by open- or image-guided biopsy. Based on this information, an interdisciplinary tumor board will determine the individual therapeutic approach. Endoprosthetic or biological reconstruction following wide tumor resection is the most common surgical therapy for primary malignant bone tumors. There is vital importance in a thorough postoperative follow-up and continous after-care by a competent tumor center which is permanentely in charge of therapy.

Reclassification and subtyping of so-called malignant fibrous histiocytoma of bone: comparison with cytogenetic features

BackgroundThe diagnostic entity malignant fibrous histiocytoma (MFH) of bone is, like its soft tissue counterpart, likely to be a misnomer, encompassing a variety of poorly differentiated sarcomas. When reviewing a series of 57 so-called MFH of bone within the framework of the EuroBoNeT consortium according to up-to-date criteria and ancillary immunohistochemistry, a fourth of all tumors were reclassified and subtyped.MethodsIn the present study, the cytogenetic data on 11 of these tumors (three myoepithelioma-like sarcomas, two leiomyosarcomas, one undifferentiated pleomorphic sarcoma with incomplete myogenic differentiation, two undifferentiated pleomorphic sarcomas, one osteosarcoma, one spindle cell sarcoma, and one unclassifiable biphasic sarcoma) are presented.ResultsAll tumors were high-grade lesions and showed very complex karyotypes. Neither the overall pattern (ploidy level, degree of complexity) nor specific cytogenetic features distinguished any of the subtypes. The subgroup of myoepithelioma-like sarcomas was further investigated with regard to the status of the EWSR1 and FUS loci; however, no rearrangement was found. Nor was any particular aberration that could differentiate any of the subtypes from osteosarcomas detected.Conclusionschromosome banding analysis is unlikely to reveal potential genotype-phenotype correlations between morphologic subtypes among so-called MFH of bone.

Autologous CTL response against cancer stem‐like cells/cancer‐initiating cells of bone malignant fibrous histiocytoma

Malignant fibrous histiocytoma (MFH) of the bone is an aggressive tumor with high rates of local recurrence and metastasis. The development of novel therapeutic approaches is critical to improve the prognosis of patients with MFH. We reported previously that the side population (SP) cells of the MFH2003 bone MFH cell line have the characteristics of cancer stem-like cells (CSC)/cancer-initiating cells. In the present study, to establish immunotherapy targeting CSC, we analyzed cell surface immune molecules on SP cells of the MHF2003 cell line, as well as autologous CTL responses against these SP cells in the tumor microenvironment and peripheral circulating lymphocytes, using autologous tumor-infiltrating lymphocytes and autologous CTL clones derived from peripheral blood, respectively. We found that the SP cells expressed human leukocyte antigen (HLA) Class I molecules on the cell surface. The autologous tumor-infiltrating lymphocyte line TIL2003 recognized both the SP and main population cells of the MFH2003 cell line. Next, we induced the CTL clone Tc4C-6 by mixed lymphocyte tumor cell culture using autologous peripheral blood mononuclear cells and freshly isolated SP cells, followed by a limiting dilution procedure. The Tc4C-6 clone showed specific cytotoxicity against the SP cells. Moreover, the cytotoxicity against SP cells was blocked by the anti-HLA Class I antibody W6/32. In conclusion, the findings of the present study support the idea that CSC of bone MFH are recognized by autologous CTL in the tumor microenvironment and peripheral circulating lymphocytes. Thus, CTL-based immunotherapy could target CSC of bone sarcoma to help prevent tumor recurrence.

MFH of Bone and Osteosarcoma Show Similar Survival and Chemosensitivity

Patients with malignant fibrous histiocytoma of bone (MFH-B) and osteosarcoma reportedly have comparable survival rates, despite the lesser chemosensitivity of patients with MFH-B compared with those with osteosarcoma. We therefore asked (1) whether there is a difference in the initial tumor volume, histologic response, and survival between cohorts with MFH-B and osteosarcoma, and (2) whether histologic responses and survival rates differed between two groups even after matching for volume and age. We retrospectively compared 27 patients with Stage IIB MFH-B with 389 patients with localized osteosarcoma for initial tumor volume, age, histologic response, and survival. We compared histologic response and survival between 27 patients with MFH-B and 54 patients with osteosarcoma matched for tumor volume and age. MFH-B occurred more frequently in older patients and they presented with a smaller mean tumor volume and more frequent osteolytic pattern when compared with patients with osteosarcoma. The 5-year metastasis-free survival rates of the MFH-B and osteosarcoma groups were similar: 61.2% ± 9.7% and 61.3% ± 2.5%, respectively. We observed similar proportions of good responders to chemotherapy in the two groups, and the 5-year metastasis-free survival rates were 61.2% ± 9.7% and 70.4% ± 6.2%, respectively. Patients with MFH-B and osteosarcoma have similar survival rates and histologic responses to chemotherapy. Although MFH-B and osteosarcoma differ in clinical presentation, their response pattern to contemporary therapy is similar. Level III, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.

Imaging findings, prevalence and outcome of de novo and secondary malignant fibrous histiocytoma of bone

To evaluate the radiographic and magnetic resonance (MR) imaging features of primary and secondary malignant fibrous histiocytoma in bone and determine the demographics, prevalence and outcome of patients with this tumor. A retrospective search of files from two institutions identified 28 patients with malignant fibrous histiocytoma (MFH) of bone. Microscope slides were reviewed to confirm diagnosis and identify any pre-existing lesions. Medical records were reviewed with respect to patients' demographic characteristics and outcomes. Radiographic features demonstrated an aggressive osteolytic lesion with a permeative pattern of bone destruction. Periosteal reaction was seen in three of 13 lesions. T1-weighted images (T1WIs) demonstrated signal intensity iso- to slightly hyperintense to muscle. T2-weighted images (T2WIs) demonstrated mildly higher signal intensity than that of muscle. The 5-year survival rate was 53%. The tumor arose secondarily in pre-existing lesions in 43% of patients. Metastases occurred in 46% of patients during the course of the disease, with pulmonary and osseous metastases being the most common. Secondary MFH of bone was slightly less common than primary MFH and had a prognosis similar to that of primary MFH of bone. MR imaging showed variable and somewhat unusual low to intermediate T2 signal characteristics for a radiographically malignant osteolytic lesion.

Side population cells have the characteristics of cancer stem-like cells/cancer-initiating cells in bone sarcomas

Background:Several human cancers have been found to contain cancer stem-like cells (CSCs) having cancer-initiating ability. However, only a few reports have shown the existence of CSCs in bone and soft tissue sarcomas. In this study, we identified and characterised side population (SP) cells that showed drug-resistant features in human bone sarcoma cell lines.Methods:In seven osteosarcoma cell lines (OS2000, KIKU, NY, Huo9, HOS, U2OS and Saos2) and in one bone malignant fibrous histiocytoma (MFH) cell line (MFH2003), the frequency of SP cells was analysed. Tumourigenicity of SP cells was assessed in vitro and in vivo. Gene profiles of SP cells and other populations (main population; MP) of cells were characterised using cDNA microarrays.Results:SP cells were found in NY (0.31%) and MFH2003 (5.28%). SP cells of MFH2003 formed spherical colonies and re-populated into SP and MP cells. In an NOD/SCID mice xenograft model, 1 × 103 sorted SP cell-induced tumourigenesis. cDNA microarray analysis showed that 23 genes were upregulated in SP cells.Conclusions:We showed that SP cells existed in bone sarcoma cell lines. SP cells of MFH2003 had cancer-initiating ability in vitro and in vivo. The gene profiles of SP cells could serve as candidate markers for CSCs in bone sarcomas.

Scalp metastasis from malignant fibrous histiocytoma of bone

Malignant fibrous histiocytoma (MFH) of bone is a relatively rare primary malignant neoplasm and an aggressive tumor, characterized by a high frequency of local recurrence and distant metastasis. The most common metastatic site is the lung (>80%), followed by bone and regional lymph node. Metastasis to other sites is extremely rare. In this report, we describe the skin as being the initial metastatic site for MFH of bone. A 42-year-old female presented with a bone tumor involving the right proximal tibia. She underwent tumor excision and knee joint reconstruction. Histologic examination confirmed a striform-pleomorphic type of MFH of bone. Six months postoperatively, the patient developed a scalp metastasis. Wide local excision was performed. Six months after the scalp operation, the patient was alive with no further relapse. We should keep the skin in mind as the possible initial site of metastatic MFH of bone.