Clinical Characteristics And Follow-up Analysis Of 24 Cases Of Primary Bone Malignant Fibrous Histiocytoma

BackgroundPrimary malignant fibrous histiocytoma of bone is a rare malignant bone tumor,accounting for 0.78%of malignant bone tumors,and there is a significant gender difference in the incidence.Because the initial course of the disease is slow and there is no significant specific clinical characteristics,the initial local pain or swelling is easy to be ignored.This project will explore the diagnostic criteria for primary malignant fibrous histiocytoma of bone through imaging examination and pathological analysis,and explore the reasonable diagnosis and treatment plan and prognostic rehabilitation plan by following up the prognosis of patients with different treatment plans.ObjectiveTo summarize and analyze the imaging and prognostic features of primary malignant fibrous histiotoma(MFH).MethodsThe preoperative imaging data,diagnosis basis and treatment process of 24 patients with MFH from October 2000 to January 2011 in our hospital were collected retrospectively and followed up.ResultsAll 24 patients were confirmed by postoperative pathology.The pathological coincidence rate of preoperative puncture biopsy was 75.00%.The diagnostic coincidence rate of X-ray images was 14.44%.The diagnostic coincidence rate of MRI was 66.67%.Typical MRI findings showed that bone lesions on T2WI showed slightly higher medium signal than muscle tissue.Radical resection was performed in 18 cases and chemotherapy was applied in 15 cases.The recurrence rate was 18.20%and the metastasis rate was 33.33%.Metastasis occurred 3-90 months after operation.Amputation was performed in 3 cases without chemotherapy.The recurrence rate was 33.33%and there was no metastasis.Six cases of simple tumor were resected without adjuvant chemotherapy.The recurrence rate was 100%,and the metastasis rate was 83.3%.Metastasis occurred 3～45 months after operation.ConclusionMetastasis in patients with primary bone MFHb mainly occurred 3 months after surgery,while metastasis in patients with radical surgery combined with radiotherapy and chemotherapy occurred 25 months after surgery.Preoperative biopsy pathology is helpful for disease diagnosis.Postoperative adjuvant chemotherapy is helpful to reduce the recurrence rate and metastasis rate of MFH.