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Undifferentiated Pleomorphic Sarcoma of Bone
Behrang Amini, MD, PhD; B. J. Manaster, MD, PhD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Undifferentiated pleomorphic sarcoma (UPS)
              • Synonyms

                • Not recommended: malignant fibrous histiocytoma of bone, pleomorphic fibrosarcoma of bone
              • Definitions

                • Pleomorphic malignant neoplasm of bone with no identifiable line of differentiation
                • Diagnosis of exclusion

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • MR Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Berkeley R et al: The rare primary bone sarcomas: imaging-pathological correlation. Skeletal Radiol. 50(8):1491-511, 2021
                                            2. Inwards CY et al: Undifferentiated pleomorphic sarcoma. In Fletcher CDM et al: WHO Classification of Tumours: Tumours of Soft Tissue and Bone. IARC Press. 480-2, 2020
                                            3. Malik AT et al: Malignant fibrous histiocytoma of bone: a survival analysis from the National Cancer Database. J Surg Oncol. 121(7):1097-103, 2020
                                            4. Qu N et al: Malignant transformation in monostotic fibrous dysplasia: clinical features, imaging features, outcomes in 10 patients, and review. Medicine (Baltimore). 94(3):e369, 2015
                                            5. Koplas MC et al: Imaging findings, prevalence and outcome of de novo and secondary malignant fibrous histiocytoma of bone. Skeletal Radiol. 39(8):791-8, 2010
                                            6. Domson GF et al: Infarct-associated bone sarcomas. Clin Orthop Relat Res. 467(7):1820-5, 2009
                                            7. Min WK et al: Malignant fibrous histiocytoma arising in the area of total hip replacement. Joint Bone Spine. 75(3):319-21, 2008
                                            8. Richter H et al: Malignant fibrous histiocytoma associated with remote internal fixation of an ankle fracture. Foot Ankle Int. 27(5):375-9, 2006
                                            9. Tarkkanen M et al: Malignant fibrous histiocytoma of bone: analysis of genomic imbalances by comparative genomic hybridisation and C-MYC expression by immunohistochemistry. Eur J Cancer. 42(8):1172-80, 2006
                                            10. Zlowodzki M et al: Case reports: malignant fibrous histiocytoma of bone arising in chronic osteomyelitis. Clin Orthop Relat Res. 439:269-73, 2005
                                            11. Murphey MD et al: From the archives of the AFIP. Musculoskeletal malignant fibrous histiocytoma: radiologic-pathologic correlation. Radiographics. 14(4):807-26; quiz 827-8, 1994
                                            12. Yokoyama R et al: Prognostic factors of malignant fibrous histiocytoma of bone. A clinical and histopathologic analysis of 34 cases. Cancer. 72(6):1902-8, 1993
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Pathology

                                                    • Clinical Issues

                                                      • Diagnostic Checklist

                                                        TERMINOLOGY

                                                        • Abbreviations

                                                          • Undifferentiated pleomorphic sarcoma (UPS)
                                                        • Synonyms

                                                          • Not recommended: malignant fibrous histiocytoma of bone, pleomorphic fibrosarcoma of bone
                                                        • Definitions

                                                          • Pleomorphic malignant neoplasm of bone with no identifiable line of differentiation
                                                          • Diagnosis of exclusion

                                                        IMAGING

                                                        • General Features

                                                          • Radiographic Findings

                                                            • CT Findings

                                                              • MR Findings

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Staging, Grading, & Classification

                                                                        • Gross Pathologic & Surgical Features

                                                                          • Microscopic Features

                                                                            CLINICAL ISSUES

                                                                            • Presentation

                                                                              • Demographics

                                                                                • Natural History & Prognosis

                                                                                  • Treatment

                                                                                    DIAGNOSTIC CHECKLIST

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Berkeley R et al: The rare primary bone sarcomas: imaging-pathological correlation. Skeletal Radiol. 50(8):1491-511, 2021
                                                                                      2. Inwards CY et al: Undifferentiated pleomorphic sarcoma. In Fletcher CDM et al: WHO Classification of Tumours: Tumours of Soft Tissue and Bone. IARC Press. 480-2, 2020
                                                                                      3. Malik AT et al: Malignant fibrous histiocytoma of bone: a survival analysis from the National Cancer Database. J Surg Oncol. 121(7):1097-103, 2020
                                                                                      4. Qu N et al: Malignant transformation in monostotic fibrous dysplasia: clinical features, imaging features, outcomes in 10 patients, and review. Medicine (Baltimore). 94(3):e369, 2015
                                                                                      5. Koplas MC et al: Imaging findings, prevalence and outcome of de novo and secondary malignant fibrous histiocytoma of bone. Skeletal Radiol. 39(8):791-8, 2010
                                                                                      6. Domson GF et al: Infarct-associated bone sarcomas. Clin Orthop Relat Res. 467(7):1820-5, 2009
                                                                                      7. Min WK et al: Malignant fibrous histiocytoma arising in the area of total hip replacement. Joint Bone Spine. 75(3):319-21, 2008
                                                                                      8. Richter H et al: Malignant fibrous histiocytoma associated with remote internal fixation of an ankle fracture. Foot Ankle Int. 27(5):375-9, 2006
                                                                                      9. Tarkkanen M et al: Malignant fibrous histiocytoma of bone: analysis of genomic imbalances by comparative genomic hybridisation and C-MYC expression by immunohistochemistry. Eur J Cancer. 42(8):1172-80, 2006
                                                                                      10. Zlowodzki M et al: Case reports: malignant fibrous histiocytoma of bone arising in chronic osteomyelitis. Clin Orthop Relat Res. 439:269-73, 2005
                                                                                      11. Murphey MD et al: From the archives of the AFIP. Musculoskeletal malignant fibrous histiocytoma: radiologic-pathologic correlation. Radiographics. 14(4):807-26; quiz 827-8, 1994
                                                                                      12. Yokoyama R et al: Prognostic factors of malignant fibrous histiocytoma of bone. A clinical and histopathologic analysis of 34 cases. Cancer. 72(6):1902-8, 1993