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High-Grade Pleomorphic Undifferentiated Sarcoma of Bone

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  • There is benign variant histologically similar in the cervical spinous processes
  • Aggressive osteolysis, premeative, destructive tumor growth centrally located in the metaphysis of long bones
  • Sequestrum may be seen
  • Most common site is distal femoral and proximal tibial metaphysis
  • Diaphyseal involvement in < 10%
  • Periosteal reaction is reported rare to frequent, cortical expansion infrequent
  • May appear as a cold defect on bone scan
  • MRI: Inhomogeneous, nodular pattern with peripheral Gd-DTPA enhancement on T1- and T2-weighted images
  • ? extraosseous ± extraosseous extension (80-100% reported)
  • ? joint ± joint invasion (up to 50%)

GROSS PATHOLOGY

  • Extensive permeation of host bone
  • ? soft ± soft tissue mass

HISTOLOGIC FEATURES

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