Tumors of Fibrous Tissue Origin

  • Claus-Peter Adler
  • Kazimierz Kozlowski


Among all primary bone tumors nonossifying fibroma is the most frequently occurring one in children and adolescents. It is questionable whether it is a true neoplasm because it usually undergoes a spontaneous resolution later in life. The lesion is fibrous and appears as an osteolytic,cystic defect in the metaphysis of a bone and is well delimited by a grape-like marginal sclerosis consisting of fibrous tissue in a whorled pattern and including histiocytes,foam cells and multinucleated giant cells. No bone formation is seen within the lesion. It develops eccentrically in a bone and, in contrast to metaphyseal fibrous cortical defect, expands towards the cortex from the inside which will be rarefied. Many nonossifying bone fibromas are detected accidentally, i.e. they are symptomless. Multiple lesions simultaneously in different bones do occur.


Fibrous Dysplasia Multinucleated Giant Cell Malignant Fibrous Histiocytoma Giant Cell Tumor Fibrous Histiocytoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Adler CP. Klassifikation der Knochentumoren und Pathologie der gutartigen und - semimalignen Knochentumoren. In: Frommhold W, Gerhardt P. Knochentumoren. Klinisch-radiologisches Seminar, vol. X. Stuttgart: Thieme, 1980Google Scholar
  2. Adler CP. Fibromyxoma of bone within the femoral neck and the tibial head. J Cancer Res Clin Oncol 1981; 101: 183–9PubMedCrossRefGoogle Scholar
  3. Adler CP, Reinartz H. Fleckige Osteosklerose des Tibaischaftes: Osteofibröse Knochendysplasie Campanacci der linken Tibia. Radiologe 1988; 28: 591–2PubMedGoogle Scholar
  4. Adler CP, Uehlinger E. Grenzfälle bei Knochentumoren. Präneoplastische Veränderungen und Geschwülste fraglicher Dignität. Verh Dtsch Ges Pathol 1979; 63: 352–8Google Scholar
  5. Bagò-Granell J, Aquirre-Canyadell M, Nardi J, Tallada N. Malignant fibrous histiocytoma of bone at the site of a total hip arthroplasty: a case report. J Bone Jt Surg 1984; B-66:38–40Google Scholar
  6. Bullough PG, Walley J. Fibrous cortical defect and non-ossifying fibroma. Postgrad Med J 1965; 41: 672–6PubMedCrossRefGoogle Scholar
  7. Caballes RL. The mechanism of metastasis in so-called “benign giant cell tumors of bone”. Hum Pathol 1981; 12: 762–7PubMedCrossRefGoogle Scholar
  8. Caffey J. On fibrous defects in cortical walls of growing tubular bones. Adv Pediat 1955; 7: 13–51Google Scholar
  9. Campanacci M, Giunti A, Olmi R. Giant-cell tumors of bone: a study of 209 cases with long-term follow-up in 130. Ital J Orthop Traumatol 1975; 1: 249–77Google Scholar
  10. Cohen DM, Dahlin DC, Pugh DG. Fibrous dysplasia associated with adamantinoma of the long bones. Cancer (Phil) 1962; 15: 515–21CrossRefGoogle Scholar
  11. Cunningham JB, Ackerman LV. Metaphyseal fibrous defects. J Bone Jt Surg 1956;A-38:797–808Google Scholar
  12. Dahlin DC, Ivins JC. Fibrosarcoma of bone: a study of 114 cases. Cancer (Phil) 1969; 23: 35–41CrossRefGoogle Scholar
  13. Dahlin DC, Unni KK, Matsuno T. Malignant (fibrous) Primary Bone Tumors and Tumorous Conditions in Children histiocytoma of bone — fact or fancy? Cancer (Phil) 1977; 39: 1508–16CrossRefGoogle Scholar
  14. Feldman F, Lattes R. Primary malignant fibrous histiocytoma (fibrous xanthoma) of bone. Skeletal Radiol 1977; 1: 145–60CrossRefGoogle Scholar
  15. Frazer AK, Hannah RH, Buxton PH. Fibrous dysplasia of the ethmoid presenting with proptosis. Br J Surg 1969; 56: 300–5PubMedCrossRefGoogle Scholar
  16. Goldenberg RR, Campbell CJ, Bonfiglio M. Giant-cell tumor of bone: an analysis of two hundred and eighteen cases. J Bone Jt Surg 1970;A-52:619–63Google Scholar
  17. Gunterberg B, Kindblom LG, Laurin S. Giant-cell tumor of bone and aneurysmal bone cyst. A correlated histologic and angiographic study. Skeletal Radiol 1977; 2: 65–74CrossRefGoogle Scholar
  18. Haag M, Alder CP. Malignant fibrous histiocytoma in association with hip replacement. J Bone Jt Surg 1989; B-71:701Google Scholar
  19. Henry A. Monostotic fibrous dysplasia. J Bone Jt Surg 1969; B-51:300–6Google Scholar
  20. Huvos AG. Primary malignant fibrous histiocytoma of bone. Clinicopathologic study of 18 patients. NY St J Med 1976; 76: 552–9Google Scholar
  21. Kempson RL. Ossifying fibroma of the long bones. A light and electron microscopic study. Arch Pathol 1966; 82: 218–33PubMedGoogle Scholar
  22. Jaffe HL, Lichtenstein L, Portis RB. Giant cell tumor of bone. Its pathologic appearance, grading, supposed variants and treatment. Arch Pathol 1940; 30: 993–1031Google Scholar
  23. Johnston J. Giant cell tumor of bone. The role of the giant cell in orthopedic pathology. Orthop Clin N Am 1977; 8: 751–70Google Scholar
  24. Kasahara K, Yamamuro T, Kasahara A. Giant cell tumour of bone: cytological studies. Br J Cancer 1979; 40: 201–9PubMedCrossRefGoogle Scholar
  25. Kempson RL. Ossifying fibroma of the long bones. A light and electron microscopic study. Arch Pathol 1966; 82: 218–33PubMedGoogle Scholar
  26. Kumar R, Madewell JE, Lindell MM, Swischuk LE. Fibrous lesions of bones. Radiographics 1990; 10: 237–56PubMedGoogle Scholar
  27. Lichtenstein L. Giant-cell tumor of bone. Current status of problems in diagnosis and treatment. J Bone Jt Surg 1951;A-33:143–50Google Scholar
  28. McCarthy EF, Matsuno T, Dorfman HD. Malignant fibrous histiocytoma of bone: A study of 35 cases. Hum Pathol 1979; 10: 57–70PubMedCrossRefGoogle Scholar
  29. McGrath PJ. Giant cell tumor of bone. An analysis of 52 cases. J Bone Jt Surg 1972;B-54:216–19Google Scholar
  30. Meister P, Finsterer H. Der Riesenzelltumor des Knochens and seine Problematik. Munch Med Wschr 1972; 114: 55–60PubMedGoogle Scholar
  31. Meister P, Konrad E, Engert J. Polyostotische fibröse kortikale Defekte (bzw. nicht ossifizierende Knochenfibrome). Arch Orthop Trauma Surg 1977; 89: 315–18Google Scholar
  32. Mellin W, Roessner A, Grundmann E, Wörmann B, Hiddemann W, Immenkamp M. Biological characterization of human bone tumors. VII. Detection of malignancy in a giant cell tumor of bone by flow cytometric DNA-analysis. Pathol Res Pract 1985; 180: 619–25PubMedCrossRefGoogle Scholar
  33. Michael RH, Dorfman HD. Malignant fibrous histiocytoma associated with bone infarcts. Report of a case. Clin Orthop 1976; 118: 180–3PubMedGoogle Scholar
  34. Mirra JM, Ulich T, Magidson J, Kaiser L, Eckardt J, Gold R. A case of probable benign pulmonary “metastases” of implants arising from a giant cell tumor of bone. Clin Orthop 1980; 162: 245–54Google Scholar
  35. Rock MG, Pritchard DJ, Unni KK. Metastases from histologically benign giant cell tumor of bone. J Bone Jt Surg 1984;A-66:263–73Google Scholar
  36. Roessner A, v. Bassewitz DB, Schlake W, Thorwesten G, Grundmann E. Biologic characterization of human bone tumors. III. Giant cell tumor of bone. A combined electron microscopical, histochemical, and autoradiographical study. Pathol Res Pract 1984; 178: 431–40PubMedCrossRefGoogle Scholar
  37. Scaglietti O, Stringa G. Myxoma of bone in childhood. J Bone Jt Surg 1961;A-43:67–80Google Scholar
  38. Schajowicz F. Giant-cell tumors of bone (osteoclastoma). A pathological and histochemical study. J Bone Jt Surg 1961;A-43:1–29Google Scholar
  39. Selby S. Metaphyseal cortical defects in the tubular bones of growing children. J Bone Jt Surg 1961;A-43:395–400Google Scholar
  40. Spanier SS. Malignant fibrous histocytoma of bone. Orthop Clin N Am 1977; 8: 947–61Google Scholar
  41. Steiner GC. Fibrous cortical defect and nonossifying fibroma of bone. Arch Pathol 1974; 97: 205–10PubMedGoogle Scholar
  42. Uehlinger E., Osteofibrosis deformans juvenilis (Polyostotische fibröse Dysplasie Jaffe-Lichtenstein). Virchows Arch [A] 1940; 306: 255–99Google Scholar
  43. Yoshida H, Akeho M, Yumoto T. Giant cell tumor of bone. Enzyme histochemical, biochemical and tissue culture studies. Virchows Arch [A] 1982; 395: 319–30CrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Limited 1993

Authors and Affiliations

  • Claus-Peter Adler
    • 1
  • Kazimierz Kozlowski
    • 2
  1. 1.Reference Center of Bone Disease, Institute of PathologyUniversity of FreiburgFreiburg i. Br.Germany
  2. 2.Department of RadiologyThe Children’s HospitalCamperdown, SydneyAustralia

Personalised recommendations