SARCOMA IN ASSOCIATION WITH BONE INFARCTS - REPORT OF 5 CASES

Sarcoma associated with bone infarct is rare, and only 43 well-documen ted cases have been published. We describe five additional patients, t hree women and two men, aged 39 to 57 years. The tumors involved the f emur (three patients), tibia (one patient), and humerus (one patient). In three patients, the infarcts were idiopathic. Radiologic evidence of malignancy was found in all patients, and bone infarcts were suspec ted in four. Four of the patients had malignant fibrous histiocytoma a nd one an osteosarcoma. Histologically, bone infarcts were seen in all patients, but in three they were mostly replaced by tumor. Portions o f intact infarcts were seen adjacent to the tumor, indicating that the y had preceded the development of the sarcoma. No hypercellular or aty pical reparative tissue was found in the infarcted bones or in three a dditional uncomplicated infarcts studied from the same patients. The p athogenesis of sarcoma arising in bone infarct is unknown. The prognos is is poor; four of our five patients died within 2 years.