Fibrous lesions of bone

Fibrous lesions of bone include entities with a wide range of radiographic appearance and clinical behavior. Many benign fibrous lesions, such as medial supracondylar defects, fibrous cortical defects, and nonossifying fibromas have typical radiographic appearances and usually are self-limited. Desmoplastic fibromas and benign fibrous histiocytomas are less common, behave more aggressively, and usually require biopsy and surgical management. Fibrous dysplasia varies from solitary clinically unimportant lesions to wide-spread, deforming skeletal involvement that can lead to severe functional impairment and, rarely, even to death. Malignant fibrous lesions, including malignant fibrous histiocytomas and fibrosarcoma, produce aggressive lytic lesions, which require careful anatomic staging, accurate biopsy, and aggressive and appropriate treatment.