从临床角度来讲，将肉瘤样癌与原发性肉瘤区分开来具有重要意义。我们旨在对转移性肉瘤样骨病及其治疗进行表征。我们分析了2001年至2021年间单个机构所有肉瘤样癌骨转移病例的特征，排除了存在非骨转移的患者。采用Kaplan-Meier方法评估生存情况。我们鉴定了15例转移性肉瘤样癌骨转移病例。其中7例患者在初次诊断时未知原发癌的存在。有9例病例疑似或经证实为肾细胞癌。9名患者出现了病理性骨折，2名患者伴有脏器转移。所有患者均接受了影像引导下的穿刺活检或开放活检。其中10例患者需接受手术治疗以处理离散的骨转移灶；其中有4例病例因无法通过冰冻切片检出肉瘤而延迟进行明确的手术治疗（延迟中位数为19天）。没有患者需要重新手术或出现构件的失效。13例患者死于疾病，中位生存期为17.5个月（四分位距为6.2-25.1）。转移性肉瘤样癌是一个临床挑战性的存在。多学科的参与和沟通是确定原发癌、定位骨转移灶以及确定手术修复方案以保证患者余生的关键。© 2023 Wiley Periodicals LLC.

Distinguishing sarcomatoid carcinoma from primary sarcoma is clinically important. We sought to characterize metastatic sarcomatoid bone disease and its management.We analyzed the characteristics of all cases of sarcomatoid carcinoma to bone at a single institution from 2001 to 2021, excluding patients with nonosseous metastases. Survival was evaluated using the Kaplan-Meier method.We identified 15 cases of metastatic sarcomatoid carcinoma to bone. In seven cases the primary cancer was unknown at presentation. Renal cell carcinoma was suspected or confirmed in nine cases. Nine patients presented with pathologic fracture and two with concomitant visceral metastases. All patients underwent image-guided core needle or open biopsy. Ten required surgery for discrete osseous metastases; in four cases definitive surgery was delayed (median delay, 19 days) due to inability to rule out sarcoma with frozen section. No patients required reoperation or had construct failure. Thirteen died of disease; median survival was 17.5 months (interquartile range, 6.2-25.1).Metastatic sarcomatoid carcinoma is a clinically challenging entity. Multidisciplinary input and communication are key to identifying the primary carcinoma, locating osseous metastases, and defining an operative fixation that will survive the remainder of the patient's life.© 2023 Wiley Periodicals LLC.