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Myxofibrosarcoma with an infiltrative growth pattern: a case report
1Department of Orthopaedic Surgery, Sapporo Medical University, School of Medicine, Japan. twada@sapmed.ac.jp
Japanese Journal of Clinical Oncology
|February 24, 2001
Summary
Myxofibrosarcoma, a common elderly extremity sarcoma, can present without a distinct mass. Its infiltrative growth pattern necessitates thorough radiological assessment for early detection and treatment.
Area of Science:
- Oncology
- Pathology
- Radiology
Background:
- Myxofibrosarcoma is a common sarcoma in elderly extremities, known for frequent local recurrence.
- It is a myxoid variant of malignant fibrous histiocytoma.
Observation:
- A case of intermediate-grade myxofibrosarcoma in the thigh presented with diffuse infiltration along fascial planes and between muscles, lacking a nodular lesion.
- Microscopic examination revealed a highly cellular tumor with spindle cells, hyperchromatic nuclei, and a storiform pattern, but no necrosis or significant pleomorphism.
Findings:
- Immunohistochemistry showed vimentin and CD34 reactivity, with over 20% p53 positivity and a MIB-1 labeling index of ~30%.
- Markers such as desmin, S-100, cytokeratin, and bcl-2 were negative.
- The tumor's infiltrative nature, without a discrete mass, hindered early recognition.
Implications:
- This case highlights the infiltrative growth potential of myxofibrosarcoma, potentially linked to high local recurrence rates.
- Preoperative radiological evaluation is crucial to determine tumor extent due to its infiltrative behavior.
- Despite the infiltrative nature, the patient remained disease-free for seven years post-amputation.