The cytologic diagnosis of epithelioid myxofibrosarcoma: a case report

The epithelioid variant of myxofibrosarcoma is a rare but recently described entity. We report a case of an elderly woman who presented with a slowly enlarging mass of the right lower extremity. Fine-needle aspiration (FNA) cytology revealed a malignant epithelioid neoplasm. The smears of the aspirate material were highly cellular and contained a dominant population of cells with uniform round-to-oval nuclei and cytoplasmic vacuolization, arranged in loosely cohesive aggregates and linear arrays within a myxoid background. A second minor population of cells consisted of aggregates of bland spindled cells. On resection, the neoplasm proved to be an epithelioid myxofibrosarcoma. To our knowledge, the cytologic features of epithelioid myxofibrosarcoma have not previously been documented. Herein, we discuss the cytologic features of epithelioid myxofibrosarcoma as seen on FNA biopsy and its distinction from other epithelioid neoplasms of soft tissue.