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Related Experiment Video

Updated: Jan 19, 2026

Acetylcholine Re-Challenge After Intracoronary Nitroglycerine Administration
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Fibrosarcoma: a challenging diagnosis.

Cristiane Rúbia Ferreira1, Leonardo Gomes da Fonseca2, Gustavo Henrique Munhoz Piotto2

  • 1Anatomic Pathology Service - Hospital Universitário - Universidade de São Paulo, São Paulo/SP - Brazil.

Autopsy & Case Reports
|September 19, 2019
PubMed
Summary

Diagnosing rare soft tissue tumors like fibrosarcoma is challenging. This case highlights a hybrid low-grade fibromyxoid sarcoma-sclerosing epithelioid fibrosarcoma, emphasizing the need for extensive immunohistochemistry and clinical correlation.

Keywords:
Drug TherapyFibrosarcomaMUC4 protein, humanSurgical Procedures, Operative

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Area of Science:

  • Oncology
  • Pathology
  • Dermatology

Background:

  • Fibrosarcomas are rare soft tissue malignancies originating from fibrous connective tissue.
  • Subtypes include low-grade fibromyxoid sarcoma (LGFMS) and sclerosing epithelioid fibrosarcoma (SEF).
  • Histological overlap between fibrosarcoma subtypes is a known diagnostic challenge.

Observation:

  • A 53-year-old patient presented with an axillary tumor initially diagnosed as a solitary fibrous tumor.
  • Recurrence and metastases prompted re-evaluation, leading to a differential diagnosis of breast metaplastic carcinoma due to p63 and hormone receptor expression.
  • Chemotherapy resistance necessitated further investigation.

Findings:

  • Immunohistochemical analysis revealed MUC4 expression and specific morphological features.
  • The final diagnosis was a hybrid LGFMS-SEF tumor.
  • This case underscores the diagnostic complexities in soft tissue tumors.

Implications:

  • Accurate diagnosis of soft tissue tumors requires a comprehensive immunohistochemical panel.
  • Clinical course and patient history are crucial for definitive diagnosis.
  • Distinguishing between fibrosarcoma subtypes and other malignancies is critical for appropriate treatment and prognosis.