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Area of Science:

  • Oncology
  • Pathology
  • Surgical Oncology

Background:

  • Ischemic fasciitis is a rare pseudosarcomatous fibroblastic lesion, typically benign and affecting the elderly.
  • Long-term natural history and follow-up data for ischemic fasciitis are limited.
  • Standard excision often lacks specific attention to margins.

Purpose of the Study:

  • To investigate the potential precursor role of ischemic fasciitis in malignancy.
  • To report a case of ischemic fasciitis progressing to myxofibrosarcoma.
  • To evaluate the adequacy of standard excision for ischemic fasciitis.

Main Methods:

  • Case presentation of a 94-year-old female with shoulder ischemic fasciitis.
  • Three-year follow-up detailing multiple re-excisions for recurrence.
  • Histopathological comparison between ischemic fasciitis and myxofibrosarcoma.

Main Results:

  • The patient's ischemic fasciitis recurred multiple times over three years.
  • The lesion ultimately progressed to a high-grade malignancy, identified as myxofibrosarcoma.
  • Histological similarities were noted between ischemic fasciitis and myxofibrosarcoma.

Conclusions:

  • Ischemic fasciitis may serve as a precursor lesion to myxofibrosarcoma.
  • The histological features of ischemic fasciitis resemble those of sarcoma.
  • Complete excision with negative margins is advised for initial treatment to prevent recurrence.