Aggressive myxoinflammatory fibroblastic sarcoma with multiple site metastases

Abstract

Myxoinflammatory fibroblastic sarcoma (MIFS) is a rare soft tissue sarcoma which was initially observed in acral sites and characterised by spindle cells, pleomorphic bizarre cells and distinctive large Reed-Sternberg-like cells admixed with an intense inflammatory cell infiltrates. MIFS manifests as a slow growing often superficial lesion which can be mistaken as infectious or chronic inflammatory process or benign tumours such as nodular fasciitis, giant cell tumour of tendon sheath or synovial pseudocyst. We report a rare presentation of a MIFS in a 38-year-old man with extensive local spread from subcutaneous tissue to the ankle joint and bones as well as multiple synchronous metastases to lung, sixth rib and vertebra. Our case is peculiar for its aggressive clinical behaviour with short duration, fast growth and extensive metastases, a feature infrequent in MIFS.

Report of two cases of myxoinflammatory fibroblastic sarcomas with preceding hematolymphoid neoplasms: Is there any association?

“… 2 Clinical symptoms resemble benign tumors, ganglion cyst, lipoma, fibroma, and inflammatory processes. 3 , 4 , 5 Some cases of MIFS have been reported in uncommon sites including the upper back, scapula, head, and cervicothoracic region. 2 , 4 , 6 , 7 Etiologic causes and risk factors are unknown.…”

“… 3 , 4 , 5 Some cases of MIFS have been reported in uncommon sites including the upper back, scapula, head, and cervicothoracic region. 2 , 4 , 6 , 7 Etiologic causes and risk factors are unknown. Only one study has reported a history of renal transplantation in one case.…”

“… 9 MIFS has been associated with t (1,10)(p22, q24) resembles hemosiderotic fibrolipomatous tumor and pleomorphic hyalinizing angiectatic tumor; therefore, MIFS has no characteristic immunohistochemistry and FISH. 2 , 4 , 8 MIFS is a postoperative diagnosis and clinicopathologic correlation is necessary for diagnosis. 2 , 6 MIFS has a high rate of local recurrence of about 22%–67%, a low rate of metastasis, about 2%, and a low mortality rate, but some cases of MIFS with inguinal lymph node involvement, liver, lung, and vertebra metastasis has been reported.…”

“… 2 , 6 MIFS has a high rate of local recurrence of about 22%–67%, a low rate of metastasis, about 2%, and a low mortality rate, but some cases of MIFS with inguinal lymph node involvement, liver, lung, and vertebra metastasis has been reported. 3 , 4 , 7 The patient needs wide local excision with a clear margin, follow‐up for 5 years after surgery for local recurrence and radiological examination for metastasis evaluation. 3 We presented two cases of challenging MIFS.…”

“…MIFS is a slow‐growing, subcutaneous mass in the distal extremities, especially the upper extremities 2 . Clinical symptoms resemble benign tumors, ganglion cyst, lipoma, fibroma, and inflammatory processes 3–5 . Some cases of MIFS have been reported in uncommon sites including the upper back, scapula, head, and cervicothoracic region 2,4,6,7 .…”