Indolent growth of low-grade myofibroblastic sarcoma of the cheek mimics benign lesions: A case report and literature review

Abstract

Low-grade myofibroblastic sarcoma (LGMS) is a neoplasm of the soft tissue characterized by myofibroblastic differentiation. This type of tumor has been observed in various sites in the whole body, but frequently occurs in the head and neck region. It typically presents as a slow-growing painless mass, which is often mistaken for a benign lesion due to its indolent growth; however, LGMS is a malignant neoplasm. In the present study, a 43-year-old female presented with a 14-mm LGMS lesion in the buccal subcutaneous tissues of the buccinator muscle. The patient had initially noticed the lesion 2-months prior to presenting at the hospital. Following biopsy, the tumor was surgically resected and no recurrence or metastasis was observed during a follow-up time of 2 years. To the best of our knowledge, this case is the first report of LGMS located in the buccal subcutaneous tissue of the buccinator muscle. The present study a literature review of 55 cases of this tumor type in the head and neck region was conducted, revealing that the indolent growth of these lesions may contribute to a delay in diagnosis. The average time between the onset of clinical symptoms and hospital admission is 3.9 months, and this form of tumor is frequently misdiagnosed as a benign lesion. Therefore, the present study suggests that an incisional biopsy may be performed to rule out LGMS when clinicians encounter patients with the aforementioned indolent lesions anywhere in the body. In addition, the avoidance of radiotherapy is recommended following resection of the LGMS tumor, as it may induce LGMS recurrence.

Low-grade myofibroblastic sarcoma of the levator scapulae muscle: a case report and literature review

“…Gadolinium enhancement T1WI showed enhancement of the tumor [ 22 , 41 ]. The border of the tumor on the MRI was varied; some author reported well demarcated tumor [ 7 , 13 , 44 ], but the others were ill-defined [ 10 , 41 , 42 ]. Morii et al [ 41 ] and Niu et al [ 50 ] reported the usefulness of 18 F-Fluorodeoxyglucose-positron emission tomography (FDG-PET)/ computed tomography (CT) for diagnosing LGMS.…”

“…LGMS is described as a distinct atypical myofibroblastic tumor, often with fibromatosis-like features and predilection for the head and neck [ 2 ]. Oral cavity [ 1 , 3 – 16 ] and larynx [ 17 – 20 ] cases are common, but a variety of tissues, including skin [ 21 – 23 ], breast [ 24 , 25 ], vulva [ 26 , 27 ], parapharyngeal space [ 28 ], jaw [ 1 , 10 ], nasal cavity [ 29 ], paranasal sinus [ 29 ], soft tissue of the cheek [ 7 , 23 ], and palate [ 3 , 30 ] have also been reported. LGMS has been characterized as having a low-grade malignant potential, the propensity to recur locally, and a low likelihood of distant metastases [ 1 , 6 , 31 ].…”

Effective Treatment of Low-Grade Myofibroblastic Sarcoma with Apatinib: A Case Report and Literature Review

“…2 LGMS is an atypical tumor composed of myofibroblasts, which are spindle-shaped mesenchymal cells present in almost every soft tissue. 3 It presents as a slow-growing, painless mass, and is often mistaken for a benign lesion. LGMS occurs most often in adults and predominantly in men of an average age of 40 years (age range: 9–75 years).…”

A rare low-grade myofibroblastic sarcoma in lower jaw with the resemblance to benign lesions

“…The etiology of LGMS is unknown. This solid infiltrative soft tissue tumor occurs in various sites of the body with a predilection for the head and neck region, particularly the tongue followed by the mandible, neck, larynx, palate, maxilla and lips [ 2 ]. Patients’ mean age is 40 years, but it has been reported in all age groups [ 3 ].…”