Low-Grade Fibromyxoid Sarcoma in the Left Gluteal Region Presenting as Sciatic Nerve Pain

Abstract

Low-grade fibromyxoid sarcoma is a slowly growing soft tissue neoplasm, mostly affecting young individuals. It usually arises in a deep soft tissue of the lower limbs and trunk, but few cases of low-grade fibromyxoid sarcoma that presents sciatic nerve pain have been reported. We report a 34-year-old woman with a low-grade fibromyxoid sarcoma originating in the left gluteal region that initially presented as sciatic nerve pain; she had experienced this type of pain for 5 years before visiting our hospital. Magnetic resonance imaging revealed a tumor in the left gluteal region. After needle biopsy revealed it to be a low-grade fibromyxoid sarcoma, we performed the wide resection. Intra-operative findings revealed no tumor invasion into the sciatic nerve. No recurrence or metastasis has been detected 6 months post-surgery. Oncologists who encounter patients with sciatic nerve pain should consider the possibility of less common causes such as the low-grade fibromyxoid sarcoma found in our patient.

The diagnostic pitfalls of lumbar disc herniation---- malignant sciatic nerve tumour: two case reports and literature review

“…To date, the relevant reports on sciatic nerve tumours misdiagnosed as LDH are case reports [ 4 – 10 , 14 , 20 , 21 ]. We systematically reviewed these reported cases.…”

“…The common clinical manifestations of these patients usually include sciatica, followed by atrophy, tenderness on deep intragluteal palpation, positive Tinel’s sign, positive Laseque’s sign, plantar flexion weakness, and a decreased ankle reflex [ 4 – 14 ]. It is worth considering that when patients present with unrelenting pain at rest, the possibility of tumours should be borne in mind, and proper imaging techniques should be used [ 10 , 11 , 14 , 15 ]. In 2019, Fernando Guedes et al [ 5 ] reported a patient with low-grade sarcoma who was misdiagnosed with LDH.…”