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

Abstract

Background Low-grade myofibroblastic sarcoma (LGMS) is described as a distinct atypical myofibroblastic tumor often with fibromatosis-like features and predilection for the head and neck, especially the oral cavity and larynx. LGMS arising in the levator scapulae muscle is extremely rare. Case presentation A 69-year-old woman was admitted to our hospital because she noticed a hard mass in her left neck six months prior. Magnetic resonance images (MRI) showed a soft tissue tumor of the left levator scapulae muscle. A core needle biopsy showed cellular fascicles or a storiform growth pattern of spindle-shaped tumor cells with minimally atypia. Immunohistochemistry revealed focally positive for α-smooth muscle actin (α-SMA), negative for S-100, and a low-grade spindle cell sarcoma was suspected. Following a biopsy, the tumor was resected with a wide surgical margin. Immunohistochemical staining was a positive for vimentin and α-SMA and negative for desmin, CD34, nuclear β-catenin, and h-caldesmon. LGMS diagnosis was determined based on the histopathological findings. The patient was alive with no evidence of disease eight years after the surgery. Conclusions To the best of our knowledge, this is the first case report of LGMS arising in the levator scapulae muscle. In addition to the case report, 48 reports with 103 LGMS cases are reviewed and discussed. In previous reports of LGMS, there were 43 females and 60 males, with a mean age of 43.0 years (range, 2–75). There were 13 (12.6%) patients aged < 18 years, 67 (65.1%) patients aged 18 to 59 years, and 23 (22.3%) patients aged ≥60 years. The average tumor size was 4.4 cm (range: 0.4–22.0). The commonest sites of LGMS was the tongue. Tumor growth patterns were evaluated in 52 cases, and 44 cases (84.6%) showed infiltrative growth patterns. Local recurrence was 26.7%, and distant metastasis was 4.4%. Because of the locally aggressive feature, it is important to diagnose LGMS with biopsy and to excise the tumor with an adequately wide margin.

Low grade myofibroblastic sarcoma in paraspinal location: A case report with review of literature

“…5 LGMS was first enlisted in the WHO bone and soft tissue blue book in the year 2002 and is still referred as a distinguished entity in the fibroblastic/ myofibroblastic tumor category. 6 Here we report a 22 year old young girl who presented with neck pain and a slowly growing mass in the cervical paraspinal region. She was evaluated thoroughly and core biopsy was performed initially.…”

Low-grade myofibroblastic sarcoma of the proximal femur: A case report and literature review

“…[ 2 ] LGMS has been reported to occur in deep soft tissues with predilection for the head and neck. [ 3 ] However, according to previous study by Kim et al, [ 4 ] the incidence of LGMS in the extremities or trunk may be higher than expected. Based on the rarity of this condition, this study aims to introduce a case report of LGMS in proximal femur and to perform a review of relevant literature.…”

Clinical Outcome of Low-Grade Myofibroblastic Sarcoma in Japan: A Multicenter Study from the Japanese Musculoskeletal Oncology Group

“…However, because it is a low-grade malignant tumor, distant metastasis is rare. Four small retrospective observational studies [ 1 , 3 , 4 , 5 ], two analytical studies using the Surveillance, Epidemiology, and End Results (SEER) database [ 6 , 7 ], and multiple case reports [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 ] have been reported to date. Because the local relapse rate is higher with simple excision than with wide excision, wide excision is generally the recommended treatment method.…”