Myxofibrosarcoma of the leg: A diagnostic challenge

Rachdi, I.; Daoud, F.; Khanchel, Fatma; Arbaoui, I.; Somaï, M.; Zoubeidi, H.; Aydi, Z.; Dhaou, B. Ben; Debbiche, Achraf; Boussema, F.

doi:10.1002/ccr3.3414

Cited by 2 publications

(8 citation statements)

References 9 publications

(19 reference statements)

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“…1 Approximately one-third of these lesions involve the fascia and skeletal muscle. 4 In our case, the clinical manifestations included multiple subcutaneous masses and nodules on the right upper limb, which are easily misdiagnosed as multiple lipomas due to their deceptive nature. The metastatic potential of MFS is closely linked to its grade, with patients harboring highgrade tumors having a three to four times higher risk of metastasis compared to those with low-grade tumors.…”

Section: Discussionmentioning

confidence: 75%

“…Typically, the clinical presentation involves a slowly enlarging, painless dermal or subcutaneous mass, which is often solitary 1 . Approximately one‐third of these lesions involve the fascia and skeletal muscle 4 . In our case, the clinical manifestations included multiple subcutaneous masses and nodules on the right upper limb, which are easily misdiagnosed as multiple lipomas due to their deceptive nature.…”

Section: Discussionmentioning

confidence: 99%

“…The primary treatment of MFS typically involves wide surgical excision with a safety margin of at least 2 cm 6 . MFS is associated with a high local recurrence rate, ranging from 16% to 54%, particularly in cases with high tumor grade, tumor size exceeding 5 cm, and inadequate surgical margins 4 . In cases of intermediate to high‐grade tumors and instances where complete tumor removal is not feasible, radiation and chemotherapy may be recommended as supplementary treatment options 5 .…”

Section: Discussionmentioning

confidence: 99%

“…With an in‐depth understanding of tumor pathogenesis and biology, promising results have been achieved in immunotherapy, such as the use of anti‐programmed death‐1 protein/anti‐cytotoxic T‐lymphocyte‐associated protein 4 antibodies 14 . The overall 5‐year survival rate for MFS is approximately 60%–70% 4 . Prognosis is strongly influenced by factors including the histopathological grade, initial tumor size, and depth.…”

Section: Discussionmentioning

confidence: 99%

“…6 MFS is associated with a high local recurrence rate, ranging from 16% to 54%, particularly in cases with high tumor grade, tumor size exceeding 5 cm, and inadequate surgical margins. 4 In cases of intermediate to high-grade tumors and instances where complete tumor removal is not feasible, radiation and chemotherapy may be recommended as supplementary treatment options. 5 To optimize therapeutic outcomes, it is recommended to implement adjuvant radiotherapy for all deep-seated, high-grade tumors, irrespective of the status of surgical margins.…”

Section: F I G U R Ementioning

confidence: 99%

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Multiple cutaneous myxofibrosarcoma on the right arm: Clinicopathological features and differential diagnosis

Ruan,

Zhang,

Huang

et al. 2024

Clinical Case Reports

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Key Clinical MessageThe clinical presentations and pathological features of low‐grade myxofibrosarcoma can be misleading, frequently resulting in diagnostic errors. An accurate diagnosis requires the application of immunohistochemistry techniques and the discerning diagnostic acumen of experienced pathologists. A 62‐year‐old male patient visited our outpatient clinic with multiple painful and rapidly enlarging subcutaneous nodules on his right forearm. Initially, the condition was misdiagnosed as multiple lipomas. The final pathology revealed characteristics consistent with low‐grade myxofibrosarcoma.

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: F I G U R Ementioning

confidence: 99%

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Multiple cutaneous myxofibrosarcoma on the right arm: Clinicopathological features and differential diagnosis

Ruan,

Zhang,

Huang

et al. 2024

Clinical Case Reports

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Anterior Thigh Myxofibrosarcoma with Management of Wide Excision and Modified Anterior Thigh Compartment Resection : A Case Report

Sentoso,

Yarsa

2023

JCTI

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Introduction: Myxofibrosarcoma (MFS) is a type of malignancy from the group of malignant fibrous histiocytoma. Myfxofibrosarcoma is a type of soft tissue neoplasm that is aggressive. The clinical symptoms are not pathognomonic and the histological picture is very heterogeneous, often receiving delayed treatment and causing misdiagnosis. Complementary histochemical and immunohistochemical staining is mandatory to confirm the diagnosis of MFS. Extensive surgical treatment and followed by radiotherapy is the first choice of myxofibrosarcoma treatment. Case Presentation: A 54-years old woman complained of a lump on her left thigh that had been getting bigger for the past 2 years. The lump initially looked the size of a marble, then grew to the size of a tennis ball in the last 7 months. On physical examination, a mass was found in the left thigh area, a hard, fixed mass, the size of a tennis ball. Fine needle aspiration examination showed suspicious results for myxofibrosarcoma. The patient underwent a Magnetic Resonance Imaging examination in the left lower extremity area and underwent wide excision and anterior thigh compartment resection surgery. Discussion: Wide resection is the standard treatment for MFS [4]. The choice of procedure for each patient is different and should be based on tumor size, location, stage, surrounding neurovascular and bony elements, as well as functional and cosmetic considerations [4]. The minimum resection margin in MFS is at least 1 cm which aims to minimize the risk of local recurrence [4]. The recommended resection margin is at least 2 cm for MFS resection [4]. We had plan a 2 cm margin of the entire preoperative MRI enhancement area. It should be noted that the local recurrence rate for MFS in margin-negative resections is relatively high compared with other STS subtypes. Conclusion: We recommend Wide Excison and Modified Anterior Thigh compartment Resection is recommended procedure for anterior thigh myxofibrosarcoma. This procedure involves preserving uncontaminated thigh neurovascular, and only resecting one of the sarcoma-infiltrated muscle heads and preserving the other quadriceps muscle head of the thigh to maintain knee extension function. This paper is the first report on the successful treatment of anterior thigh myxofibrosarcoma without weakness of knee extension complication.

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Myxofibrosarcoma of the leg: A diagnostic challenge

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 2 publications

References 9 publications

Multiple cutaneous myxofibrosarcoma on the right arm: Clinicopathological features and differential diagnosis

Multiple cutaneous myxofibrosarcoma on the right arm: Clinicopathological features and differential diagnosis

Anterior Thigh Myxofibrosarcoma with Management of Wide Excision and Modified Anterior Thigh Compartment Resection : A Case Report

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