Introduction: Low-grade myxofibrosarcoma (LGMFS) is a neoplasm of soft tissues. According to the World Health Organization, LGMFS is a malignant myofibroblastic tumor arising from deep soft tissues with potential for recurrence and late metastatic spread. The incidence estimates are 0.18/million, accounting for 0.6% of all soft-tissue sarcomas. It can directly invade the bone and metastasize to bone; however, primary osseous low-grade myxofibrosarcoma is a rare entity. Thus, recognizing atypical presentations of uncommon neoplasms are a pertinent skill for the radiologist due to significant implications for management. Case Report: A 40-year-old male with complaints of midfoot pain was referred to radiology department for imaging. Radiographs of the foot showed a lytic mildly expansile lesion in the first metacarpal with wide zone of transition and no sclerotic margin or matrix calcification. Magnetic resource imaging (MRI) and computed tomography (CT) examination demonstrated well defined lobulated lesion which appeared heterogeneously hyperintense on T2W images with cortical breach, extraosseous soft-tissue component, and early rapid progressive enhancement. The radiological diagnosis of enchondroma with pathological fracture was considered. Atypical findings of early progressive enhancement and extraosseous soft-tissue component were, however, incongruous with enchondroma and possibility of an aggressive/malignant etiology was also considered. Hence, the lesion was biopsied and diagnosis of LGMFS was made and subsequently confirmed on excised specimen. Follow-up CT scan post 6 months of surgical resection demonstrated no recurrence. Conclusion: Primary osseous LGMFS is a rare entity and radiologically mimics enchondromas. Both LGMFS and enchondromas show T2W hyperintensity. MRI features that distinguish LGMFS from enchondroma include low apparent diffusion coefficient values and slow progressive enhancement in dynamic contrast-enhanced MRI.

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Benign tumors of larynx in adults are common and are often presents with hoarseness of voice or respiratory difficulty with stridor. Papilloma constitutes the major benign tumor of larynx in adults and usually presents with hoarseness of voice or stridor. A unique case of inflammatory myofibroblastic tumour of left aryepiglottic fold in a 19 year old female presenting with lateral neck swelling is presented. MRI revealed a polypoidal left aryepiglottic fold mass with caudal extension into the glottis and changing its position into the left PFS on e-phonation. The diagnosis of inflammatory myofibroblastic tumour remained elusive till it was proved histopathologically, after excision by laryngofissure approach. We present this rare case so that this condition and its surgical approach can be better recognized and understood.