Low-grade myofibroblastic sarcoma. Two rare tumors in two rare locations

Gómez-Oliveira, Guillermo; Arribas-García, Ignacio; Álvarez-Buylla, Adriana Serrano; Sánchez-Burgos, Rocío; Martínez-Pérez, Fátima; Alvarez-Flores, Modesto

doi:10.1016/j.maxilo.2013.04.004

Cited by 8 publications

(6 citation statements)

References 13 publications

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“…LGMS lesions are local, aggressive and characterized by frequent recurrence and metastasis, but exhibit a relatively indolent course, and tend to recur locally rather than metastasizing (4,29). However, LGMS is able to metastasize to distant sites, including the left humerus and the cardiac region (39,42). Therefore, disease management via wide excision of the tumor and long-term follow-up is suggested (25).…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2017

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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.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2017

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“…As presented in Table 2 , LGMS was located in the head and neck in 53 cases (51.5%); soft tissue 41 cases vs. bone 6 cases, trunk in 26 cases (25.2%); soft tissue 11 cases vs. bone 1 cases, and extremity in 24 cases (23.3%); soft tissue 12 cases vs. bone 7 cases. In the head and neck region, the most common site was the tongue [ 1 , 6 , 8 – 10 , 13 , 14 ], followed by the larynx [ 17 – 20 , 47 ], and gingiva [ 3 , 12 , 15 , 16 ]. LGMS was also observed in the mandible [ 10 , 23 ], face [ 23 ], skull [ 9 ], acoustic meatus [ 9 ], and deep tissue spaces, including the parapharyngeal space [ 28 ] as well as throughout the head and neck region.…”

Section: Discussionmentioning

confidence: 99%

“…Two out of 12 patients in biopsy group was positive surgical margin. Both cases had infiltrative growth pattern and the tumor locations were deep (larynx and left maxillary sinus) [ 18 , 47 ]. Regarding to the LGMS in the upper aerodigestive tract, Meng et al [ 29 ] reported that owing to the diverse histologic appearance in the same tumor of myofibroblastic sarcoma; misdiagnosis may occur in small and superficial biopsy samples.…”

Section: Discussionmentioning

confidence: 99%

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

Yonezawa

Yamamoto

Hayashi

et al. 2020

BMC Musculoskelet Disord

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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.

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“…LGMS arising in the maxillary sinus are extremely uncommon. 7 Patients usually complain of a slow growing painless swelling. Our patient presented with a painless swelling over the right cheek.…”

Section: Low Grade Myofibroblastic Sarcomamentioning

confidence: 99%

Unilateral maxillary swelling: a varied spectrum

Satish¹,

Pratibha²,

Balasubramanya³

et al. 2018

Int J Otorhinolaryngol Head Neck Surg

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Background: Diverse disease entities may present with mass in the maxilla and include benign conditions and malignant tumours. A detailed evaluation including preoperative imaging is essential to plan approach to management of isolated maxillary sinus lesions optimally.Methods: We did a retrospective chart review of 14 patients with isolated maxillary swelling and involvement of maxillary sinus who presented to the Department of ENT in a tertiary care hospital over a period of 4 years. A detailed history and examination were done and investigations including contrast enhanced CT scan of the nose and paranasal sinuses was done in all patients. Results: A total of 14 patients were included in this study. 7 were male and 7 were female. The mean age of the patients was 52.6, the age group of patients varied from 6 to 77 years. In our series we had patients with benign lesions like dentigerous cyst, fibro-osseous lesions, mucocele, radicular cyst, aspergilloma, and mucormycosis. Malignant cases included Adenoid cystic carcinoma, Low grade myofibroblastic sarcoma, Diffuse B cell lymphoma and undifferentiated carcinoma. All patients were treated surgically, they underwent a combined endoscopic and Caldwell Luc approach.Conclusions: In patients with unilateral maxillary swelling, a systematic approach to diagnosis with preoperative contrast enhanced CT scan is essential with a high index of suspicion. Trans nasal endoscopic approach with sinus surgery is the preferred approach for these lesions, however, in cases of jaw cysts and odontogenic cysts extending laterally it can be combined with a Caldwel-Luc approach.

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Low-grade myofibroblastic sarcoma. Two rare tumors in two rare locations

Cited by 8 publications

References 13 publications

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

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

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

Unilateral maxillary swelling: a varied spectrum

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