Myxofibrosarcoma: A Diagnostic Pitfall

Castronovo, Charlotte; Arrese, Jorge E.; Quatresooz, Pascale; Nikkels, Arjen F.

doi:10.4081/rt.2013.e15

Cited by 29 publications

(34 citation statements)

References 12 publications

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“…Our case had an unusual presentation as a large pedunculated, cutaneous polyp, which is extremely rare with only few cases reported in literature to date . Most of the tumors measure less than 10 cm . There are no definite criteria as to the proportion of myxoid areas required to call a tumor a MFS.…”

Section: Discussionmentioning

confidence: 99%

“…Many of the tumors show the presence of multi‐vacuolated cells (pseudolipoblasts) . On IHC there are no specific markers and thus a battery of markers is required to rule out other lesions which can mimic it . On cytology, these tumors show atypical spindled to stellate cells in a myxoid matrix.…”

Section: Discussionmentioning

confidence: 99%

“…Increased tumor depth and mitotic activity were more commonly associated with metastases . Differential diagnosis includes benign and malignant cutaneous myxoid lesions like nerve sheath myxoma, papular mucinosis, myxoid neurofibroma, angiomyxoma, granuloma annulare, necrobiosis lipoidica, atypical fibroxanthoma, fibromyxoid sarcoma, myxoid dermatofibrosarcoma protuberans (DFSPs), myxoid leiomyoma, myxoid liposarcoma, and myxoid Ewing sarcoma . Myxoid benign lesions are ruled out as atypical pleomorphic cells can be seen in one or the other areas, generally seen in deeper tumor tissue .…”

Section: Discussionmentioning

confidence: 99%

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Rare, risky, recurrent: An enigmatic cutaneous polyp

Singh

Brar²,

Dey³

et al. 2019

J Cutan Pathol

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Myxofibrosarcomas (MFSs) are sarcomas most commonly seen in older patients. These are tumors of deep soft tissue seen in subcutaneous tissue and deep fascia, with frequent muscle involvement. These sarcomas are notorious for recurrences and progression to a higher grade with notable metastatic potential. They are very often under‐diagnosed owing to their inherent morphological variability. A case of MFS is presented as a cutaneous, exophytic, polypoidal mass because of its rarity and importance of timely diagnosis, as under‐diagnosis may lead to inadequate clearance of tumor, recurrences, metastases and increased mortality.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Rare, risky, recurrent: An enigmatic cutaneous polyp

Singh

Brar²,

Dey³

et al. 2019

J Cutan Pathol

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“…The vacuolated lipoblasts of liposarcoma (which can have necrotic areas) and the keratin‐positive cells of epitheliod sarcoma are not found. Ischemic fasciitis does not show the aggressive loco‐regional behavior nor arcuate vascularity surrounded by bizarre tumor cells suspended in copious colloidal iron‐positive mucin typical of myxofibrosarcoma (formally, the myxoid variant of malignant fibrous histiocytoma) …”

Section: Discussionmentioning

confidence: 99%

Ischemic fasciitis: enhanced diagnostic resolution through clinical, histopathologic and radiologic correlation in 17 cases

Lehmer

Moore²,

Ragsdale³

2016

J Cutan Pathol

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Ischemic fasciitis is a pseudosarcomatous nodule or mass resulting from sustained or repeated pressure and consequent ischemia of soft tissue. Fibrin and hemorrhage expand its hypocellular epicenter bordered by enlarged (atypical, ischemic) fibroblasts and reactive vascular prominence resulting in diagnostically important histologic zonation. Although classically in bedridden patients, ischemic fasciitis owing to posture-related intermittent pressure in ambulatory adults is not well characterized; there has not been a thorough review of its presentation in ambulatory patients in the dermatology/dermatopathology literature. This article reviews the clinical, pathologic and radiologic presentation of 17 cases of ischemic fasciitis diagnosed over a 14-year period. Eighty-six percent of the six cases submitted by non-dermatologists were limb girdle/trunk lesions averaging 6.7 cm in greatest diameter while 90% of the eleven lesions submitted by dermatologists were elbow and forearm lesions averaging 2.3 cm. In no case was the diagnosis anticipated pre-biopsy by clinician or radiologist. Dermatologists submitted the majority of cases. Because ischemic fasciitis may simulate soft tissue sarcoma clinically and histologically, diagnosis helps prevent overtreatment. Zonal histopathologic structure may be shown by any form of biopsy and should motivate correlation with available radiologic studies. Importantly, determining a history of postural pressure at the site confirms the histopathologic diagnosis and avoids unnecessary excision.

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“…MFS, first described by Angervall et al ,6 is a variant of a group of malignant fibrous histiocytomas (MFH), a highly heterogeneous group of soft tissue neoplasms 9. In fact, because ultrastructural studies have shown a fibroblastic differentiation, today it is considered a distinct tumour, with myxoid features, myogenic differentiation with immunoreactivity to SMA and a better prognosis than other cellular subtypes of MFH 10 11.…”

Section: Discussionmentioning

confidence: 99%

Right cardiac intracavitary metastases from a primary intracranial myxofibrosarcoma

Costa¹,

Barata

Gouveia³

et al. 2016

BMJ Case Reports

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Primary intracranial myxofibrosarcoma is exceedingly rare, with less than 10 cases published. We present a case of a 23-year-old man with previous history of a primary low grade myxofibrosarcoma of the left parietal-occipital convexity resected in March 1999. He subsequently underwent several interventions for multiple local recurrent disease until March 2004. At that time, complete remission was documented. About 8 years later, in February 2012, the patient was admitted to the emergency room with refractory acute pulmonary oedema. On work up, sustained monomorphic ventricular tachycardia and hyperechoic myocardial mass with invasion of the right ventricular cavity were detected. Electrical cardioversion was unsuccessful and irreversible cardiac arrest followed. The autopsy confirmed multiple bilateral lung metastases, malignant pulmonary embolism and myocardial invasion by the primary tumour, with intracavitary cardiac thrombosis and absence of intracranial disease. To the best of our knowledge, this is the first report of extracranial metastases of this neoplasm.

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Myxofibrosarcoma: A Diagnostic Pitfall

Cited by 29 publications

References 12 publications

Rare, risky, recurrent: An enigmatic cutaneous polyp

Rare, risky, recurrent: An enigmatic cutaneous polyp

Ischemic fasciitis: enhanced diagnostic resolution through clinical, histopathologic and radiologic correlation in 17 cases

Right cardiac intracavitary metastases from a primary intracranial myxofibrosarcoma

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