Myxoinflammatory Fibroblastic Sarcoma: Report of a Case and Review of the Literature

Abstract

Myxoinflammatory fibroblastic sarcoma (MIFS) is a low-grade sarcoma generally arising in adults. We present a case of MIFS in a 5-year-old boy with a palpable nodule in the subcutaneous tissue of the scalp. We carried out a literature review to evaluate the diagnostic patterns based on histologic and cytologic features and possible pitfalls and misdiagnoses. A systematic search for articles of interest published between 1995 and 2011 was performed in MEDLINE and PubMed using the words “myxoinflammatory fibroblastic sarcoma,” “myxohyaline tumor,” and “inflammatory myxoid tumor.” Histology and cytology have a pivotal role in the differential diagnosis between MIFS and other potential soft-tissue mimics, such as nodular and proliferative fasciitis and inflammatory myofibroblastic tumor. Fine-needle aspiration cytology is a safe and useful tool for the diagnosis of pediatric patients with MIFS and is important for an accurate and precise preoperative workup to optimize subsequent management and treatment.

Myxoinflammatory Fibroblastic Sarcoma in Children and Adolescents: Clinicopathologic Aspects of a Rare Neoplasm

“…A 5-year-old male presented with a slowly growing scalp mass [7]. The round, tender, subcutaneous scalp nodule was not associated with regional lymphadenopathy or previous trauma.…”

“…The histologic differential diagnosis of MIFS is broad, especially when the tumor arises in non-acral sites, similar to other fibroblastic and myofibroblastic tumors [7]. It includes reactive processes, as well as a spectrum of myxoid and spindle cell neoplasms with associated inflammation [3,4,7,19,21].…”

“…Here we report the clinicopathologic, immunohistochemical, and molecular cytogenetic findings in 5 examples of MIFS in children and adolescents, 1 of which was previously published [7]. This analysis focuses on the occurrence in young patients, notably its expanded anatomic distribution, favorable outcome, and differential diagnosis in children and adolescents.…”

“…The preoperative differential diagnosis often includes such tumors as ganglion cyst, fibroma of tendon sheath, tenosynovitis, or tenosynovial giant cell tumor [4]. Recent reports have noted the utility of fine-needle aspiration biopsy in raising the question of a malignant process and guiding further surgical treatment [7].…”

Multidisciplinary and multimodal diagnostic approach in paediatric tumours combining fine needle aspiration, core needle biopsy and ancillary techniques

“…As in the experience of Barroca and Bom‐Sucesso, we believe that many malignancies can be unquestionably diagnosed using FNA material, as in Ewing sarcoma, rhabdomyosarcoma, neuroblastoma, rhabdoid tumour, and myxo‐inflammatory fibroblastic sarcoma . Cytological features are sufficient to permit grading and to predict MYC amplification in neuroblastoma . For certain rare entities such as retinoblastomas and nephroblastomas, imaging can be sufficient for a conclusive diagnosis and in many other cases FNA cytology is satisfactory for diagnosis.…”