Ossifying fibromyxoid tumor: Fine‐needle aspiration cytology findings of a rare soft tissue neoplasm

Abstract

Ossifying fibromyxoid tumors (OFMTs) are rare tumors of uncertain origin and intermediate (rarely metastasizing) biologic potential, with characteristic morphology of an encapsulated tumor containing polygonal cells in an abundant fibromyxoid matrix surrounded by a peripheral layer of metaplastic lamellar bone. FNA cytology of OFMT has not been sufficiently reported and till date cytological features of only seven cases have been reported so far. We report another case of OFMT in a 55‐year‐old female presenting with longstanding swelling in thigh. On fine‐needle aspiration, a tumor with moderate cellularity and myxoid areas was seen; coupled with compatible radiological findings, a diagnosis of OFMT was suggested. Establishing a correct diagnosis is important as although OFMT is benign in nature, local recurrences or rarely distant metastasis have been seen of this tumor. Hence, a high degree of suspicion with radiological correlation is of utmost importance for identification of this entity.

Ossifying fibromyxoid tumor in the lower extremity mimicking a sebaceous cyst. Case report and literature review

“…The proliferation fraction (Ki67) was less than 1%. Our case resulted to be of the typical variant as most of the reported OFMT cases in Table 1 [ [12] , [13] , [14] , [15] , [16] ], with the exception of two patients that were atypical and malignant variants respectively [ 10 , 11 ].…”

“…Our patient was booked for excision without further imaging. Interestingly, Table 1 reveals that US is not regularly used in the diagnosis of OFMT, where only two of the reported cases underwent preoperative US [ 12 , 13 ].…”

“…As for preoperative biopsy and fine needle aspiration (FNA), only two reported cases underwent preoperative FNA ( Table 1 ), of which OFMT diagnosis was narrowed in the differentials after correlating both the FNA and the imaging findings in one case. For these patients, FNA demonstrated singly scattered, monomorphic medium- to few large-sized epithelioid to ovoid tumor cells set in a variably myxoid and fine fibrillary pink matrix in the first patient; and pauci-cellular myxoid material along with cords of cytologically bland cells within a fibromyxoid stroma in the other patient [ 13 , 14 ]. Other differential diagnosis fitting such descriptions are sclerosing epithelioid fibrosarcoma and low-grade fibromyxoid sarcoma [ 13 , 14 ].…”