Subcutaneous ossifying fibromyxoid tumor of the scalp: a potential importance of <scp>CT</scp>,<scp> MRI</scp>, and <scp>PET</scp>/<scp>CT</scp> on the diagnosis

Namiki, Takeshi; Hsieh, Ming-Hsiu; Iwamoto, Yutaro; Ugajin, Tsukasa; Tanaka, Kentaro; Mori, Hiroki; Miura, Keiko; Yokozeki, Hiroo

doi:10.1111/ijd.14431

Cited by 1 publication

(4 citation statements)

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“…of high T1-and T2-weighted signal intensities, indicating intratumoral hemorrhage [8] but these are not observed in our patient. In our case, the extradural nature of the OFMT formed an obtuse angle with the surrounding CSF space, distinguishing it from intradural extramedullary tumors, which often form an acute angle with the surrounding CSF.Technetium-99m methylene diphosphonate scintigraphy may demonstrate avid tracer uptake due to mature bone formation within the tumor [6].…”

Section: Approved Galley Proofmentioning

confidence: 63%

“…On microscopic examination, OFMT often shows variable histopathologic features containing bone and osteoid and collagen elements [9]. Most tumors are composed of small, evenly sized, round tumor cells separated by variable amounts of osteoid [6,9,11,12]. According to Folpe et al, OFMT has a high nuclear grade with a high mitotic activity of >2 mitotic figures per 50 high-power fields [13].…”

Section: Approved Galley Proofmentioning

confidence: 99%

“…Other positive neural markers of OFMT are Leu-7, GFAP, neurofilament, synaptophysin, and collagen type IV [11]. Macroscopically, most tumors are surrounded by a thick collagenous capsule and osseous fibrous rim [6,11]. In 80% of the cases, the tumor periphery consists of an incomplete shell of bone [14].…”

Section: Approved Galley Proofmentioning

confidence: 99%

“…They present clinically as a slowly enlarging painless mass in the subcutaneous tissues or skeletal muscles [2,3]. They commonly arise in the proximal extremities [2,3] but their occurrence at other sites, including the head, neck, and torso have also been reported [4][5][6]. It is exceedingly rare for OFMT to involve the spine.…”

Section: Introductionmentioning

confidence: 99%

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A Case of an 82-Year-Old Man with a Spinal Extradural Malignant Ossifying Fibromyxoid Tumor

2023

Am J Case Rep

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Male, 82-year-old Final Diagnosis: Malignant ossifying fibromyxoid tumor Symptoms: Paresthesia of the upper limbs • weakness of the lower limbs Clinical Procedure: -Specialty: Radiology Objective: Rare disease Background:Ossifying fibromyxoid tumor (OFMT) is a rare mesenchymal tumor predominantly involving the subcutaneous tissues or skeletal muscles in the proximal extremities, typically in middle-aged men. OFMT in the spine is extremely rare, with only 3 previously reported cases in the literature. Case Report:Here, we present a rare case of an 82-year-old man presenting with paresthesia of both arms and weakness of both legs, who underwent magnetic resonance imaging (MRI) of the spine, which showed an aggressive extradural tumor. Following surgical debulking, histology examination revealed a tumor of stromal origin with myxoid and ossifying components and pleomorphic features. Overall findings were suggestive of a malignant OFMT. The patient underwent postoperative adjuvant radiotherapy. However, the first follow-up MRI study at 8 months showed residual tumor, which also demonstrated avid tracer uptake on technetium-99m scintigraphy and PET-CT scans. The second MRI follow-up about 9 months later showed several metastatic foci along the craniospinal axis. Despite subsequent resection of the spinal metastasis, the patient eventually died of sepsis about 21 months after the initial tumor diagnosis. Conclusions:We presented a case of extradural spinal malignant OFMT and highlighted the difficulty distinguishing this rare primary tumor from spinal metastases. In this case, MRI signal intensities and identifying intratumoral bone formation, combined with histopathology following surgical resection, confirmed the diagnosis. This case has also shown the importance of follow-up by a multidisciplinary team to monitor for the recurrence of primary OFMT.

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Section: Approved Galley Proofmentioning

confidence: 63%