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Kramer SP, Bowman CJ, Wang ZJ, Sheahon KM, Nakakura EK, Cho SJ, Umetsu SE, Behr SC. Hybrid Low-Grade Fibromyxoid Sarcoma and Sclerosing Epithelioid Fibrosarcoma of the Pancreas. J Gastrointest Cancer 2021; 51:1025-1029. [PMID: 32034641 DOI: 10.1007/s12029-020-00369-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Sage P Kramer
- Department of Radiology and Biomedical Imaging, UCSF Medical Center, 505 Parnassus Ave, San Francisco, CA, 94143, USA
| | | | - Zhen J Wang
- Department of Radiology and Biomedical Imaging, UCSF Medical Center, 505 Parnassus Ave, San Francisco, CA, 94143, USA
| | | | - Eric K Nakakura
- Division of General Surgery, UCSF Medical Center, CA, San Francisco, USA
| | - Soo-Jin Cho
- Department of Pathology, UCSF Medical Center, San Francisco, CA, USA
| | - Sarah E Umetsu
- Department of Pathology, UCSF Medical Center, San Francisco, CA, USA
| | - Spencer C Behr
- Department of Radiology and Biomedical Imaging, UCSF Medical Center, 505 Parnassus Ave, San Francisco, CA, 94143, USA.
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Dugalic V, Ignjatovic II, Kovac JD, Ilic N, Sopta J, Ostojic SR, Vasin D, Bogdanovic MD, Dumic I, Milovanovic T. Low-grade fibromyxoid sarcoma of the liver: A case report. World J Clin Cases 2021; 9:175-182. [PMID: 33511182 PMCID: PMC7809678 DOI: 10.12998/wjcc.v9.i1.175] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 09/15/2020] [Accepted: 11/21/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Low grade fibromyxoid sarcoma (LGFMS) is a rare and benign mesenchymal tumor with indolent course, most commonly found in young or middle-aged men. The majority of the LGFMSs are located in the trunk and deep soft tissue of the lower extremities. They appear as well circumscribed, although not encapsulated, which often leads to incomplete surgical resection. Despite their seemingly benign appearance, these tumors have aggressive behavior with high metastatic and recurrence rates. Accurate histopathologic examination of the specimen and its immunohistochemical analysis are mandatory for a precise diagnosis.
CASE SUMMARY We report a case of a 38 year-old-man who presented with jaundice and upper abdominal discomfort. Multi-detector computed tomography and magnetic resonance imaging showed a large left liver tumor mass, extending to the hepatoduodenal ligament. Left hepatectomy was performed with resection and reconstruction of hepatic artery and preservation of middle hepatic vein. Histopathologic examination confirmed the tumor being a low-grade fibromyxoid sarcoma. Three and a half years after surgery, the patient died after being diagnosed with spine metastasis.
CONCLUSION Due to poor response to all modalities of adjuvant treatment, we consider that the focus of treatment should be on surgery as the only option for curing the disease.
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Affiliation(s)
- Vladimir Dugalic
- Department of Hepatobiliary & Pancreatic Surgery, Clinic for Digestive Surgery, Clinical Center of Serbia, Belgrade 11000, Serbia
| | - Igor I Ignjatovic
- Department of Hepatobiliary & Pancreatic Surgery, Clinic for Digestive Surgery, Clinical Center of Serbia, Belgrade 11000, Serbia
| | | | - Nikola Ilic
- Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade 11000, Serbia
| | - Jelena Sopta
- Institute of Pathology, University of Belgrade, Belgrade 11000, Serbia
| | - Slavenko R Ostojic
- Department of Hepatobiliary & Pancreatic Surgery, Clinic for Digestive Surgery, Clinical Center of Serbia, Belgrade 11000, Serbia
| | - Dragan Vasin
- Department of Radiology, Clinical Center of Serbia, Belgrade 11000, Serbia
| | - Marko D Bogdanovic
- Department of Hepatobiliary & Pancreatic Surgery, Clinic for Digestive Surgery, Clinical Center of Serbia, Belgrade 11000, Serbia
| | - Igor Dumic
- Mayo Clinic Health System, Mayo Clinic College of Medicine and Science, Rochester, NY 10029, United States
| | - Tamara Milovanovic
- Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade 11000, Serbia
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Huang J, Cohen S, Jour G. Primary small intestine mesenteric low-grade fibromyxoid sarcoma with foci of atypical epithelioid whorls and diffuse DOG1 expression: a case report. Diagn Pathol 2020; 15:23. [PMID: 32164724 PMCID: PMC7069053 DOI: 10.1186/s13000-019-0905-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 11/06/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Low-grade fibromyxoid sarcoma (LGFMS) is a rare fibroblastic tumor often involving deep tissue of trunk and lower extremities in young to middle-aged patients. Rarely, LGFMS can occur in other sites including head and neck, chest, abdomen and female reproductive system. Three cases of LGFMS in mesentery of small intestine have been reported and all have conventional histologic features. Herein we reported a unique case of LGFMS in mesentery of small intestine. CASE PRESENTATION A 43 year-old male with chief complaint of lower back pain for 4 years presented to our hospital. Physical exam reveal a firm, non-tender, non-distended, mobile large abdominal mass, which was shown on abdominal CT as a 10 cm retroperitoneal tumor. Biopsy revealed a spindle cell neoplasm in a myxoid background with a delicate vascular network. Tumor resection was performed. Gross examination of the resected specimen showed a 10.8 cm, tan-white, smooth, firm, lobulated mesenteric mass with bulging and gelatinous cut surface and confined within small bowel serosa. Microscopic examination demonstrated foci epithelioid cords and whorls with prominent atypia, in additional of regular, bland-appearing spindle cells in a fibrous and myxoid stroma and osseous metaplasia. The tumor cells stained diffusely positive for DOG1 with moderate staining density, and diffusely and strongly positive for MUC4. Rearrangement involving FUS (16p11.2) gene was identified with break-apart probe and confirmed by Anchored Multiplex PCR. A final diagnosis of low-grade fibromyxoid sarcoma was rendered. CONCLUSION Our case highlights the importance of including LGFMS in the differential diagnosis of mesenteric tumors and the DOG1 positivity which could represent a potential diagnostic pitfall.
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Affiliation(s)
- Jialing Huang
- Department of Pathology, Langone Medical Center, New York University, 550 1st Avenue, New York, NY, 10016, USA.
| | - Steven Cohen
- Department of Surgery, Langone Medical Center, New York University, 550 1st Avenue, New York, NY, 10016, USA
| | - Gerorge Jour
- Department of Pathology, Langone Medical Center, New York University, 550 1st Avenue, New York, NY, 10016, USA
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Primary low-grade fibromyxoid sarcoma of the large intestine with lung metastases: A case report and review of the literature. HUMAN PATHOLOGY: CASE REPORTS 2019. [DOI: 10.1016/j.ehpc.2018.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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5
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Geramizadeh B, Zare Z, Dehghanian AR, Bolandparvaz S, Marzban M. Huge mesenteric low-grade fibromyxoid sarcoma: A case report and review of the literature. Rare Tumors 2018; 10:2036361318777031. [PMID: 29854356 PMCID: PMC5971385 DOI: 10.1177/2036361318777031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 04/25/2018] [Indexed: 11/17/2022] Open
Abstract
Low-grade fibromyxoid sarcoma is a rare soft tissue tumor which has been mostly reported in lower extremities; however, it can also occur in other parts of the body such as head and neck and abdominal wall, but its occurrence in the abdominal cavity and mesentery of bowel is an extremely rare event and has very rarely been reported. Herein, we report our experience with a 24-year-old lady with a huge mesenteric mass, turned out to be low-grade fibromyxoid sarcoma. This case is the largest one reported in the English literature. We will also discuss about the previously reported cases of low-grade fibromyxoid sarcoma in the English literature.
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Affiliation(s)
- Bita Geramizadeh
- Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Zare
- Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Shahram Bolandparvaz
- Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran.,Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahsa Marzban
- The University of British Columbia, Vancouver, BC, Canada
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Tsukamoto Y, Takahata H, Teramoto N, Nishimura R, Hato S, Nozaki I, Matsuo S, Hirota S. Primary gastric low-grade fibromyxoid sarcoma with FUS-CREB3L1 fusion – A hitherto undescribed origin of Evans tumor. HUMAN PATHOLOGY: CASE REPORTS 2018. [DOI: 10.1016/j.ehpc.2017.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Ud Din N, Ahmad Z, Zreik R, Horvai A, Folpe AL, Fritchie K. Abdominopelvic and Retroperitoneal Low-Grade Fibromyxoid Sarcoma: A Clinicopathologic Study of 13 Cases. Am J Clin Pathol 2018; 149:128-134. [PMID: 29385413 DOI: 10.1093/ajcp/aqx137] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES Low-grade fibromyxoid sarcoma (LGFMS) is a rare tumor often arising in the lower extremities. Only rare examples in the abdominal cavity, pelvis, and retroperitoneum have been reported. METHODS cases of abdominopelvic and retroperitoneal LGFMS were retrieved. MUC4, Actin, ALK, β-catenin, desmin, DOG1, KIT, S100 protein, and STAT6 testing was performed, and a subset was tested for FUS rearrangement. RESULTS Sites included intra-abdominal/abdominal wall (four cases), retroperitoneum (three cases), pelvis (three cases), small bowel (two cases), and kidney (one case) (median size, 15 cm; age range, 5-61 years). Tumors harbored spindled cells with mild to moderate atypia, displaying alternating myxoid nodules and hyalinized areas. All cases were positive for MUC4, and five (of five) cases tested harbored FUS rearrangement. Variable positivity for DOG1 (four of 10) and actin (two of 10) was identified. Six tumors recurred, and one patient developed metastasis. CONCLUSION LGFMS arising in these central locations exhibits similar clinicopathologic features to its counterpart in the extremities. LGFMS at these sites may show limited immunoreactivity for DOG1 and actin.
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Affiliation(s)
- Nasir Ud Din
- Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Zubair Ahmad
- Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Riyam Zreik
- Department of Pathology, Scott & White Medical Center, Temple, TX
| | - Andrew Horvai
- Department of Pathology, University of California, San Francisco
| | - Andrew L Folpe
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - Karen Fritchie
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
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Ban LK, Tseng AH, Huang SH, Lee HHC. Low-grade fibromyxoid sarcoma of the external anal sphincter: a case report. World J Surg Oncol 2017; 15:109. [PMID: 28558780 PMCID: PMC5450221 DOI: 10.1186/s12957-017-1174-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 05/17/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Low-grade fibromyxoid sarcoma (LGFMS) is a rare soft tissue tumor that has a tendency to grow in the deep soft tissue of the trunk and extremities. Despite its benign appearance, the tumor has a high recurrence rate and metastatic potential. LGFMS in the perineal space is rare, and only a few cases have been reported. We present the first case of LGFMS to be located at the external anal sphincter. CASE PRESENTATION A 27-year-old male patient admitted to our Surgical Department with perianal pain and swollen for a year. The digital rectal examination revealed a perianal mass. Oral metronidazole and analgesia were prescribed on suspicion of perianal abscess failed to alleviate the symptom; hence, the patient was scheduled for surgery. Intraoperative diagnosis revealed an encapsulated tumor in the external anal sphincter that extended from the perianal region orally to the pararectal space. The results of immunohistochemistry (MUC4 staining) and FUS gene rearrangement by fluorescence in situ hybridization confirmed the diagnosis of LGFMS. CONCLUSIONS This case is unique in terms of the location of the rare soft tissue tumor. Although LGFMS is considered low grade, its unpredictable behavior necessitates a long-term follow-up.
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Affiliation(s)
- Lee-Kiat Ban
- Department of Surgery, Hsinchu Cathay General Hospital, Jhonghua Rd, Hsinchu, Taiwan.,College of Medical Technology, Nursing and Wellbeing, Yuanpei University of Medical Technology, Yuanpei Street, Hsinchu, Taiwan
| | - Ailun Heather Tseng
- Department of Surgery, Hsinchu Cathay General Hospital, Jhonghua Rd, Hsinchu, Taiwan
| | - Shih-Hung Huang
- Department of Pathology, Cathay General Hospital, Jen-Ai Road, Taipei, Taiwan
| | - Henry Hsin-Chung Lee
- Department of Surgery, Hsinchu Cathay General Hospital, Jhonghua Rd, Hsinchu, Taiwan. .,Graduate Institute of Translational and Interdisciplinary Medicine, College of Health Sciences and Technology, National Central University, Jung-Da Rd, Taoyuan, Taiwan. .,School of Medicine, Fu Jen Catholic University, Zhongzheng Rd, New Taipei, Taiwan.
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Kim M, Song TJ, Kang SD, Kang JS, Kim JS, Lee JS, Kim CN, Kim HS. [A case of low-grade fibromyxoid sarcoma of the colon]. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2016; 64:375-9. [PMID: 25530590 DOI: 10.4166/kjg.2014.64.6.375] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Low-grade fibromyxoid sarcoma is a slowly growing soft tissue neoplasm that shows benign histologic features but may have clinical course of malignant disease. It has been reported to occur in the thigh, inguinal area, axilla, shoulder, neck, perineum or buttock. However, there have been few cases of abdominal organ involvement. A 21-year-old woman presented with a large palpable abdominal mass. A 7×4 cm sized round soft tissue tumor at right upper quadrant area was identified by abdominopelvic CT scan. Percutaneous ultrasound-guided biopsy revealed features of spindle cell tumor. On exploration, the tumor originated from transvers colon and was attached to gastrocolic ligament, transverse mesocolon and stomach. The tumor could be dissected with transverse colectomy and partial gastrectomy. The excised tumor, measuring 7×5×5 cm, was well demarcated and appeared as an ovoid mass with firm and myxoid cut surface. She was diagnosed with low-grade fibromyxoid sarcoma arising from transverse colon, and is currently being followed-up without recurrence or metastasis.
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Affiliation(s)
- Min Kim
- Departments of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Tae Jun Song
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seung Dae Kang
- Departments of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Jong Sik Kang
- Departments of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Jin Suk Kim
- Departments of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - June Sung Lee
- Departments of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Chul Nam Kim
- Departments of General Surgery, and Pathology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Han Seong Kim
- Departments of Pathology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
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Cowan ML, Thompson LD, Leon ME, Bishop JA. Low-Grade Fibromyxoid Sarcoma of the Head and Neck: A Clinicopathologic Series and Review of the Literature. Head Neck Pathol 2015; 10:161-6. [PMID: 26276044 PMCID: PMC4838961 DOI: 10.1007/s12105-015-0647-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 08/10/2015] [Indexed: 12/29/2022]
Abstract
Low-grade fibromyxoid sarcoma (LGFMS) is a deceptively bland malignancy with potential for late recurrence and metastasis, which usually occurs in the deep soft tissues of the extremities and trunk. Most LGFMSs harbor a characteristic gene fusion of FUS-CREB3L2, and recently MUC4 immunostaining has been found to be highly sensitive and specific for the diagnosis. We present a dedicated series of head and neck LGFMS, including the first reported laryngeal case, as well as a review of reported head and neck cases. The surgical pathology archives of our three institutions were searched for cases of LGFMS arising within the head and neck, and four cases were identified. The H&E slides were reviewed, and immunohistochemistry were performed for pancytokeratin, p63, p40, EMA, S100 protein, β-catenin, actin, CD34, and MUC4. The patients were 6, 43, 45, and 73 years old (mean 41.8 years) and included three males and one female. The tumors were located in the posterior cervical spine, facial skin, mandible, and larynx. The tumors were treated with surgical excision, and all four had histologic features typical for LGFMS including alternating myxoid and fibrous areas with prominent curvilinear vasculature. All tumors were MUC4 positive (100%), 2/4 (50%) were p63 positive, 1/4 (25%) showed focal EMA positivity; all 4 were negative for pancytokeratin, p40, S100 protein, β-catenin, actin, and CD34. LGFMS is a low grade sarcoma that rarely develops in the head and neck. Due to its rarity, a pathologist may not consider LGFMS in the differential diagnosis of spindle cell neoplasms within the head and neck. Immunohistochemical staining is helpful, but stains should be selected carefully to avoid misdiagnosis.
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Affiliation(s)
- Morgan L. Cowan
- Department of Pathology, The Johns Hopkins University School of Medicine, 600 North Wolfe Street, Pathology 401, Baltimore, MD 21287 USA
| | - Lester D. Thompson
- Department of Pathology, Southern California Permanente Medical Group, Woodland Hills, CA USA
| | - Marino E. Leon
- Department of Anatomic Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL USA
| | - Justin A. Bishop
- Department of Pathology, The Johns Hopkins University School of Medicine, 600 North Wolfe Street, Pathology 401, Baltimore, MD 21287 USA ,Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, 600 North Wolfe Street, Pathology 401, Baltimore, MD 21287 USA
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Konecna J, Liberale G, Haddad J, de Saint-Aubain N, El Nakadi I. Diffuse intra-abdominal low grade fibromyxoid sarcoma with hepatic metastases: Case report and review of the literature. Int J Surg Case Rep 2015. [PMID: 26217915 PMCID: PMC5963136 DOI: 10.1016/j.ijscr.2015.06.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Introduction Low grade fibromyxoid sarcoma (LGFMS)1 is a rare soft tissue tumor involving deep soft tissues of the extremities and trunk. Abdominal location is extremely uncommon in which the few cases published in the literature are characterized by slow tumoral progression and long recurrence-free intervals. Methods We report the first case of an intra-abdominal LGFMS which was discovered incidentally in a 42-year-old woman presenting diffuse peritoneal nodules and hepatic metastasis on CT and MRI scans. Results The patient was successfully treated through conservative measures and remained asymptomatic at the 48 month follow-up. Conclusions This is the first reported case of LGFMS with peritoneal and hepatic metastases. Despite the discovery of an advance disease at exploration, the patient who refused a major surgical operation presents an uneventful follow-up and long term survival.
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Affiliation(s)
- Jana Konecna
- Department of Digestive Surgery, Institut Jules Bordet, Brussels, Belgium
| | - Gabriel Liberale
- Department of Digestive Surgery, Institut Jules Bordet, Brussels, Belgium.
| | - Johnny Haddad
- Department of Digestive Surgery, Institut Jules Bordet, Brussels, Belgium
| | | | - Issam El Nakadi
- Department of Digestive Surgery, Institut Jules Bordet, Brussels, Belgium
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Chen N, Gong J, Nie L, Chen X, Xu M, Chen M, Zhou Q. Primary intracranial low-grade fibromyxoid sarcoma with FUS gene rearrangement. Neuropathology 2015; 35:348-53. [PMID: 25828939 DOI: 10.1111/neup.12197] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 12/24/2014] [Accepted: 12/25/2014] [Indexed: 02/05/2023]
Affiliation(s)
- Ni Chen
- Department of Pathology and Laboratory of Pathology, State Key Laboratory of Biotherapy; West China Hospital, West China Medical School, Sichuan University; Chengdu Sichuan 610041 China
| | - Jing Gong
- Department of Pathology and Laboratory of Pathology, State Key Laboratory of Biotherapy; West China Hospital, West China Medical School, Sichuan University; Chengdu Sichuan 610041 China
| | - Ling Nie
- Department of Pathology and Laboratory of Pathology, State Key Laboratory of Biotherapy; West China Hospital, West China Medical School, Sichuan University; Chengdu Sichuan 610041 China
| | - Xueqin Chen
- Department of Pathology and Laboratory of Pathology, State Key Laboratory of Biotherapy; West China Hospital, West China Medical School, Sichuan University; Chengdu Sichuan 610041 China
| | - Miao Xu
- Department of Pathology and Laboratory of Pathology, State Key Laboratory of Biotherapy; West China Hospital, West China Medical School, Sichuan University; Chengdu Sichuan 610041 China
| | - Min Chen
- Department of Pathology and Laboratory of Pathology, State Key Laboratory of Biotherapy; West China Hospital, West China Medical School, Sichuan University; Chengdu Sichuan 610041 China
| | - Qiao Zhou
- Department of Pathology and Laboratory of Pathology, State Key Laboratory of Biotherapy; West China Hospital, West China Medical School, Sichuan University; Chengdu Sichuan 610041 China
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Intra-abdominal low-grade fibromyxoid sarcoma of the transverse mesocolon mimicking lymphoma. Jpn J Radiol 2014; 32:360-4. [DOI: 10.1007/s11604-014-0305-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2013] [Accepted: 03/04/2014] [Indexed: 12/13/2022]
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Alatise OI, Oke OA, Olaofe OO, Omoniyi-Esan GO, Adesunkanmi ARK. A huge low-grade fibromyxoid sarcoma of small bowel mesentery simulating hyper immune splenomegaly syndrome: a case report and review of literature. Afr Health Sci 2013; 13:736-40. [PMID: 24250315 DOI: 10.4314/ahs.v13i3.31] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Low-grade fibromyxoid sarcoma (LGFMS) is a rare non epithelial tumour. It usually arises from the smooth muscles of the extremities. It is, however, occasionally reported to arise from other regions of the body. CASE REPORT We report the case of a 32 year old man who complained of a progressive abdominal swelling of 4 months duration. There was associated abdominal discomfort and weight loss. Abdominal examination revealed a non-tender intra abdominal mass filling the abdomen completely. Abdominal ultrasound suggested a massive splenomegaly. Abdomina Computerized Tomography (CT) scan was not done due to financial constraints. At laparotomy, a large, pearl-coloured mass was found within the mesentery of the proximal jejunum, with dilated, tortuous vessels. It was resected along with the overlying 60 cm of jejunum. It weighed 7.5 kg. Histology and immunohistochemistry confirmed the diagnosis of lowgrade fibromyxoid sarcoma. Post-operative period was uneventful and there were no features of recurrent after 2 year of follow up. CONCLUSION LGFMS may cause a diagnostic dilemma, especially in a third world setting where preoperative diagnosis is hampered by lack of facilities and poverty. A high index of suspicion is needed for preoperative diagnosis, which is necessary for proper planning of the operation.
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Rose B, Tamvakopoulos GS, Dulay K, Pollock R, Skinner J, Briggs T, Cannon S. The clinical significance of the FUS-CREB3L2 translocation in low-grade fibromyxoid sarcoma. J Orthop Surg Res 2011; 6:15. [PMID: 21406083 PMCID: PMC3063187 DOI: 10.1186/1749-799x-6-15] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2010] [Accepted: 03/15/2011] [Indexed: 01/07/2023] Open
Abstract
Background Low-grade fibromyxoid sarcoma (LGFMS) is a rare soft-tissue neoplasm with a deceptively benign histological appearance. Local recurrences and metastases can manifest many years following excision. The FUS-CREB3L2 gene translocation, which occurs commonly in LGFMS, may be detected by reverse-transcriptase polymerase chain reaction (RT-PCR) and fluorescence in situ hybridisation (FISH). We assessed the relationship between clinical outcome and translocation test result by both methods. Methods We report genetic analysis of 23 LGFMS cases and clinical outcomes of 18 patients with mean age of 40.6 years. During follow-up (mean 24.8 months), there were no cases of local recurrence or metastasis. One case was referred with a third recurrence of a para-spinal tumour previously incorrectly diagnosed as a neurofibroma. Results Results showed 50% of cases tested positive for the FUS-CREB3L2 translocation by RT-PCR and 81.8% by FISH, suggesting FISH is more sensitive than RT-PCR for confirming LGFMS diagnosis. Patients testing positive by both methods tended to be younger and had larger tumours. Despite this, there was no difference in clinical outcome seen during short and medium-term follow-up. Conclusions RT-PCR and FISH for the FUS-CREB3L2 fusion transcript are useful tools for confirming LGFMS diagnosis, but have no role in predicting medium-term clinical outcome. Due to the propensity for late recurrence or metastasis, wide excision is essential, and longer-term follow-up is required. This may identify a difference in long-term clinical outcome between translocation-positive and negative patients.
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Affiliation(s)
- Barry Rose
- The Royal National Orthopaedic Hospital NHS Trust, The London Bone and Soft-Tissue Tumour Unit, London, UK.
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Abstract
Low-grade fibromyxoid sarcoma (LGFMS) is a rare neoplasm commonly affecting young adults and typically arising in the somatic soft tissue of the proximal extremities. Its occurrence within the big toe is exceedingly rare. A 43-year-old man had surgery on a mass located in the big toe, which was first noted 6 months previously. Histological examination revealed LGFMS. One year after surgery, the patient is alive with no evidence of disease. Low-grade fibromyxoid sarcoma is a rare neoplasm that should be considered in the differential diagnosis of spindle cell neoplasms of the foot.
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Solano Iturri G, Blanco Sampascual S, Orive Cura V. [Low-grade fibromixoid tumor]. GASTROENTEROLOGIA Y HEPATOLOGIA 2011; 34:56-7. [PMID: 21216042 DOI: 10.1016/j.gastrohep.2010.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2010] [Accepted: 09/22/2010] [Indexed: 11/30/2022]
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Notarnicola A, Moretti L, Cocca MP, Martucci A, Orsini U, Moretti B. Low-grade fibromyxoid sarcoma of the medial vastus: a case report. Musculoskelet Surg 2010; 94:109-12. [PMID: 20376587 DOI: 10.1007/s12306-010-0075-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2009] [Accepted: 03/11/2010] [Indexed: 10/19/2022]
Abstract
Low-grade fibromyxoid sarcoma (LGFMS) was first described by Evans in 1987, and since then, just over 150 cases have been reported, showing the rarity of this tumor. We report the clinical case of a 56-year-old man with a swelling on the distal third of the left thigh. The mass had grown in the course of 1 year and was surgically excised, obtaining complete resolution. Immuno-histological examination demonstrated the lesion to be a LGFMS, defined as a benign tumor but with a high incidence of local and distant recurrence (5-10%). At 2-year follow-up the patient was disease-free, confirming the efficacy of the surgical excision. In literature, the frequency of incomplete excision of LGFMS due to inappropriate diagnosis is stressed. It is this element that contributes most to the high rate of recurrence. We recommend that the eventuality of observing this rare tumor be borne in mind, and that care be taken to perform a complete, ample excision.
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Affiliation(s)
- Angela Notarnicola
- Department of Clinical Methodology and Surgical Technique, Orthopaedics Section, University of Bari, Piazza G. Cesare 11, Bari, Italy.
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Low-Grade Fibromyxoid Sarcoma: Clinical Study and Case Report. J Oral Maxillofac Surg 2010; 68:873-84. [DOI: 10.1016/j.joms.2009.04.136] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2008] [Accepted: 04/24/2009] [Indexed: 02/03/2023]
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Fisher C. Soft tissue sarcomas with non-EWS translocations: molecular genetic features and pathologic and clinical correlations. Virchows Arch 2009; 456:153-66. [DOI: 10.1007/s00428-009-0776-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2009] [Revised: 03/27/2009] [Accepted: 04/14/2009] [Indexed: 12/15/2022]
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Primary intrathoracic low-grade fibromyxoid sarcoma. Hum Pathol 2008; 39:623-8. [PMID: 18275982 DOI: 10.1016/j.humpath.2007.08.017] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2007] [Revised: 08/21/2007] [Accepted: 08/28/2007] [Indexed: 11/23/2022]
Abstract
Low-grade fibromyxoid sarcoma (LGFMS) is a rare neoplasm commonly affecting young adults and typically arising in the somatic soft tissue of the proximal extremities. Its occurrence within the thoracic cavity is exceedingly rare. We report an LGFMS arising from the epicardial surface of the right side of the heart in a 44-year-old woman. Diagnosis was aided by a strikingly characteristic light microscopic appearance of a bland spindle cell sarcoma containing numerous so-called giant collagen rosettes and supported by immunohistology, evidence of FUS translocation by fluorescence in situ hybridization, and electron microscopy demonstrating a fibroblastic phenotype. Aspiration cytology showed a nonspecific bland spindle cell lesion. Review of the literature uncovered 5 previously reported examples of intrathoracic LGFMS. Low-grade fibromyxoid sarcoma is probably an underrecognized intrathoracic neoplasm and should be considered in the differential diagnosis of spindle cell neoplasms of the mediastinum, pleura, heart, and lungs.
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