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Giraldo-Roldan D, Louredo BVR, Penafort PVM, Pontes HAR, Alves AP, Lima FCA, Fonseca TC, Abrahão AC, Romañach MJ, Fonseca FP, Delgado WA, Robinson L, Van Heerden WFP, de Almeida OP, Vargas PA. Low-Grade Myofibroblastic Sarcoma of the Oral and Maxillofacial Region: An International Clinicopathologic Study of 13 Cases and Literature Review. Head Neck Pathol 2023; 17:832-850. [PMID: 37540486 PMCID: PMC10513986 DOI: 10.1007/s12105-023-01577-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 07/20/2023] [Indexed: 08/05/2023]
Abstract
Low-grade myofibroblastic sarcoma (LGMS) represents an atypical tumor composed of myofibroblasts with a variety of histological patterns and with a high tendency to local recurrence and a low probability of distant metastases. LGMS has predilection for the head and neck regions, especially the oral cavity. This study aimed to report 13 new cases of LGMS arising in the oral and maxillofacial region. This study included LGMS cases from five oral and maxillofacial pathology laboratories in four different countries (Brazil, Peru, Guatemala, and South Africa). Their clinical, radiographic, histopathological, and immunohistochemical findings were evaluated. In this current international case series, most patients were females with a mean age of 38.7 years, and commonly presenting a nodular lesion in maxilla. Microscopically, all cases showed a neoplasm formed by oval to spindle cells in a fibrous stroma with myxoid and dense areas, some atypical mitoses, and prominent nucleoli. The immunohistochemical panel showed positivity for smooth muscle actin (12 of 13 cases), HHF35 (2 of 4 cases), β-catenin (3 of 5 cases), desmin (3 of 11 cases), and Ki-67 (range from 5 to 50%). H-caldesmon was negative for all cases. The diagnosis of LGMS was confirmed in all cases. LGMS shows predominance in young adults, with a slight predilection for the female sex, and maxillary region. LGMS should be a differential diagnosis of myofibroblastic lesions that show a proliferation of spindle cells in a fibrous stroma with myxoid and dense areas and some atypical mitoses, supporting the diagnosis with a complementary immunohistochemical study. Complete surgical excision with clear margins is the treatment of choice. However, long-term follow-up information is required before definitive conclusions can be drawn regarding the incidence of recurrence and the possibility of metastasis.
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Affiliation(s)
- Daniela Giraldo-Roldan
- Department of Oral Diagnosis, Oral Pathology Area, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil
| | | | - Paulo Victor Mendes Penafort
- Department of Oral Diagnosis, Oral Pathology Area, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil
| | - Hélder Antônio Rebelo Pontes
- Oral Pathology Service, João de Barros Barreto University Hospital, Federal University of Pará, Belém, PA, Brazil
| | - Aline Pinheiro Alves
- Oral & Maxilofacial Surgery, Hospital Federal dos Servidores do Estado, Rio de Janeiro, RJ, Brazil
| | - Fernando C A Lima
- Oral & Maxilofacial Surgery, Hospital Federal dos Servidores do Estado, Rio de Janeiro, RJ, Brazil
| | - Thamyres Campos Fonseca
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Aline Corrêa Abrahão
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Mário José Romañach
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Felipe Paiva Fonseca
- Department of Oral Surgery and Pathology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
- Department of Oral and Maxillofacial Pathology, Faculty of Health Sciences, School of Dentistry, University of Pretoria, Pretoria, South Africa
| | - Wilson A Delgado
- Department of Oral and Maxillofacial Pathology and Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Liam Robinson
- Department of Oral and Maxillofacial Pathology, Faculty of Health Sciences, School of Dentistry, University of Pretoria, Pretoria, South Africa
| | - Willie F P Van Heerden
- Department of Oral and Maxillofacial Pathology, Faculty of Health Sciences, School of Dentistry, University of Pretoria, Pretoria, South Africa
| | - Oslei Paes de Almeida
- Department of Oral Diagnosis, Oral Pathology Area, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil
| | - Pablo Agustin Vargas
- Department of Oral Diagnosis, Oral Pathology Area, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil.
- Department of Oral and Maxillofacial Pathology, Faculty of Health Sciences, School of Dentistry, University of Pretoria, Pretoria, South Africa.
- Department of Oral Diagnosis, Oral Pathology Area Piracicaba Dental School, State University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil.
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Yang G, Li C, Long Y, Liu Z, Rao C, Zhang Y, Liu Y, Yang H. Low-Grade Malignant Myofibroblastic Sarcoma of the Larynx: A Case Report and Literature Review. EAR, NOSE & THROAT JOURNAL 2022:1455613221145284. [PMID: 36476124 DOI: 10.1177/01455613221145284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023] Open
Abstract
Squamous cell carcinomas predominate in laryngeal malignancies, while spindle cell tumors, typically derived from non-epithelial tissues, are uncommon, accounting for 0.3%-1% of all malignant laryngeal tumors. Low-grade malignant myofibroblastic sarcoma (LGMS) is an extremely rare, atypical myofibroblastic tumor classified as a spindle cell tumor that primarily affects the head and neck region. There have been few reports in the literature regarding the LGMS of the larynx. LGMS of the larynx was discovered during a pathological biopsy. There was no recurrence during the 6-month follow-up after the total laryngectomy.
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Affiliation(s)
- Guilian Yang
- Department of Otolaryngology, Affiliated Hospital of Zunyi Medical University, China
| | - Chunlei Li
- Department of Otolaryngology, Affiliated Hospital of Zunyi Medical University, China
| | - Yilin Long
- Department of Otolaryngology, Affiliated Hospital of Zunyi Medical University, China
| | - Zhaohui Liu
- Department of Otolaryngology, Affiliated Hospital of Zunyi Medical University, China
| | - Cheng Rao
- Department of Otolaryngology, Affiliated Hospital of Zunyi Medical University, China
| | - Yangchun Zhang
- Department of Otolaryngology, Affiliated Hospital of Zunyi Medical University, China
| | - Yi Liu
- Department of Otolaryngology, Affiliated Hospital of Zunyi Medical University, China
| | - Hanghang Yang
- Department of Otolaryngology, Affiliated Hospital of Zunyi Medical University, China
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Yonezawa H, Yamamoto N, Hayashi K, Takeuchi A, Miwa S, Igarashi K, Langit MB, Kimura H, Shimozaki S, Kato T, Morinaga S, Araki Y, Asano Y, Ikeda H, Nojima T, Tsuchiya H. Low-grade myofibroblastic sarcoma of the levator scapulae muscle: a case report and literature review. BMC Musculoskelet Disord 2020; 21:836. [PMID: 33302922 PMCID: PMC7731512 DOI: 10.1186/s12891-020-03857-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 12/03/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Low-grade myofibroblastic sarcoma (LGMS) is described as a distinct atypical myofibroblastic tumor often with fibromatosis-like features and predilection for the head and neck, especially the oral cavity and larynx. LGMS arising in the levator scapulae muscle is extremely rare. CASE PRESENTATION A 69-year-old woman was admitted to our hospital because she noticed a hard mass in her left neck six months prior. Magnetic resonance images (MRI) showed a soft tissue tumor of the left levator scapulae muscle. A core needle biopsy showed cellular fascicles or a storiform growth pattern of spindle-shaped tumor cells with minimally atypia. Immunohistochemistry revealed focally positive for α-smooth muscle actin (α-SMA), negative for S-100, and a low-grade spindle cell sarcoma was suspected. Following a biopsy, the tumor was resected with a wide surgical margin. Immunohistochemical staining was a positive for vimentin and α-SMA and negative for desmin, CD34, nuclear β-catenin, and h-caldesmon. LGMS diagnosis was determined based on the histopathological findings. The patient was alive with no evidence of disease eight years after the surgery. CONCLUSIONS To the best of our knowledge, this is the first case report of LGMS arising in the levator scapulae muscle. In addition to the case report, 48 reports with 103 LGMS cases are reviewed and discussed. In previous reports of LGMS, there were 43 females and 60 males, with a mean age of 43.0 years (range, 2-75). There were 13 (12.6%) patients aged < 18 years, 67 (65.1%) patients aged 18 to 59 years, and 23 (22.3%) patients aged ≥60 years. The average tumor size was 4.4 cm (range: 0.4-22.0). The commonest sites of LGMS was the tongue. Tumor growth patterns were evaluated in 52 cases, and 44 cases (84.6%) showed infiltrative growth patterns. Local recurrence was 26.7%, and distant metastasis was 4.4%. Because of the locally aggressive feature, it is important to diagnose LGMS with biopsy and to excise the tumor with an adequately wide margin.
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Affiliation(s)
- Hirotaka Yonezawa
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Norio Yamamoto
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan.
| | - Katsuhiro Hayashi
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Akihiko Takeuchi
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Shinji Miwa
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Kentaro Igarashi
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Mickhael Bang Langit
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan.,Department of Orthopedics, Philippine Orthopedic Center, Quezon City, Manilla, Philippines
| | - Hiroaki Kimura
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Shingo Shimozaki
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Takashi Kato
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Sei Morinaga
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Yoshihiro Araki
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Yohei Asano
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Hiroko Ikeda
- Department of Diagnostic Pathology, Kanazawa University Hospital, Kanazawa, Japan
| | - Takayuki Nojima
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan.,Department of Diagnostic Pathology, Kanazawa University Hospital, Kanazawa, Japan
| | - Hiroyuki Tsuchiya
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
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