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Low-grade myxofibrosarcoma following a metal implantation in femur: a case report.

Li W, Li D, Zhu X, Lu S, He C, Yang Q - Diagn Pathol (2014)

Bottom Line: Immunohistochemical studies revealed that the tumor cells was positive for VIM and MDM2, and was negative for CK, MSA, SMA, DES, S-100 and CD34.Labeling index of Ki-67 was 25%.The clinical and imaging examinations did not reveal the evidence of a primary cancer elsewhere, and the patient had no personal or family history of malignancy.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Pathology, Gannan Medical University, No, 1, Yixueyuan Road, Ganzhou, Jiangxi 341000, China. dan.li.liu@hotmail.com.

ABSTRACT

Unlabelled: Myxofibrosarcoma is a myxoid variant of malignant fibrous histiocytoma that most commonly involves the extremities of elderly people. However, a primary myxofibrosarcoma with bone invasion in young adults is extremely rare. Herein, we report the case of a 31-year-old male with a gradually enlarging left thigh mass, who had a history of left femur fracture and received an open reduction and internal fixation with titanium alloy plates and screws 33 months previously. Imaging investigations revealed an irregularly shaped soft tissue mass around the left femur shaft and a partial bone defect in the middle one-third of the left femur. Pathological examination of the resected specimen showed a multi-nodular appearance, abundant myxoid matrix and elongated curvilinear capillaries. Immunohistochemical studies revealed that the tumor cells was positive for VIM and MDM2, and was negative for CK, MSA, SMA, DES, S-100 and CD34. Labeling index of Ki-67 was 25%. Based on the morphological finding and immunostaining, it was diagnosed as a low-grade myxofibrosarcoma. The clinical and imaging examinations did not reveal the evidence of a primary cancer elsewhere, and the patient had no personal or family history of malignancy. To our knowledge, this is the first case of a primary myxofibrosarcoma developed following a fracture and metal implantation in young adults.

Virtual slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1745984882113605.

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Related in: MedlinePlus

CT images of the left thigh. (a) Transverse image. (b) Coronal image. A high-resolution volumetric CT scanning revealed a 9.7 × 11 × 19 cm irregularly shaped soft tissue mass in the anteromedial left thigh (yellow arrow) and a partial bone defect approximately 9.7 cm in length on the medial border of the left femur shaft (light blue arrow).
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Figure 1: CT images of the left thigh. (a) Transverse image. (b) Coronal image. A high-resolution volumetric CT scanning revealed a 9.7 × 11 × 19 cm irregularly shaped soft tissue mass in the anteromedial left thigh (yellow arrow) and a partial bone defect approximately 9.7 cm in length on the medial border of the left femur shaft (light blue arrow).

Mentions: The X-ray examination demonstrated an ill-defined osteolytic lesion with disappearance of the medial cortical bone in the middle of the left femur shaft, as well as an ambiguous image of a soft tissue mass. Computed tomography (CT) images clearly showed a partial bone defect approximately 9.7 cm in length on the medial border of the left femur shaft. A 9.7 × 11 × 19 cm irregularly shaped soft tissue mass was observed around the left femur, with the surrounding tissues compressed and shifted significantly (Figure 1). CT findings also showed that the soft tissue mass was heterogeneous in density with CT value of 36 HU, in which small pieces of slightly high-density lesions were found. These imaging findings suggested that the mass was neoplastic.


Low-grade myxofibrosarcoma following a metal implantation in femur: a case report.

Li W, Li D, Zhu X, Lu S, He C, Yang Q - Diagn Pathol (2014)

CT images of the left thigh. (a) Transverse image. (b) Coronal image. A high-resolution volumetric CT scanning revealed a 9.7 × 11 × 19 cm irregularly shaped soft tissue mass in the anteromedial left thigh (yellow arrow) and a partial bone defect approximately 9.7 cm in length on the medial border of the left femur shaft (light blue arrow).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3926977&req=5

Figure 1: CT images of the left thigh. (a) Transverse image. (b) Coronal image. A high-resolution volumetric CT scanning revealed a 9.7 × 11 × 19 cm irregularly shaped soft tissue mass in the anteromedial left thigh (yellow arrow) and a partial bone defect approximately 9.7 cm in length on the medial border of the left femur shaft (light blue arrow).
Mentions: The X-ray examination demonstrated an ill-defined osteolytic lesion with disappearance of the medial cortical bone in the middle of the left femur shaft, as well as an ambiguous image of a soft tissue mass. Computed tomography (CT) images clearly showed a partial bone defect approximately 9.7 cm in length on the medial border of the left femur shaft. A 9.7 × 11 × 19 cm irregularly shaped soft tissue mass was observed around the left femur, with the surrounding tissues compressed and shifted significantly (Figure 1). CT findings also showed that the soft tissue mass was heterogeneous in density with CT value of 36 HU, in which small pieces of slightly high-density lesions were found. These imaging findings suggested that the mass was neoplastic.

Bottom Line: Immunohistochemical studies revealed that the tumor cells was positive for VIM and MDM2, and was negative for CK, MSA, SMA, DES, S-100 and CD34.Labeling index of Ki-67 was 25%.The clinical and imaging examinations did not reveal the evidence of a primary cancer elsewhere, and the patient had no personal or family history of malignancy.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Pathology, Gannan Medical University, No, 1, Yixueyuan Road, Ganzhou, Jiangxi 341000, China. dan.li.liu@hotmail.com.

ABSTRACT

Unlabelled: Myxofibrosarcoma is a myxoid variant of malignant fibrous histiocytoma that most commonly involves the extremities of elderly people. However, a primary myxofibrosarcoma with bone invasion in young adults is extremely rare. Herein, we report the case of a 31-year-old male with a gradually enlarging left thigh mass, who had a history of left femur fracture and received an open reduction and internal fixation with titanium alloy plates and screws 33 months previously. Imaging investigations revealed an irregularly shaped soft tissue mass around the left femur shaft and a partial bone defect in the middle one-third of the left femur. Pathological examination of the resected specimen showed a multi-nodular appearance, abundant myxoid matrix and elongated curvilinear capillaries. Immunohistochemical studies revealed that the tumor cells was positive for VIM and MDM2, and was negative for CK, MSA, SMA, DES, S-100 and CD34. Labeling index of Ki-67 was 25%. Based on the morphological finding and immunostaining, it was diagnosed as a low-grade myxofibrosarcoma. The clinical and imaging examinations did not reveal the evidence of a primary cancer elsewhere, and the patient had no personal or family history of malignancy. To our knowledge, this is the first case of a primary myxofibrosarcoma developed following a fracture and metal implantation in young adults.

Virtual slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1745984882113605.

Show MeSH
Related in: MedlinePlus