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Large cervicothoracic myxoinflammatory fibroblastic sarcoma with brachial plexus invasion: A case report and literature review

View Article: PubMed Central - PubMed

ABSTRACT

Myxoinflammatory fibroblastic sarcoma is a rare sarcoma that develops in patients of all ages, which usually presents as a slow-growing painless mass in the distal extremities. To date, myxoinflammatory fibroblastic sarcoma with invasion of the brachial plexus has rarely been reported in the literature. In this study, a case of large cervicothoracic sarcoma, which invaded the brachial plexus, is presented. The patient reported no sensory disturbance or dyskinesia. The tumor was completely resected without injury of the brachial plexus. The postoperative histological diagnosis was myxoinflammatory fibroblastic sarcoma. Follow-up examination performed 24 months after surgery revealed no tumor recurrence and no sensory disturbance or dyskinesia was reported. This study presents a rare case of large myxoinflammatory fibroblastic sarcoma with brachial plexus invasion that was successfully managed by surgery.

No MeSH data available.


The mass was gradually resected to maintain the integrity of the nerves.
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f4-ol-0-0-4824: The mass was gradually resected to maintain the integrity of the nerves.

Mentions: The mass was extremely large, with a supraclavicular portion measuring 10×5×3 cm and an infraclavicular portion measuring 25×18×8 cm (Fig. 2). The mass was exposed via supraclavicular incision and the supraclavicular portion of the hard mass, measuring 10×5×3 cm, with clear boundaries and an abundant blood supply, was identified. The tumor oppressed the brachial plexus and vessels, and could not be separated by only supraclavicular incision. The mass extended from the supraclavicle to the infraclavicle and could not be completely exposed by only supraclavicular incision. An additional incision from the infraclavicle region to the deltopectoral interval and midaxillary line was made, and the infraclavicular portion of the hard mass, sized 25×18×8 cm, with clear boundaries and an abundant blood supply, was identified. The tumor was lobulated. The mass was enwrapped and separated by the medial, lateral and posterior cords and the axillary, musculocutaneus, median and ulnar nerves (Fig. 3). The mass was evidently adhered to the aforementioned nerves and could not be easily separated. The mass was gradually resected carefully to maintain the integrity of the nerves (Fig. 4). Clavicotomy was performed prior to separation of the nerves and vessels surrounding the mass. Finally, the mass was completely resected (Fig. 5). Tumor invasion of the clavicle without bone destruction was observed. Intraoperative electromyography recorded the somatosensory evoked potential by stimulating the axillary, musculocutaneus, median, radial and ulnar nerves. Following surgery, the activity and sensation of the right upper limb were normal.


Large cervicothoracic myxoinflammatory fibroblastic sarcoma with brachial plexus invasion: A case report and literature review
The mass was gradually resected to maintain the integrity of the nerves.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4998063&req=5

f4-ol-0-0-4824: The mass was gradually resected to maintain the integrity of the nerves.
Mentions: The mass was extremely large, with a supraclavicular portion measuring 10×5×3 cm and an infraclavicular portion measuring 25×18×8 cm (Fig. 2). The mass was exposed via supraclavicular incision and the supraclavicular portion of the hard mass, measuring 10×5×3 cm, with clear boundaries and an abundant blood supply, was identified. The tumor oppressed the brachial plexus and vessels, and could not be separated by only supraclavicular incision. The mass extended from the supraclavicle to the infraclavicle and could not be completely exposed by only supraclavicular incision. An additional incision from the infraclavicle region to the deltopectoral interval and midaxillary line was made, and the infraclavicular portion of the hard mass, sized 25×18×8 cm, with clear boundaries and an abundant blood supply, was identified. The tumor was lobulated. The mass was enwrapped and separated by the medial, lateral and posterior cords and the axillary, musculocutaneus, median and ulnar nerves (Fig. 3). The mass was evidently adhered to the aforementioned nerves and could not be easily separated. The mass was gradually resected carefully to maintain the integrity of the nerves (Fig. 4). Clavicotomy was performed prior to separation of the nerves and vessels surrounding the mass. Finally, the mass was completely resected (Fig. 5). Tumor invasion of the clavicle without bone destruction was observed. Intraoperative electromyography recorded the somatosensory evoked potential by stimulating the axillary, musculocutaneus, median, radial and ulnar nerves. Following surgery, the activity and sensation of the right upper limb were normal.

View Article: PubMed Central - PubMed

ABSTRACT

Myxoinflammatory fibroblastic sarcoma is a rare sarcoma that develops in patients of all ages, which usually presents as a slow-growing painless mass in the distal extremities. To date, myxoinflammatory fibroblastic sarcoma with invasion of the brachial plexus has rarely been reported in the literature. In this study, a case of large cervicothoracic sarcoma, which invaded the brachial plexus, is presented. The patient reported no sensory disturbance or dyskinesia. The tumor was completely resected without injury of the brachial plexus. The postoperative histological diagnosis was myxoinflammatory fibroblastic sarcoma. Follow-up examination performed 24 months after surgery revealed no tumor recurrence and no sensory disturbance or dyskinesia was reported. This study presents a rare case of large myxoinflammatory fibroblastic sarcoma with brachial plexus invasion that was successfully managed by surgery.

No MeSH data available.