Challenging Diagnosis of Low-grade Fibromyxoid Sarcoma of the Chest Wall: Case Report

Authors

  • Rafael Everton Assunção Ribeiro da Costa Universidade Estadual do Piauí, Centro de Ciências da Saúde. Teresina (PI), Brazil. https://orcid.org/0000-0002-0798-890X
  • Ana Carolina Vieira Mendes Universidade Estadual do Maranhão, Centro de Ciências da Saúde. Caxias (MA), Brazil. https://orcid.org/0000-0003-3761-4543
  • Eugênio de Sá Coutinho Neto Hospital Macrorregional de Caxias Dr. Everardo Aragão, Unidade de Alta Complexidade em Oncologia. Caxias (MA), Brazil. https://orcid.org/0000-0002-0806-3933
  • Raimundo Gerônimo da Silva Júnior Universidade Federal do Piauí, Centro de Ciências da Saúde. Teresina (PI), Brazil. https://orcid.org/0000-0003-4032-6710
  • Cromwell Barbosa de Carvalho Melo Hospital Macrorregional de Caxias Dr. Everardo Aragão, Unidade de Alta Complexidade em Oncologia. Caxias (MA), Brazil. https://orcid.org/0000-0002-0148-9413
  • José Santana Moreira Ramos Júnior Hospital Macrorregional de Caxias Dr. Everardo Aragão, Unidade de Alta Complexidade em Oncologia. Caxias (MA), Brazil. https://orcid.org/0000-0003-1170-4719
  • Sabas Carlos Vieira Oncocenter. Teresina (PI), Brazil. https://orcid.org/0000-0003-0935-7316
  • Carlos Eduardo Coelho de Sá Hospital Macrorregional de Caxias Dr. Everardo Aragão, Unidade de Alta Complexidade em Oncologia. Caxias (MA), Brazil. Oncocenter. Teresina (PI), Brazil. https://orcid.org/0000-0002-9610-8010

DOI:

https://doi.org/10.32635/2176-9745.RBC.2023v69n2.3288

Keywords:

sarcoma, thoracic wall, immunohistochemistry, diagnosis, differential, case reports

Abstract

Introduction: Low-grade fibromyxoid sarcoma (LGFMS) is a rare special subtype of fibrosarcoma, it is more common in the trunk and proximal limbs. First described by Evans in 1987, this tumor is also named Evans tumor. Diagnosis of LGFMS may be quite challenging, either due to the low suspicion rate of the tumor or low specificity of its morphological pattern and immunohistochemical profile, a phenomenon that is magnified when tumor location is less usual, such as in the chest wall. The present article presents a challenging case of LGFMS of the chest wall. Case report: Female, 58-year-old patient was referred to the oncology referral clinic with a breast tumor. Diagnostic investigation included imaging tests (breast US and chest CT scan) and core needle biopsy. CT scan revealed the epicenter of the tumor in the left anterior thoracic wall. Biopsy to evaluate the histologic type of tumor was carried out and the result was inconclusive. Therefore, surgical excision of the tumor was performed. Histopathology and immunohistochemistry studies of the surgical specimen confirmed the diagnosis of LGFMS of the chest wall. Currently, after 36 months of the surgical excision, the patient is still doing well and continues under clinical follow-up. Conclusion: Although the diagnosis of LGFMS of the chest wall is challenging, it should be done correctly, since these cases require a long and thorough clinical follow-up.

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References

Folpe AL. Fibrosarcoma: a review and update. Histopathology. 2014;64(1):12-25. doi: https://doi.org/10.1111/his.12282 DOI: https://doi.org/10.1111/his.12282

Evans HL. Low-grade fibromyxoid sarcoma. A report of two metastasizing neoplasms having a deceptively benign appearance. Am J Clin Pathol. 1987;88(5):615-9. doi: https://doi.org/10.1093/ajcp/88.5.615 DOI: https://doi.org/10.1093/ajcp/88.5.615

Evans HL. Low-grade fibromyxoid sarcoma. A report of 12 cases. Am J Surg Pathol. 1993;17(6):595-600. doi: https://doi.org/10.1097/00000478-199306000-00007 DOI: https://doi.org/10.1097/00000478-199306000-00007

Zhang Y, Wan D, Gao F. Primary low-grade fibromyxoid sarcoma of the breast: a rare case report with immunohistochemical and fluorescence in situ hybridization detection. Hum Pathol. 2018;79:208-11. doi: https://doi.org/10.1016/j.humpath.2018.02.013 DOI: https://doi.org/10.1016/j.humpath.2018.02.013

Perez D, El-Zammar O, Cobanov B, et al. Low-grade fibromyxoid sarcoma: a rare case in an unusual location. SAGE Open Med Case Rep. 2020;8:2050313X20944315. doi: https://doi.org/10.1177/2050313X20944315 DOI: https://doi.org/10.1177/2050313X20944315

Park JM, Lim HR, Kim JH, et al. Giant low-grade fibromyxoid sarcoma in the neck. Korean J Otorhinolaryngol-Head Neck Surg. 2020;63(9):432-5. doi: https://doi.org/10.3342/kjorl-hns.2019.00857 DOI: https://doi.org/10.3342/kjorl-hns.2019.00857

Chamberlain F, Engelmann B, Al-Muderis O, et al. Low-grade fibromyxoid sarcoma: treatment outcomes and efficacy of chemotherapy. In Vivo. 2020;34(1):239-45. doi: https://doi.org/10.21873/invivo.11766 DOI: https://doi.org/10.21873/invivo.11766

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Published

2023-02-14

How to Cite

1.
Costa REAR da, Mendes ACV, Coutinho Neto E de S, Silva Júnior RG da, Melo CB de C, Ramos Júnior JSM, Vieira SC, Sá CEC de. Challenging Diagnosis of Low-grade Fibromyxoid Sarcoma of the Chest Wall: Case Report. Rev. Bras. Cancerol. [Internet]. 2023 Feb. 14 [cited 2024 Jul. 22];69(2):e-023288. Available from: https://rbc.inca.gov.br/index.php/revista/article/view/3288

Issue

Vol. 69 No. 2 (2023): Apr./May/June

Section

CASE REPORT

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