Skip to main content
Top
Published in: Journal of Maxillofacial and Oral Surgery 4/2011

01-12-2011 | Review Paper

Myxofibrosarcoma Arising in the Maxillary Sinus: A Case Report with a Review of the Ultrastructural Findings and Differential Diagnoses

Authors: Ernst J. G. Norval, Erich J. Raubenheimer

Published in: Journal of Maxillofacial and Oral Surgery | Issue 4/2011

Login to get access

Abstract

This is a case report of a patient presenting with a destructive lesion with histologic features of a low grade malignancy in a predominantly myxoid matrix. Various low grade myxoid malignancies were considered in the differential diagnosis of which an overview is presented. A literature review of the ultrastructural findings and possible histogenesis is discussed along with the diagnostic criteria and recent change in the terminology regarding the malignancies previously diagnosed as myxoid malignant fibrous histiocytomas. A final diagnosis of a myxofibrosarcoma was only possible after assessing the immuno-histochemical profile, results of histochemical stains and ultrastructural features of this lesion.
Literature
1.
go back to reference Merck C, Angerval L, Kindblom L, Oden A (1983) Myxofibrosarcoma: a malignant soft tissue tumor of fibroblastic-histiocytic origin. Acta Path Microbiol Scand 91(282):1–40 Merck C, Angerval L, Kindblom L, Oden A (1983) Myxofibrosarcoma: a malignant soft tissue tumor of fibroblastic-histiocytic origin. Acta Path Microbiol Scand 91(282):1–40
2.
go back to reference Angervall I, Kindblom L, Merck C (1977) Myxofibrosarcoma. Acta Path Microbiol Scand 85:127–140 Angervall I, Kindblom L, Merck C (1977) Myxofibrosarcoma. Acta Path Microbiol Scand 85:127–140
4.
go back to reference Anavi Y, Herman GE, Graybrill S, MacIntosh RB, Tiqva P (1987) Malignant fibrous histiocytoma of the mandible. Oral Surg Oral Med Oral Pathol 68:436–443CrossRef Anavi Y, Herman GE, Graybrill S, MacIntosh RB, Tiqva P (1987) Malignant fibrous histiocytoma of the mandible. Oral Surg Oral Med Oral Pathol 68:436–443CrossRef
5.
go back to reference Bras J, Batsakis JG, Luna MA (1987) Malignant fibrous histiocytoma of the oral soft tissues. Oral Surg Oral Med Oral Pathol 64:57–67PubMedCrossRef Bras J, Batsakis JG, Luna MA (1987) Malignant fibrous histiocytoma of the oral soft tissues. Oral Surg Oral Med Oral Pathol 64:57–67PubMedCrossRef
6.
go back to reference Weiss SW, Enzinger FM (1977) Myxoid variant of malignant fibrous histiocytoma. Cancer 39:1672–1685PubMedCrossRef Weiss SW, Enzinger FM (1977) Myxoid variant of malignant fibrous histiocytoma. Cancer 39:1672–1685PubMedCrossRef
7.
go back to reference Hollowood K, Fletcher CDM (1995) Malignant fibrous histiocytoma: morhologic pattern or pathologic entity. Semin Diagn Pathol 12(3):210–220PubMed Hollowood K, Fletcher CDM (1995) Malignant fibrous histiocytoma: morhologic pattern or pathologic entity. Semin Diagn Pathol 12(3):210–220PubMed
8.
go back to reference Wada T, Hasegawa T, Nagoya S, Kwaguchi S, Kaya M, Ishii S (2000) Myxofibrosarcoma with infitrative growth pattern: a case report. Jap Jnl Clin Oncol 30:458–462CrossRef Wada T, Hasegawa T, Nagoya S, Kwaguchi S, Kaya M, Ishii S (2000) Myxofibrosarcoma with infitrative growth pattern: a case report. Jap Jnl Clin Oncol 30:458–462CrossRef
9.
go back to reference Waters B, Panice KDM, Lefkowitz RA, Antonescu CR, Healy JH, Athanason EA, Brennan MF (2007) Low-grade myxofibrosarcoma: CT and MRI patterns in recurrent disease. Am J Roentgenol 188(2):W193–W198CrossRef Waters B, Panice KDM, Lefkowitz RA, Antonescu CR, Healy JH, Athanason EA, Brennan MF (2007) Low-grade myxofibrosarcoma: CT and MRI patterns in recurrent disease. Am J Roentgenol 188(2):W193–W198CrossRef
10.
go back to reference Pezzi CM, Rawlings MS, Esqro JJ, Pollock RE, Romsdhal MM (1992) Prognostic factors in 227 patients with malignant fibrous histiocytoma. Cancer 69(8):2013–2098CrossRef Pezzi CM, Rawlings MS, Esqro JJ, Pollock RE, Romsdhal MM (1992) Prognostic factors in 227 patients with malignant fibrous histiocytoma. Cancer 69(8):2013–2098CrossRef
11.
go back to reference Huang HY, Quin J, Brennan MF, Antonescu CR (2004) Low-grade myxofibrosarcoma: a clinicopathologic analysis of 49 cases treated at a single institution with simultaneous assessment of the efficacy of 3-tier and 4-tier grading systems. Human Pathol 35(5):612–621CrossRef Huang HY, Quin J, Brennan MF, Antonescu CR (2004) Low-grade myxofibrosarcoma: a clinicopathologic analysis of 49 cases treated at a single institution with simultaneous assessment of the efficacy of 3-tier and 4-tier grading systems. Human Pathol 35(5):612–621CrossRef
12.
go back to reference Silverman JF, Coalson JJ (1984) Primary myxoid malignant fibrous histiocytoma of the lung. Arch Pathol Lab Med 108:49–54PubMed Silverman JF, Coalson JJ (1984) Primary myxoid malignant fibrous histiocytoma of the lung. Arch Pathol Lab Med 108:49–54PubMed
13.
go back to reference Rooser B, Willen H, Gustafson P, Alvegard TA, Rydbholm A (1991) Malignant fibrous histiocytoma of soft tissue. Cancer 67:499–505PubMedCrossRef Rooser B, Willen H, Gustafson P, Alvegard TA, Rydbholm A (1991) Malignant fibrous histiocytoma of soft tissue. Cancer 67:499–505PubMedCrossRef
14.
go back to reference Nascimento AF, Bertoni F, Fletcher CD (2007) Epithelioid variant of myxofibrosarcoma: expanding the clinicomorphologic spectrum of myxofibrosarcoma in a series of 17 cases. Am J Surg Pathol 115(7):1237–1240 Nascimento AF, Bertoni F, Fletcher CD (2007) Epithelioid variant of myxofibrosarcoma: expanding the clinicomorphologic spectrum of myxofibrosarcoma in a series of 17 cases. Am J Surg Pathol 115(7):1237–1240
15.
go back to reference Fletcher CDM, Mehrtens F (2002) World heath organization classification of tumors: pathology and genetics of tumors of soft tissue and bone. IARC Press, France Fletcher CDM, Mehrtens F (2002) World heath organization classification of tumors: pathology and genetics of tumors of soft tissue and bone. IARC Press, France
16.
go back to reference Mentzel T, Calonje E, Wadden C, Camplejohn RS, Beham A, Smith MA, Fletcher C (1996) Myxofibrosarcoma: clinicopathological analysis of 75 cases with emphasis on the low-grade variant. Am J Surg Pathol 20(4):391–405PubMedCrossRef Mentzel T, Calonje E, Wadden C, Camplejohn RS, Beham A, Smith MA, Fletcher C (1996) Myxofibrosarcoma: clinicopathological analysis of 75 cases with emphasis on the low-grade variant. Am J Surg Pathol 20(4):391–405PubMedCrossRef
17.
go back to reference Mansoor A, White CR (2003) Myxofibrosarcoma presenting in the skin: clinicopathological features and differential diagnosis with cutaneous myxoid neoplasms. Am J Dermatopathol 25(4):281–286PubMedCrossRef Mansoor A, White CR (2003) Myxofibrosarcoma presenting in the skin: clinicopathological features and differential diagnosis with cutaneous myxoid neoplasms. Am J Dermatopathol 25(4):281–286PubMedCrossRef
18.
go back to reference Ackerman M (1997) Malignant fibrous histiocytoma—the commonest soft tissue sarcoma or a nonexistent entity? Acta Orthop Scand Suppl 273:41–46 Ackerman M (1997) Malignant fibrous histiocytoma—the commonest soft tissue sarcoma or a nonexistent entity? Acta Orthop Scand Suppl 273:41–46
19.
go back to reference Lagare R, Aurias A (2002) Does malignant fibrous histiocytoma exist? Ann Pathol 22(1):29–34 Lagare R, Aurias A (2002) Does malignant fibrous histiocytoma exist? Ann Pathol 22(1):29–34
20.
go back to reference Erlandsen RA, Antonescu CR (2004) The rise and fall of malignant fibrous histiocytoma. Ultrastruct Pathol 28:283–289CrossRef Erlandsen RA, Antonescu CR (2004) The rise and fall of malignant fibrous histiocytoma. Ultrastruct Pathol 28:283–289CrossRef
21.
go back to reference Oda Y, Tamiya S, Oshiro Y, Hachitanda Y, Kinukawa N, Iwamoto Y, Tsuneyoshi M (2002) Reassessment and clinicopathological prognostic factors of malignant fibrous histiocytoma of soft parts. Pathol Int 52(9):595–606PubMedCrossRef Oda Y, Tamiya S, Oshiro Y, Hachitanda Y, Kinukawa N, Iwamoto Y, Tsuneyoshi M (2002) Reassessment and clinicopathological prognostic factors of malignant fibrous histiocytoma of soft parts. Pathol Int 52(9):595–606PubMedCrossRef
22.
go back to reference Al-Agha OM, Igbokwe AA (2008) Malignant fibrous histiocytoma: between the past and the present. Arch Path Lab Med 132(6):1030–1035PubMed Al-Agha OM, Igbokwe AA (2008) Malignant fibrous histiocytoma: between the past and the present. Arch Path Lab Med 132(6):1030–1035PubMed
23.
go back to reference Blitzer A, Lawson W, Zak FG, Biller HF, Som ML (1981) Clinicopathological determinants in prognosis of fibrous histiocytomas of head and neck. Laryngoscope 87(9):2053–2070 Blitzer A, Lawson W, Zak FG, Biller HF, Som ML (1981) Clinicopathological determinants in prognosis of fibrous histiocytomas of head and neck. Laryngoscope 87(9):2053–2070
24.
go back to reference Allen PW (1980) Myxoid tumors of soft tissues. Path Ann 15(1):133–192 Allen PW (1980) Myxoid tumors of soft tissues. Path Ann 15(1):133–192
25.
go back to reference Weiss SW, Enzinger FM (1978) Malignant fibrous histiocytoma: an analysis of 200 cases. Cancer 41(6):2250–2260PubMedCrossRef Weiss SW, Enzinger FM (1978) Malignant fibrous histiocytoma: an analysis of 200 cases. Cancer 41(6):2250–2260PubMedCrossRef
26.
go back to reference Kindblom L, Merck C, Angercvall L (1979) The ultrastructre of myxofibrosarcoma: a study of 11 cases. Virchows Arch Anat Pathol 381:121–139 Kindblom L, Merck C, Angercvall L (1979) The ultrastructre of myxofibrosarcoma: a study of 11 cases. Virchows Arch Anat Pathol 381:121–139
27.
go back to reference Hollowood K, Fletcher CDM (1995) Soft tissue sarcomas that mimick benign lesions. Semin Diagn Pathol 12(1):87–97PubMed Hollowood K, Fletcher CDM (1995) Soft tissue sarcomas that mimick benign lesions. Semin Diagn Pathol 12(1):87–97PubMed
28.
go back to reference Nuamah IK, Browne RM (1995) Malignant fibrous histiocytoma presenting as a perioral abscess. Int J Oral Maxillofac Surg 24:158–159PubMedCrossRef Nuamah IK, Browne RM (1995) Malignant fibrous histiocytoma presenting as a perioral abscess. Int J Oral Maxillofac Surg 24:158–159PubMedCrossRef
29.
go back to reference Parka SW, Kimb H-J, Leed JH, Koc YH (2009) Malignant fibrous histiocytoma of the head and neck: CT and MRI findings. Am J Neuroradiol 30:71–76CrossRef Parka SW, Kimb H-J, Leed JH, Koc YH (2009) Malignant fibrous histiocytoma of the head and neck: CT and MRI findings. Am J Neuroradiol 30:71–76CrossRef
30.
go back to reference Ogura JH, Toomey JM, Setzen M, Sobol S (1980) Malignant fibrous histiocytoma of the head and neck. Laryngoscope 90(9):1429–1440PubMed Ogura JH, Toomey JM, Setzen M, Sobol S (1980) Malignant fibrous histiocytoma of the head and neck. Laryngoscope 90(9):1429–1440PubMed
31.
go back to reference Crissman JD, Henson SL (1987) Malignant fibrous histiocytoma of the maxillary sinus. Arch Otolaryngol 104:228–230 Crissman JD, Henson SL (1987) Malignant fibrous histiocytoma of the maxillary sinus. Arch Otolaryngol 104:228–230
32.
go back to reference Schaefer SD, Denton RA, Blend BL, Carder HM (1983) Malignant fibrous histiocytoma of the frontal sinus. Laryngoscope 93(2):2021–2026 Schaefer SD, Denton RA, Blend BL, Carder HM (1983) Malignant fibrous histiocytoma of the frontal sinus. Laryngoscope 93(2):2021–2026
33.
go back to reference Al-Salihi KA, Al-Jashamy KA, Ab Rahman S, Samsudin AR (2006) Maxilla tuberosity malignant fibrous histiocytoma with giant fibroblastic cells: case report and review of the literature. Oral Oncol Extra 42(3):112–115CrossRef Al-Salihi KA, Al-Jashamy KA, Ab Rahman S, Samsudin AR (2006) Maxilla tuberosity malignant fibrous histiocytoma with giant fibroblastic cells: case report and review of the literature. Oral Oncol Extra 42(3):112–115CrossRef
34.
go back to reference Barnes L, Kanbour A (1988) Malignant fibrous hiostiocytoma of the head and neck. A report of 12 cases. Arch Otolaryngol Head Neck Surg 114:1149–1156PubMedCrossRef Barnes L, Kanbour A (1988) Malignant fibrous hiostiocytoma of the head and neck. A report of 12 cases. Arch Otolaryngol Head Neck Surg 114:1149–1156PubMedCrossRef
35.
go back to reference Van Hale HM, Handlers JP, Abrams AM, Strahs G (1981) Malignant fibrous histiocytoma, myxoid variant metastatic to the oral cavity. Oral Surg Oral Med Oral Pathol 51(2):156–163PubMedCrossRef Van Hale HM, Handlers JP, Abrams AM, Strahs G (1981) Malignant fibrous histiocytoma, myxoid variant metastatic to the oral cavity. Oral Surg Oral Med Oral Pathol 51(2):156–163PubMedCrossRef
36.
go back to reference Lam PK, Trendell-Smith N, Li JHC, Fan YW, Yuen PW (2002) Myxofibrosarcoma of the sphenoid sinus. J Laryngol Otol 116:464–466PubMed Lam PK, Trendell-Smith N, Li JHC, Fan YW, Yuen PW (2002) Myxofibrosarcoma of the sphenoid sinus. J Laryngol Otol 116:464–466PubMed
37.
go back to reference Enoz M, Suoglu Y (2007) Myxofibrosarcoma of the maxillary sinus. Int J Head and Neck Surg 1(1):1–5 Enoz M, Suoglu Y (2007) Myxofibrosarcoma of the maxillary sinus. Int J Head and Neck Surg 1(1):1–5
38.
go back to reference Shinozaki T, Kato F, Watanabe H, Yanagawa T, Ahmed AR, Takagishi K (2001) Discriminant analysis of prognostic factors for malignant fibrous histiocytoma in soft tissue. J Orthop Sci 6(4):339–342PubMedCrossRef Shinozaki T, Kato F, Watanabe H, Yanagawa T, Ahmed AR, Takagishi K (2001) Discriminant analysis of prognostic factors for malignant fibrous histiocytoma in soft tissue. J Orthop Sci 6(4):339–342PubMedCrossRef
39.
go back to reference Blumber AK, Kay S, Adelaar RS (1989) Nerve sheath myxoma of digital nerve. Cancer 63:1215–1218CrossRef Blumber AK, Kay S, Adelaar RS (1989) Nerve sheath myxoma of digital nerve. Cancer 63:1215–1218CrossRef
40.
go back to reference Lagace R, Delage C, Seemayer TA (1979) Myxoid variant of malignant fibrous histiocytoma. Cancer 43:526–534PubMedCrossRef Lagace R, Delage C, Seemayer TA (1979) Myxoid variant of malignant fibrous histiocytoma. Cancer 43:526–534PubMedCrossRef
41.
go back to reference Kreicbergs A, Lonnquist P, Willems J (1985) Chondromyxoid fibroma. A review of the literature and a report on our own experience. Acta Pathol Microbiol Scand A 93(4):189–197 Kreicbergs A, Lonnquist P, Willems J (1985) Chondromyxoid fibroma. A review of the literature and a report on our own experience. Acta Pathol Microbiol Scand A 93(4):189–197
42.
go back to reference Vuzevski VD, Van der Heul RO (1988) Comparative ultrastructure of soft-tissue myxoid tumors. Ultrastr Pathol 12(1):87–105CrossRef Vuzevski VD, Van der Heul RO (1988) Comparative ultrastructure of soft-tissue myxoid tumors. Ultrastr Pathol 12(1):87–105CrossRef
43.
go back to reference Fujimura T, Okuyama R, Terui T, Okuno K, Masu A, Masu T, Chiba S et al (2005) Myxofibrosarcoma (MFH) showing cutaneous presentation: report of two cases. J Cut Pathol 32(7):512–515CrossRef Fujimura T, Okuyama R, Terui T, Okuno K, Masu A, Masu T, Chiba S et al (2005) Myxofibrosarcoma (MFH) showing cutaneous presentation: report of two cases. J Cut Pathol 32(7):512–515CrossRef
44.
go back to reference Vasuder S, Harris M (1978) Sarcoma of myofibroblasts. Arch Pathol Lab Med 102:185–188 Vasuder S, Harris M (1978) Sarcoma of myofibroblasts. Arch Pathol Lab Med 102:185–188
45.
go back to reference Mentzel T, Dry S, Katenkamp D, Fletcher CD (1998) Low-grade myofibroblastic sarcoma: analysis of 18 cases in the spectrum of myofibroblastic tumors. Am J Surg Pathol 22(10):1228–1238PubMedCrossRef Mentzel T, Dry S, Katenkamp D, Fletcher CD (1998) Low-grade myofibroblastic sarcoma: analysis of 18 cases in the spectrum of myofibroblastic tumors. Am J Surg Pathol 22(10):1228–1238PubMedCrossRef
46.
go back to reference Evans HL (1987) Low-grade fibromyxoid sarcoma: a report of the metastatizing neoplasm having a deceptively benign appearance. Am J Clin Pathol 88(5):615–619PubMed Evans HL (1987) Low-grade fibromyxoid sarcoma: a report of the metastatizing neoplasm having a deceptively benign appearance. Am J Clin Pathol 88(5):615–619PubMed
47.
go back to reference Foshini MP, Fulcheri, Boracchini C, Betts CM, Eusebi V (1990) Squamous cell carcinoma with prominent myxoid stroma. Human Pathol 21:859–865CrossRef Foshini MP, Fulcheri, Boracchini C, Betts CM, Eusebi V (1990) Squamous cell carcinoma with prominent myxoid stroma. Human Pathol 21:859–865CrossRef
48.
go back to reference Fletcher CD, Gustafson P, Rydholm A, Willen H, Ackerman M (2001) Clinicopathologic re-evaluation of 100 malignant fibrous histiocytomas: prognostic relevance of subclassification. J Clin Oncol 19(2):3045–3050PubMed Fletcher CD, Gustafson P, Rydholm A, Willen H, Ackerman M (2001) Clinicopathologic re-evaluation of 100 malignant fibrous histiocytomas: prognostic relevance of subclassification. J Clin Oncol 19(2):3045–3050PubMed
49.
go back to reference Suh CH, Ordonez NG, Mackay B (2000) Malignant fibrous histiocytoma: an ultrastructural perspective. Ultrastruct Pathol 24:243–250PubMedCrossRef Suh CH, Ordonez NG, Mackay B (2000) Malignant fibrous histiocytoma: an ultrastructural perspective. Ultrastruct Pathol 24:243–250PubMedCrossRef
50.
go back to reference Bloustein PA (1978) Hepatic leiomyosarcoma; ultrastructural study and review of the differential diagnoses. Human Pathol 9(6):713–715CrossRef Bloustein PA (1978) Hepatic leiomyosarcoma; ultrastructural study and review of the differential diagnoses. Human Pathol 9(6):713–715CrossRef
51.
go back to reference Evans HL (1993) Low-grade fibromyxoid sarcoma: a report of 12 cases. Am J Surg Pathol 17(6):595–600PubMedCrossRef Evans HL (1993) Low-grade fibromyxoid sarcoma: a report of 12 cases. Am J Surg Pathol 17(6):595–600PubMedCrossRef
52.
go back to reference Block MS, Cade JE, Rodriquez FH (1986) Malignant fibrous histiocytoma of the maxilla. J Oral Maxillofac Surg 44:404–412PubMedCrossRef Block MS, Cade JE, Rodriquez FH (1986) Malignant fibrous histiocytoma of the maxilla. J Oral Maxillofac Surg 44:404–412PubMedCrossRef
53.
go back to reference Hirose T, Toshiaki S, Hizawa K (1988) Ultrastructural study of the myxoid area of malignant fibrous histiocytomas. Ultrastruct Pathol 12:621–630PubMedCrossRef Hirose T, Toshiaki S, Hizawa K (1988) Ultrastructural study of the myxoid area of malignant fibrous histiocytomas. Ultrastruct Pathol 12:621–630PubMedCrossRef
54.
go back to reference Tsuneyoshi M, Hashimoto H, Enjoji M (1983) Myxoid malignant fibrous histiocytoma versus myxoid liposarcoma. Virchows Arch (Anat Pathol) 400:187–199CrossRef Tsuneyoshi M, Hashimoto H, Enjoji M (1983) Myxoid malignant fibrous histiocytoma versus myxoid liposarcoma. Virchows Arch (Anat Pathol) 400:187–199CrossRef
55.
go back to reference Matushansky I, Charytonowicz E, Mills J, Siddiqqi S, Hricik T, Cordon-Cardo C (2009) MFH classification: differentiating undifferentiated pleomorphic sarcoma in the 21st century. Expert Rev Anticancer Ther 9(8):1113–1144CrossRef Matushansky I, Charytonowicz E, Mills J, Siddiqqi S, Hricik T, Cordon-Cardo C (2009) MFH classification: differentiating undifferentiated pleomorphic sarcoma in the 21st century. Expert Rev Anticancer Ther 9(8):1113–1144CrossRef
Metadata
Title
Myxofibrosarcoma Arising in the Maxillary Sinus: A Case Report with a Review of the Ultrastructural Findings and Differential Diagnoses
Authors
Ernst J. G. Norval
Erich J. Raubenheimer
Publication date
01-12-2011
Publisher
Springer-Verlag
Published in
Journal of Maxillofacial and Oral Surgery / Issue 4/2011
Print ISSN: 0972-8279
Electronic ISSN: 0974-942X
DOI
https://doi.org/10.1007/s12663-011-0259-0

Other articles of this Issue 4/2011

Journal of Maxillofacial and Oral Surgery 4/2011 Go to the issue