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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2020

01-12-2020 | Sarcoma | Case report

Low-grade myofibroblastic sarcoma of the levator scapulae muscle: a case report and literature review

Authors: Hirotaka Yonezawa, Norio Yamamoto, Katsuhiro Hayashi, Akihiko Takeuchi, Shinji Miwa, Kentaro Igarashi, Mickhael Bang Langit, Hiroaki Kimura, Shingo Shimozaki, Takashi Kato, Sei Morinaga, Yoshihiro Araki, Yohei Asano, Hiroko Ikeda, Takayuki Nojima, Hiroyuki Tsuchiya

Published in: BMC Musculoskeletal Disorders | Issue 1/2020

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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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Metadata
Title
Low-grade myofibroblastic sarcoma of the levator scapulae muscle: a case report and literature review
Authors
Hirotaka Yonezawa
Norio Yamamoto
Katsuhiro Hayashi
Akihiko Takeuchi
Shinji Miwa
Kentaro Igarashi
Mickhael Bang Langit
Hiroaki Kimura
Shingo Shimozaki
Takashi Kato
Sei Morinaga
Yoshihiro Araki
Yohei Asano
Hiroko Ikeda
Takayuki Nojima
Hiroyuki Tsuchiya
Publication date
01-12-2020
Publisher
BioMed Central
Keyword
Sarcoma
Published in
BMC Musculoskeletal Disorders / Issue 1/2020
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-020-03857-3

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