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Published in: Journal of Medical Case Reports 1/2021

Open Access 01-12-2021 | Soft Tissue Sarcoma | Case report

Recurrent neck myxofibrosarcoma: a case report 

Authors: Chiara Pagnoni, Luca Improta, Rossana Alloni, Francesco Mallozzi Santa Maria, Irene Aprile, Beniamino Brunetti, Carlo Greco, Bruno Vincenzi, Alessandro Gronchi, Sergio Valeri

Published in: Journal of Medical Case Reports | Issue 1/2021

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Abstract

Background

Myxofibrosarcoma (MFS) is a rare soft tissue sarcoma with a high recurrence rate and a low risk of distant metastasis. It occurs mainly in the extremities of elderly men. Head and neck MFS is extremely rare. Surgery is the cornerstone of treatment. The role of radiotherapy (RT) and chemotherapy (CHT) on MFS is still debated.

Case presentation

A 67-year-old Caucasian man presented to our sarcoma referral center (SRC) with a history of MFS of the neck excised with microscopic positive surgical margins in a non-referral center. Staging imaging exams did not reveal distant metastasis. After a multidisciplinary discussion, preoperative RT was administered with a total dose of 50 Gy followed by wide surgical excision. Histological examination was negative for viable tumor cells. No relapse occurred during the 24-month postoperative follow-up.

Conclusions

The case described suggests the importance of planned combined treatments with both RT and surgery for high-grade soft tissue sarcoma. RT seems to be promising within this specific histotype. Close follow-up is advisable in all cases. Further studies are needed to confirm if the observed efficacy of combined treatments results in a prolonged time of disease-free survival and overall survival.
Literature
1.
go back to reference Dell’Aversana Orabona G, Iaconetta G, et al. Head and neck myxofibrosarcoma: a case report and review of the literature. J Med Case Rep. 2014;8:468.CrossRef Dell’Aversana Orabona G, Iaconetta G, et al. Head and neck myxofibrosarcoma: a case report and review of the literature. J Med Case Rep. 2014;8:468.CrossRef
2.
go back to reference Roland CL, Wang WL, et al. Myxofirbosarcoma. Surg Oncol Clin N Am. 2016;25(4):775–88.CrossRef Roland CL, Wang WL, et al. Myxofirbosarcoma. Surg Oncol Clin N Am. 2016;25(4):775–88.CrossRef
3.
go back to reference Merk C, Angervall L, et al. Myxofibrosarcoma. A malignant soft tissue tumor of fibroblastic-histiocytic origin. A clinicopathologic and prognostic study of 110 cases using multivariate analysis. Acta Pathol Microbiol Immunol Scand Suppl. 1983;282:1–40. Merk C, Angervall L, et al. Myxofibrosarcoma. A malignant soft tissue tumor of fibroblastic-histiocytic origin. A clinicopathologic and prognostic study of 110 cases using multivariate analysis. Acta Pathol Microbiol Immunol Scand Suppl. 1983;282:1–40.
4.
go back to reference Mansoor A, White CR Jr. Myxofibrosarcoma presenting in the skin: clinicopathological features and differential diagnosis with cutaneous myxoid neoplasm. Am J Dermatophatol. 2003;25(4):2–11. Mansoor A, White CR Jr. Myxofibrosarcoma presenting in the skin: clinicopathological features and differential diagnosis with cutaneous myxoid neoplasm. Am J Dermatophatol. 2003;25(4):2–11.
6.
go back to reference Casali PG, Abecassis N, et al. Soft tissue and visceral sarcomas: ESMO–EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2018;29:iv51–67.CrossRef Casali PG, Abecassis N, et al. Soft tissue and visceral sarcomas: ESMO–EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2018;29:iv51–67.CrossRef
7.
go back to reference Callegaro D, Miceli R, Bonvalot S, et al. Impact of perioperative chemotherapy and radiotherapy in patients with primary extremity soft tissue sarcoma: retrospective analysis across major histological subtypes and major reference centres. Eur J Cancer. 2018;105:19–27.CrossRef Callegaro D, Miceli R, Bonvalot S, et al. Impact of perioperative chemotherapy and radiotherapy in patients with primary extremity soft tissue sarcoma: retrospective analysis across major histological subtypes and major reference centres. Eur J Cancer. 2018;105:19–27.CrossRef
8.
go back to reference Teurneau H, Engellau J, et al. High recurrence rate of myxofibrosarcoma: the effect of radiotherapy is not clear. Hindawi Sarcoma. 2019;2019:8. Teurneau H, Engellau J, et al. High recurrence rate of myxofibrosarcoma: the effect of radiotherapy is not clear. Hindawi Sarcoma. 2019;2019:8.
10.
go back to reference Kikuta K, Nakayama R, Yoshida A, Sasaki A, Kameyama K, Chuman H, Kawai A, Nakamura M, Matsumoto M, Morioka H. A histological positive margin after surgery is correlated with high local re-recurrence rate in patients with recurrent myxofibrosarcoma. Jpn J Clin Oncol. 2017;47(4):334–41. https://doi.org/10.1093/jjco/hyw199.CrossRefPubMed Kikuta K, Nakayama R, Yoshida A, Sasaki A, Kameyama K, Chuman H, Kawai A, Nakamura M, Matsumoto M, Morioka H. A histological positive margin after surgery is correlated with high local re-recurrence rate in patients with recurrent myxofibrosarcoma. Jpn J Clin Oncol. 2017;47(4):334–41. https://​doi.​org/​10.​1093/​jjco/​hyw199.CrossRefPubMed
11.
go back to reference Le Grange F, Cassoni AM, et al. Tumour volume changes following pre-operative radiotherapy in borderline resectable limb and trunk soft tissue sarcoma. Eur J Surg Oncol. 2014;40(4):394–401.CrossRef Le Grange F, Cassoni AM, et al. Tumour volume changes following pre-operative radiotherapy in borderline resectable limb and trunk soft tissue sarcoma. Eur J Surg Oncol. 2014;40(4):394–401.CrossRef
13.
go back to reference Bismarck O, Jean-Claud BS, et al. Predictors of local recurrence in patients with myxofibrosarcoma. Am J Clin Oncol. 2017;00:000–000. Bismarck O, Jean-Claud BS, et al. Predictors of local recurrence in patients with myxofibrosarcoma. Am J Clin Oncol. 2017;00:000–000.
14.
go back to reference Cante D, Franco P, et al. Combined chemoradiation for head and neck region myxofibrosarcoma of the maxillary sinus. Tumori. 2013;99:e80–3.CrossRef Cante D, Franco P, et al. Combined chemoradiation for head and neck region myxofibrosarcoma of the maxillary sinus. Tumori. 2013;99:e80–3.CrossRef
15.
go back to reference Group SS. SSG XXIV, recommendations for radiotherapy in bone- and soft tissue sarcoma. 2015 Group SS. SSG XXIV, recommendations for radiotherapy in bone- and soft tissue sarcoma. 2015
16.
go back to reference Haas RL, Delaney TF, O’Sullivan B, et al. Radiotherapy for management of extremity soft tissue sarcomas: why, when, and where? Int J Radiat Oncol Biol Phys. 2012;84:572–80.CrossRef Haas RL, Delaney TF, O’Sullivan B, et al. Radiotherapy for management of extremity soft tissue sarcomas: why, when, and where? Int J Radiat Oncol Biol Phys. 2012;84:572–80.CrossRef
17.
go back to reference Sampath S, Timothy MD, Schultheiss E, et al. Preoperative versus postoperative radiotherapy in soft-tissue sarcoma: multi-institutional analysis of 821 patients. Int J Radiat Oncol Biol Phys. 2011;81(2):498–505.CrossRef Sampath S, Timothy MD, Schultheiss E, et al. Preoperative versus postoperative radiotherapy in soft-tissue sarcoma: multi-institutional analysis of 821 patients. Int J Radiat Oncol Biol Phys. 2011;81(2):498–505.CrossRef
Metadata
Title
Recurrent neck myxofibrosarcoma: a case report 
Authors
Chiara Pagnoni
Luca Improta
Rossana Alloni
Francesco Mallozzi Santa Maria
Irene Aprile
Beniamino Brunetti
Carlo Greco
Bruno Vincenzi
Alessandro Gronchi
Sergio Valeri
Publication date
01-12-2021
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2021
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/s13256-021-03053-4

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