Hu Hongyu, Hu Xianwen, Li Dandan, Cai Jiong, Wang Pan
Department of Nuclear Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China.
Department of Obstetrics, Zunyi Hospital of Traditional Chinese Medicine, Zunyi, China.
Front Oncol. 2022 May 4;12:894421. doi: 10.3389/fonc.2022.894421. eCollection 2022.
Myxofibrosarcoma (MFS) is a rare soft tissue sarcoma that originates in the mesenchymal tissue and occurs mainly in the limbs of elderly patients. Herein, we present the case of a 64-year-old woman who underwent extensive left vulvar resection and bilateral lymphadenectomy for vulvar squamous cell carcinoma 6 months previously. A mass was found again at the original surgical site of the left groin 3 months prior, and its size had increased significantly in the past 1 month, with ulceration and pus. Magnetic resonance imaging (MRI) showed a 10-cm mass in the left groin area; fluoro18-labeled deoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) showed a marked increase in mass metabolism in the left groin area, which was highly suspected to be a recurrence of squamous cell carcinoma. Subsequently, the patient underwent surgery and the postoperative pathology and immunohistochemistry confirmed MFS. In conclusion, MFS has rarely been reported to arise from the surgical site of squamous cell carcinoma. Our case study demonstrates that MFS should be included in the differential diagnosis of superficial masses in patients with a prior surgical history who present with a soft tissue mass at the surgical site, especially for recently developed rapidly increasing masses. This study aimed to systematically review the clinical features, diagnosis, differential diagnosis, treatment, and prognosis of this disease based on our case and related published literature and to provide clinicians with a broader perspective on the differential diagnosis of soft tissue tumors.
黏液纤维肉瘤(MFS)是一种罕见的软组织肉瘤,起源于间充质组织,主要发生于老年患者的四肢。在此,我们报告一例64岁女性病例,该患者6个月前因外阴鳞状细胞癌接受了广泛的左外阴切除术和双侧淋巴结清扫术。3个月前在左腹股沟原手术部位再次发现一个肿块,其大小在过去1个月内显著增大,并伴有溃疡和脓性分泌物。磁共振成像(MRI)显示左腹股沟区有一个10厘米的肿块;氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描(F-FDG PET/CT)显示左腹股沟区肿块代谢明显增加,高度怀疑为鳞状细胞癌复发。随后,患者接受了手术,术后病理及免疫组化证实为MFS。总之,很少有报道称MFS起源于鳞状细胞癌的手术部位。我们的病例研究表明,对于有手术史且手术部位出现软组织肿块的患者,尤其是近期出现且迅速增大的肿块,MFS应纳入浅表肿块的鉴别诊断。本研究旨在基于我们的病例及相关已发表文献,系统回顾该疾病的临床特征、诊断、鉴别诊断、治疗及预后,为临床医生提供关于软组织肿瘤鉴别诊断的更广阔视角。