Zhong Linkun, Zhang Ying, Kang Hongjian, Wang Zhaohua
Department of General Surgery, Zhongshan City People's Hospital, Zhongshan, Guangdong Province, China.
Department of Otorhinolaryngology & Head and Neck Surgery, Dalian Municipal Friendship Hospital, Dalian, Liaoning Province, China.
Medicine (Baltimore). 2025 Apr 18;104(16):e42150. doi: 10.1097/MD.0000000000042150.
Myxofibrosarcoma (MFS) is a subtype of soft tissue sarcoma that commonly occurs in the extremities but is rare in the neck. It is characterized by a high risk of local recurrence due to its specific infiltrative growth pattern.
A 56-year-old male presented with a large mass in the right neck with disability of the right upper limb.
Magnetic resonance imaging revealed a 12.48 × 9.01 × 14.16 cm mass with a "tail sign." Resection with wide margins was performed to remove the tumor and the invaded surrounding tissues. Histopathological examination confirmed the diagnosis of high-grade MFS.
The patient developed local recurrence 24 months after surgery and died of the disease 26 months after the recurrence.
This case presents the largest MFS located in the neck reported to date. The treatment of giant MFS in the neck is challenging due to the proximity of vital structures including vessels, nerves, and other tissues. The invasive pattern of MFS facilitates extensive spread into surrounding tissues, complicating complete surgical removal. And insufficient margins frequently result in disease recurrence.
This case highlights the significance of wide surgical margins in instances of extensive neck infiltration by MFS. However, further studies are required to confirm the specific margin values, and the advancement of effective adjuvant therapy is essential for improving patient survival.
黏液纤维肉瘤（MFS）是软组织肉瘤的一种亚型，常见于四肢，但在颈部罕见。因其特定的浸润性生长模式，具有较高的局部复发风险。
一名56岁男性，右颈部出现巨大肿块，并伴有右上肢功能障碍。
磁共振成像显示一个12.48×9.01×14.16厘米的肿块，伴有“尾征”。进行了广泛切缘的切除手术，以切除肿瘤及周围受侵组织。组织病理学检查确诊为高级别MFS。
患者术后24个月出现局部复发，复发后26个月死于该疾病。
该病例是迄今为止报道的位于颈部的最大MFS。由于颈部存在包括血管、神经和其他组织在内的重要结构，颈部巨大MFS的治疗具有挑战性。MFS的浸润模式使其易于广泛扩散至周围组织，导致完整手术切除复杂化。切缘不足常导致疾病复发。
该病例凸显了在MFS广泛浸润颈部的情况下进行广泛手术切缘的重要性。然而，需要进一步研究以确定具体的切缘值，并且有效的辅助治疗进展对于提高患者生存率至关重要。
