Adult fibrosarcoma: From clinical challenges to cutting-edge innovations.

Adult fibrosarcoma is a rare and aggressive soft tissue malignancy originating from spindle-shaped fibroblasts, primarily affecting deep soft tissues in the extremities, trunk, head, and neck. Surgical resection with R0 margins remains the gold standard, with adjuvant radiation therapy recommended for large or high-grade tumors to reduce recurrence risk. Chemotherapy and immunotherapy play complementary roles in disease management, with emerging strategies targeting matrix metalloproteinases and tumor microenvironment interactions to enhance chemosensitivity and overcome drug resistance. Despite advances in treatment, prognosis remains poor due to the tumor's aggressive nature. However, early detection with complete surgical excision and multimodal therapies offer the best prospects for improved patient survival.