Myxofibrosarcoma

Case contributed by Khaloud Alghamdi
Diagnosis almost certain

Presentation

Fast growing solid soft tissue mass in the right antecubital fossa.

Patient Data

Age: 35 years
Gender: Female
mri

The MRI sequences demonstrate:

  • well-encapsulated, round to oval, heterogeneous signal soft tissue mass lesion measuring approximately 6.2 x 5.0 x 4.5 cm along the anterolateral aspect of the lower right arm, with maintained fat planes with the underlying muscles. The lesion shows intermediate signal on T1, heterogeneous high signal on T2, with heterogeneous enhancement on postcontrast sequences. Irregular, eccentric, nonenhancing necrotic areas are identified along the medial part of the lesion (necrosis involving approximately 30-35% of the lesion). There is encasement of the cephalic vein in the lower right arm by the lesion
  • thickening and enhancement of the skin along the medial aspect of the lower right arm, which is suspicious for cutaneous involvement
  • two nodular lesions in the subcutaneous soft tissues along the medial aspect of the right arm, superomedial to the above-mentioned lesion. These could represent enlarged lymph nodes or satellite deposits in the subcutaneous tissues

 

Case Discussion

Features are suggestive of a soft tissue sarcoma involving the lower right arm, possibly a myxofibrosarcoma.

Histopathological analysis confirmed low-grade myofibroblastic sarcoma.

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