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Spresser WJ, Neal TW, McLean AC, Schlieve T. A case report and diagnostic discussion of maxillofacial low-grade myofibroblastic sarcoma. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 138:e67-e72. [PMID: 38871621 DOI: 10.1016/j.oooo.2024.04.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 04/15/2024] [Accepted: 04/27/2024] [Indexed: 06/15/2024]
Affiliation(s)
- Wyatt J Spresser
- Department of Surgery, Division of Oral and Maxillofacial Surgery, UT Southwestern/Parkland Memorial Hospital, Dallas, TX.
| | - Timothy W Neal
- Department of Surgery, Division of Oral and Maxillofacial Surgery, UT Southwestern/Parkland Memorial Hospital, Dallas, TX
| | - Anne C McLean
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Thomas Schlieve
- Department of Surgery, Division of Oral and Maxillofacial Surgery, UT Southwestern/Parkland Memorial Hospital, Dallas, TX
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Giraldo-Roldan D, Louredo BVR, Penafort PVM, Pontes HAR, Alves AP, Lima FCA, Fonseca TC, Abrahão AC, Romañach MJ, Fonseca FP, Delgado WA, Robinson L, Van Heerden WFP, de Almeida OP, Vargas PA. Low-Grade Myofibroblastic Sarcoma of the Oral and Maxillofacial Region: An International Clinicopathologic Study of 13 Cases and Literature Review. Head Neck Pathol 2023; 17:832-850. [PMID: 37540486 PMCID: PMC10513986 DOI: 10.1007/s12105-023-01577-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 07/20/2023] [Indexed: 08/05/2023]
Abstract
Low-grade myofibroblastic sarcoma (LGMS) represents an atypical tumor composed of myofibroblasts with a variety of histological patterns and with a high tendency to local recurrence and a low probability of distant metastases. LGMS has predilection for the head and neck regions, especially the oral cavity. This study aimed to report 13 new cases of LGMS arising in the oral and maxillofacial region. This study included LGMS cases from five oral and maxillofacial pathology laboratories in four different countries (Brazil, Peru, Guatemala, and South Africa). Their clinical, radiographic, histopathological, and immunohistochemical findings were evaluated. In this current international case series, most patients were females with a mean age of 38.7 years, and commonly presenting a nodular lesion in maxilla. Microscopically, all cases showed a neoplasm formed by oval to spindle cells in a fibrous stroma with myxoid and dense areas, some atypical mitoses, and prominent nucleoli. The immunohistochemical panel showed positivity for smooth muscle actin (12 of 13 cases), HHF35 (2 of 4 cases), β-catenin (3 of 5 cases), desmin (3 of 11 cases), and Ki-67 (range from 5 to 50%). H-caldesmon was negative for all cases. The diagnosis of LGMS was confirmed in all cases. LGMS shows predominance in young adults, with a slight predilection for the female sex, and maxillary region. LGMS should be a differential diagnosis of myofibroblastic lesions that show a proliferation of spindle cells in a fibrous stroma with myxoid and dense areas and some atypical mitoses, supporting the diagnosis with a complementary immunohistochemical study. Complete surgical excision with clear margins is the treatment of choice. However, long-term follow-up information is required before definitive conclusions can be drawn regarding the incidence of recurrence and the possibility of metastasis.
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Affiliation(s)
- Daniela Giraldo-Roldan
- Department of Oral Diagnosis, Oral Pathology Area, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil
| | | | - Paulo Victor Mendes Penafort
- Department of Oral Diagnosis, Oral Pathology Area, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil
| | - Hélder Antônio Rebelo Pontes
- Oral Pathology Service, João de Barros Barreto University Hospital, Federal University of Pará, Belém, PA, Brazil
| | - Aline Pinheiro Alves
- Oral & Maxilofacial Surgery, Hospital Federal dos Servidores do Estado, Rio de Janeiro, RJ, Brazil
| | - Fernando C A Lima
- Oral & Maxilofacial Surgery, Hospital Federal dos Servidores do Estado, Rio de Janeiro, RJ, Brazil
| | - Thamyres Campos Fonseca
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Aline Corrêa Abrahão
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Mário José Romañach
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Felipe Paiva Fonseca
- Department of Oral Surgery and Pathology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
- Department of Oral and Maxillofacial Pathology, Faculty of Health Sciences, School of Dentistry, University of Pretoria, Pretoria, South Africa
| | - Wilson A Delgado
- Department of Oral and Maxillofacial Pathology and Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Liam Robinson
- Department of Oral and Maxillofacial Pathology, Faculty of Health Sciences, School of Dentistry, University of Pretoria, Pretoria, South Africa
| | - Willie F P Van Heerden
- Department of Oral and Maxillofacial Pathology, Faculty of Health Sciences, School of Dentistry, University of Pretoria, Pretoria, South Africa
| | - Oslei Paes de Almeida
- Department of Oral Diagnosis, Oral Pathology Area, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil
| | - Pablo Agustin Vargas
- Department of Oral Diagnosis, Oral Pathology Area, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil.
- Department of Oral and Maxillofacial Pathology, Faculty of Health Sciences, School of Dentistry, University of Pretoria, Pretoria, South Africa.
- Department of Oral Diagnosis, Oral Pathology Area Piracicaba Dental School, State University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil.
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Gao G, Liu Y, Ao Y, Wang J, Xu Y. Low-grade myofibroblastic sarcoma of the proximal femur: A case report and literature review. Medicine (Baltimore) 2022; 101:e31715. [PMID: 36397412 PMCID: PMC9666109 DOI: 10.1097/md.0000000000031715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
RATIONAL Low-grade myofibroblastic sarcoma (LGMS) is an atypical type of tumor composed of myofibroblasts. LGMS in the femoral head neck junction is extremely rare and no case treated by hip arthroscopy was reported. PATIENT CONCERNS We reported a case of LGMS in the femoral head neck junction treated by hip arthroscopy. A 30-year-old female was admitted to our hospital with discomfort and pain after left hip sprained one year prior. Physical examination revealed swelling of the left hip and magnetic resonance images showed a soft tissue mass in the femoral head neck junction. DIAGNOSIS Via microscopy of pathological specimens, spindle cell proliferative lesions, atypia of some cells, and mitotic figures/pathological mitotic figures of some cells were observed. Immunohistochemistry revealed positive for smooth muscle actin, focally positive for CD34 and CD68, while negative for S-100, desmin, and anaplastic lymphoma kinase. The imaging, histomorphological and immunohistochemical features suggested a final diagnosis of LGMS of the proximal femur. INTERVENTIONS This patient underwent hip arthroscopy for excision of the soft tissue mass. OUTCOMES The clinical and imaging follow-up at 6 months postoperatively showed that surgery had achieved good clinical outcomes. LESSONS To the best of our knowledge, this is the first case report of LGMS in the femoral head neck junction treated by hip arthroscopy. Beyond the present case, other 120 cases from 58 literatures (1998-2022) are reviewed and discussed. The age of LGMS patients ranged from 11 months to 77 years and the male-to-female ratio was approximately 1.28:1. The location distribution of previously reported LGMS cases and the present case was as follows: Head&neck (45.90%), trunk (30.33%), and extremity (23.77%). Hip arthroscopic excision of LGMS may achieve relatively good clinical outcomes.
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Affiliation(s)
- Guanying Gao
- Institute of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, Beijing, China
| | - Yuhao Liu
- Institute of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, Beijing, China
| | - Yingfang Ao
- Institute of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, Beijing, China
| | - Jianquan Wang
- Institute of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, Beijing, China
| | - Yan Xu
- Institute of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, Beijing, China
- * Correspondence: Yan Xu Institute of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, Beijing, China (e-mail: )
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