Genetic profiling differentiates second primary tumors from metastases in adult metachronous soft tissue sarcoma

Giant Myxofibrosarcoma in the Lower Limb: An Overview of Diagnostic and Clinical Management

Myxofibrosarcoma (MFS), an aggressive soft tissue sarcoma, is one of the undifferentiated pleomorphic sarcomas; it has a low incidence, affecting people in the sixth to eighth decades of life. It usually involves the extremities and is painless with a slow-growing pattern. Based on the case of a 52-year-old female patient who presented with a painful, massive, rapid-growing, ulcerated tumor of the anterior surface of the left thigh, we performed a literature review regarding the current standard of care for patients with MFS. Computed tomography examination, followed by magnetic resonance imaging and surgical biopsy with histopathological examination, confirmed the diagnosis and the presence of lung and inguinal lymph node metastases. Due to the rapid-growing pattern and the local aggressiveness, our tumor board team recommended emergency excisional surgery, with subsequent reconstructive procedures followed by referral to an oncological center. This review emphasizes the importance of proper and rapid diagnosis, followed by multidisciplinary management, for MFS cases with atypical presentation and distal metastases to improve overall outcomes.

Bilateral symmetrical metachronous myxofibrosarcoma: a case report and review of the literature

Soft tissue sarcomas (STS) are rare. Affected patients are at increased risk of developing a second primary malignancy, particularly another primary STS. These rarely affect the extremities, tending to occur in the abdomen, head or neck. We describe a patient with myxofibrosarcoma of the buttock who developed a second primary tumour of the same histological type in the contralateral buttock thirty months after excision. Remarkably, the second tumour was symmetrical and there were no predisposing factors or evidence of metastatic spread. The second tumour was a significant size at presentation with encasement of the sciatic nerve. Awareness of the sarcoma patient's increased risk of developing a second tumour could lead to earlier diagnosis and improved outcome. A review of the literature on multiple soft tissue sarcomas is also presented.