Aksiller lokalizasyonu olan nadir yüksek dereceli miksofibrosarkom olgusu
Yıl 2020,
, 35 - 38, 21.04.2020
Yeliz Yılmaz Bozok
,
Murat Kemal Atahan
,
Furkan Tosun
,
Sultan Deniz Altındağ
,
Asli Kahraman Akkalp
Öz
Miksofibrosarkom nadir görülen yumuşak bir doku sarkomudur. Çoğunlukla ekstremitelerde lokalizedir. Kesin tanı histopatolojik inceleme ile yapılsa da, görüntüleme yöntemleri derecelendirme ve tedavi planlamasında önemli rol oynamaktadır. Aksiller bölge nadiren dahil olabilse de literatürde bildirilmiş bir durum yoktur. Tümörün bol miktarda nörovasküler bir yapıya sahip olması göz önüne alındığında, tümörün geniş cerrahi marjlarla eksize edilmesi zordur. Olgumuz literatürde aksiller lokalizasyonu olan ilk olgu olduğu için dikkat çekicidir. Geniş marjlı cerrahi eksizyon tedavinin en önemli basamağıdır. R0 rezeksiyonu sağkalım üzerinde önemli bir etkiye sahiptir. Sonuç olarak, aksiller MFS'de kemoterapinin ardından geniş cerrahi eksizyonun lokal nüksü azaltmada olumlu bir katkısı olacağını düşünüyoruz
Kaynakça
- 1. Angervall L, Kindblom LG, Merck C. Myxofibrosarcoma: A study of 30 cases. Acta Pathol Microbiol Scand 1977;85A:127–140. (PMID:15396)
- 2. Look Hong NJ, Hornicek FJ, Raskin KA, Yoon SS, Szymonifka J, Yeap B, et al. Prognostic factors and outcomes of patients with myxofibrosarcoma. Ann Surg Oncol 2013;20:80-86. (PMID:22890594)
- 3. Mentzel E, van den Berg E, Molenaar AA. Myxofibrosarcoma. In: Fletcher CDM, Unni KK, Mertens F, ed. Yumuşak Doku ve Kemik Tümörlerinin Patolojisi ve Genetiği Lyon, Fransa: IARC Press; 2002: 102-103.
- 4. Weiss SW, Goldblum JR. Fibrosarkom. In: Weiss S, Goldblum JR, ed. Enzinger ve Weiss'in Yumuşak Doku Tümörleri. 4. baskı St Louis, Mo: MosbyInc; 2001: 422–425.
- 5. Huang HY, Lal P, Qin J, Brennan MF, Antonescu CR. Low-grade myxofibrosarcoma: a clinicopathologic analysis of 49 cases treated at a single institution with simultaneous assessment of the efficacy of 3-tier and 4-tier grading systems. Human pathology 2004;35:612-621.( PMID: 15138937)
- 6. Haglund KE, Raut CP, Nascimento AF, Wang Q, George S, Baldini EH. Recurrence patterns and survival for patients with intermediate- and high-grade myxofibrosarcoma. Int J Radiat Oncol Biol Phys 2012;82:361-367. (PMID: 20951504)
- 7. Mutter RW, Singer S, Zhang Z, Brennan MF, Alektiar KM. The enigma of myxofibrosarcoma of the extremity. Cancer 2012;118:518-527. (PMID: 21717447)
- 8. Gronchi A, Lo Vullo S, Colombo C, Collini P, Stacchiotti S, Mariani L, et al. Extremity soft tissue sarcoma in a series of patients treated at a single institution: local control directly impacts survival. Ann Surg 2010;251:506–511. (PMID: 20130465)
- 9. Lin CN, Chou SC, Li CF, Tsai KB, Chen WC, Hsiung CY, et al. Prognostic factors of myxofibrosarcomas: implications of margin status, tumor necrosis, and mitotic rate on survival. J Surg Oncol 2006;93:294-303. (PMID: 16496357)
- 10. Fletcher CD, Bridge JA, Hogendoorn PC, et al. WHO classification of tumours of softtissueand bone. 4th edition. Lyon (France): IARC Press; 2013:39-40.
- 11. Evans HL. Low-grade fibromyxoidsarcoma: a report of 12 cases. Am J Surg Pathol 1993;17:595–600. (PMID: 8333558)
- 12. Sanfilippo R, Miceli R, Grosso F, Fiore M, Puma E, Pennacchioli E, et al. Myxofibrosarcoma: prognostic factors and survival in a series of patients treated at a single institution. Ann Surg Oncol 2011;18: 720-725. (PMID: 20878245)
A case of high-grade myxofibrosarcoma with rare axillary localization
Yıl 2020,
, 35 - 38, 21.04.2020
Yeliz Yılmaz Bozok
,
Murat Kemal Atahan
,
Furkan Tosun
,
Sultan Deniz Altındağ
,
Asli Kahraman Akkalp
Öz
Myxofibrosarcoma is a rare soft tissue sarcoma. It is mostly localized at extremities. Although definitive diagnosis is made by histopathological examination, imaging modalities play an important role in grading and treatment planning. Although axillary region can be involved rarely, there is no reported case in the literature. Given that tumor has an abundant neurovascular structure, it is challenging to excise tumor with wide surgical margins. Our case is striking as it is the first case with axillary localization in the literature. The surgical excision with wide margin is the most important step of the treatment. The R0 resection has an important impact on survival. In conclusion, we think that, in axillary MFS, wide surgical excision followed by chemotherapy will have positive contribution in reducing local recurrence.
Kaynakça
- 1. Angervall L, Kindblom LG, Merck C. Myxofibrosarcoma: A study of 30 cases. Acta Pathol Microbiol Scand 1977;85A:127–140. (PMID:15396)
- 2. Look Hong NJ, Hornicek FJ, Raskin KA, Yoon SS, Szymonifka J, Yeap B, et al. Prognostic factors and outcomes of patients with myxofibrosarcoma. Ann Surg Oncol 2013;20:80-86. (PMID:22890594)
- 3. Mentzel E, van den Berg E, Molenaar AA. Myxofibrosarcoma. In: Fletcher CDM, Unni KK, Mertens F, ed. Yumuşak Doku ve Kemik Tümörlerinin Patolojisi ve Genetiği Lyon, Fransa: IARC Press; 2002: 102-103.
- 4. Weiss SW, Goldblum JR. Fibrosarkom. In: Weiss S, Goldblum JR, ed. Enzinger ve Weiss'in Yumuşak Doku Tümörleri. 4. baskı St Louis, Mo: MosbyInc; 2001: 422–425.
- 5. Huang HY, Lal P, Qin J, Brennan MF, Antonescu CR. Low-grade myxofibrosarcoma: a clinicopathologic analysis of 49 cases treated at a single institution with simultaneous assessment of the efficacy of 3-tier and 4-tier grading systems. Human pathology 2004;35:612-621.( PMID: 15138937)
- 6. Haglund KE, Raut CP, Nascimento AF, Wang Q, George S, Baldini EH. Recurrence patterns and survival for patients with intermediate- and high-grade myxofibrosarcoma. Int J Radiat Oncol Biol Phys 2012;82:361-367. (PMID: 20951504)
- 7. Mutter RW, Singer S, Zhang Z, Brennan MF, Alektiar KM. The enigma of myxofibrosarcoma of the extremity. Cancer 2012;118:518-527. (PMID: 21717447)
- 8. Gronchi A, Lo Vullo S, Colombo C, Collini P, Stacchiotti S, Mariani L, et al. Extremity soft tissue sarcoma in a series of patients treated at a single institution: local control directly impacts survival. Ann Surg 2010;251:506–511. (PMID: 20130465)
- 9. Lin CN, Chou SC, Li CF, Tsai KB, Chen WC, Hsiung CY, et al. Prognostic factors of myxofibrosarcomas: implications of margin status, tumor necrosis, and mitotic rate on survival. J Surg Oncol 2006;93:294-303. (PMID: 16496357)
- 10. Fletcher CD, Bridge JA, Hogendoorn PC, et al. WHO classification of tumours of softtissueand bone. 4th edition. Lyon (France): IARC Press; 2013:39-40.
- 11. Evans HL. Low-grade fibromyxoidsarcoma: a report of 12 cases. Am J Surg Pathol 1993;17:595–600. (PMID: 8333558)
- 12. Sanfilippo R, Miceli R, Grosso F, Fiore M, Puma E, Pennacchioli E, et al. Myxofibrosarcoma: prognostic factors and survival in a series of patients treated at a single institution. Ann Surg Oncol 2011;18: 720-725. (PMID: 20878245)