Recurrent neck myxofibrosarcoma: a case report

J Med Case Rep. 2021 Oct 1;15(1):484. doi: 10.1186/s13256-021-03053-4.

Abstract

Background: Myxofibrosarcoma (MFS) is a rare soft tissue sarcoma with a high recurrence rate and a low risk of distant metastasis. It occurs mainly in the extremities of elderly men. Head and neck MFS is extremely rare. Surgery is the cornerstone of treatment. The role of radiotherapy (RT) and chemotherapy (CHT) on MFS is still debated.

Case presentation: A 67-year-old Caucasian man presented to our sarcoma referral center (SRC) with a history of MFS of the neck excised with microscopic positive surgical margins in a non-referral center. Staging imaging exams did not reveal distant metastasis. After a multidisciplinary discussion, preoperative RT was administered with a total dose of 50 Gy followed by wide surgical excision. Histological examination was negative for viable tumor cells. No relapse occurred during the 24-month postoperative follow-up.

Conclusions: The case described suggests the importance of planned combined treatments with both RT and surgery for high-grade soft tissue sarcoma. RT seems to be promising within this specific histotype. Close follow-up is advisable in all cases. Further studies are needed to confirm if the observed efficacy of combined treatments results in a prolonged time of disease-free survival and overall survival.

Keywords: Myxofibrosarcoma (MFS); Preoperative radiotherapy; Sarcoma referral centers (SRCs); Soft tissue sarcoma (STS); Wide surgical margins.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Fibrosarcoma* / diagnostic imaging
  • Fibrosarcoma* / surgery
  • Humans
  • Male
  • Margins of Excision
  • Neoplasm Recurrence, Local
  • Retrospective Studies
  • Sarcoma*
  • Soft Tissue Neoplasms* / surgery