Fibrosarcoma: a challenging diagnosis

Authors

  • Cristiane Rúbia Ferreira Serviço de Anatomia Patológica - Hospital Universitário da Universidade de São Paulo, São Paulo/SP
  • Leonardo Gomes da Fonseca Instituto do Câncer do Estado de São Paulo, São Paulo/SP
  • Gustavo Henrique Munhoz Piotto Instituto do Câncer do Estado de São Paulo, São Paulo/SP
  • Felipe Correa Geyer Instituto do Câncer do Estado de São Paulo, São Paulo/SP
  • Paulo Sérgio Martins de Alcântara Divisão de Clínica Cirúrgica - Hospital Universitário da Universidade de São Paulo, São Paulo/SP

DOI:

https://doi.org/10.4322/acr.%25y.75884

Keywords:

Fibrosarcoma, MUC4 protein, human, Drug Therapy, Surgical Procedures, Operative.

Abstract

Fibrosarcoma represent a rare group of soft tissue malignancies derived from fibrous connective tissue and immature proliferating fibroblasts or undifferentiated anaplastic spindle cells. It affects patients in the fourth and fifth decade of life. Fibrosarcomas can be classified in subtypes such as low-grade fibromyxoid sarcoma (LGFMS) and sclerosing epithelioid fibrosarcoma (SEF),and others. Histological features that overlap between types of fibrosarcomas is well known and reported in the literature. We report the case of a 53-year-old patient who presented a tumor in the axillary fossa, which was initially diagnosed as a solitary fibrous tumor. Due to recurrence of the lesion, as well as the presence of distant metastases, the histological revision considered the diagnosis of breast metaplastic carcinoma, since the tumor expressed the p63 antigen and estrogen and progesterone receptors. Unexpected resistance to chemotherapy motivated the diagnosis re-evaluation, which was due to MUC4 expression and morphological characteristics concluded by a hybrid LGFMSSEF tumor. The authors call attention to the difficult diagnosis in cases of soft tissue tumors. A broad panel of immunohistochemical research is required as the clinical course is essential to the final diagnosis.

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Published

2013-10-02

How to Cite

Ferreira, C. R., Fonseca, L. G. da, Piotto, G. H. M., Geyer, F. C., & Alcântara, P. S. M. de. (2013). Fibrosarcoma: a challenging diagnosis. Autopsy and Case Reports, 3(3), 21-29. https://doi.org/10.4322/acr.%y.75884

Issue

Section

Article / Autopsy Case Report