PMC3437693_01
Magnetic resonance images of the left buttock. (a) T1-weighted, (b) T2-weighted, and (c) T2-STIR MR images demonstrated a multilobular intermuscular mass.
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fig1
Magnetic resonance imaging (MRI) demonstrated a multilobular intermuscular mass on the left buttock (Figures 1(a)-1(c)).
Hematoxylin and eosin stain x40 (a) and x100 (b). Biopsy of the tumor showed a typical histology of myxofibrosarcoma. The histological grade was determined as grade 1.
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Based on the histopathological features, the tumor was diagnosed as myxofibrosarcoma (Figures 2(a) and 2(b)).
Hematoxylin and eosin stain of the resected tumor (a) x40 and (b) x100. Spindle-shaped tumor cells were arranged within the loose myxoid stroma. Only a few atypical mitoses and necroses were found. The histological grade was determined as grade 1.
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The histological grade of the resected tumor was also determined as grade 1 (Figures 3(a) and 3(b)).
15 months after the operation, MR images, plain X-ray, and computed tomography demonstrated (a) a local recurrence and multiorgan dissemination including the (b) clavicle, (c) lung, (d) spine, (e) liver, (f) abdomen, and (g) paravertebral muscles.
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fig4
The postoperative period was uneventful; however, 15 months after the operation, an MRI showed local recurrence (Figure 4(a)). A plain X-ray taken for the evaluation of her left shoulder pain showed a pathological fracture and metastatic bone tumor of the left clavicle (Figure 4(b)). A total body computed tomography scan documented multiorgan dissemination including the skeletal bones, lung, whole spine, liver, subcutaneous layer of abdomen, and paravertebral muscles (Figures 4(b)-4(g)).
Hematoxylin and eosin stain of metastatic lesion of clavicle (a) x40 and (b) x100. The histological grade was also determined as grade 1.
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fig5
Histological grading was still grade 1 (Figures 5(a) and 5(b)).