Low-grade myofibroblastic sarcoma

Low-grade myofibroblastic sarcoma
Other namesIntermediate-grade myofibroblastic sarcoma is now regarded as a low-grade myofibroblastic sarcoma
SymptomsTumor, sometimes painful
ComplicationsPost-surgical recurrences; uncommonly metastasizes
Usual onsetAll ages
CausesUnknown
TreatmentSurgical removal of tumor
PrognosisGuarded
DeathsUncommon

Low-grade myofibroblastic sarcoma (LGMS) is a subtype of the malignant sarcomas.[1] As it is currently recognized, LGMS was first described as a rare, atypical myofibroblastic tumor (i.e. a tumor consisting of cells with the microscopic features of fibroblasts and smooth muscle cells) by Mentzel et al. in 1998.[2] Myofibroblastic sarcomas had been divided into low-grade myofibroblastic sarcomas, intermediate‐grade myofibroblasic sarcomas, i.e. IGMS, and high‐grade myofibroblasic sarcomas, i.e. HGMS (also termed undifferentiated pleomorphic sarcoma and pleomorphic myofibrosarcoma [and formerly termed malignant fibrous histiocytoma[3]]) based on their microscopic morphological, immunophenotypic, and malignancy features.[4] LGMS and IGMS are now classified together[5] by the World Health Organization (WHO), 2020, in the category of intermediate (rarely metastasizing) fibroblastic and myofibroblastic tumors.[6] WHO, 2020, classifies HGMS (preferred name: undifferentiated pleomorphic sarcoma) as a soft tissue tumor in the category of tumors of uncertain differentiation.[7] This article follows the WHO classification: here, LGMS includes IGMS but not HGMS which is a more aggressive and metastasizing tumor than LGMS[8] and consists of cells of uncertain origin.[4]

LGMS tumors are typically painless lesions that develop in: 1) the subcutaneous tissues, i.e. the lowermost layer of the skin;[9] 2) submucosa, i.e. the thin layer of tissue lying just below the mucous membranes that line passageways such as the gastrointestinal, respiratory, genitourinary tracts;[8] 3) muscles; and 4) bones.[9] They most often develop in middle-aged adults (average: 40 years old) but have been diagnosed in all age-groups.[8] These tumors often recur at the sites of their surgical removal and may metastasize to nearby lymph nodes and distant tissues.[10]

LGMS's are commonly treated by surgical removal of the tumor along with all its cells, which if not removed increase the probability that the tumor will recur at the site of its removal.[1] LGMS tumors typically show little or no sensitivity to radiotherapy and chemotherapy treatments.[11]

  1. ^ a b Yonezawa H, Yamamoto N, Hayashi K, Takeuchi A, Miwa S, Igarashi K, Langit MB, Kimura H, Shimozaki S, Kato T, Morinaga S, Araki Y, Asano Y, Ikeda H, Nojima T, Tsuchiya H (December 2020). "Low-grade myofibroblastic sarcoma of the levator scapulae muscle: a case report and literature review". BMC Musculoskeletal Disorders. 21 (1): 836. doi:10.1186/s12891-020-03857-3. PMC 7731512. PMID 33302922.
  2. ^ Mentzel T, Dry S, Katenkamp D, Fletcher CD (October 1998). "Low-grade myofibroblastic sarcoma: analysis of 18 cases in the spectrum of myofibroblastic tumors". The American Journal of Surgical Pathology. 22 (10): 1228–38. doi:10.1097/00000478-199810000-00008. PMID 9777985.
  3. ^ Zhao KY, Yan X, Yao PF, Mei J (September 2021). "Malignant fibrous histiocytoma of the bone in a traumatic amputation stump: A case report and review of the literature". World Journal of Clinical Cases. 9 (26): 7930–7936. doi:10.12998/wjcc.v9.i26.7930. PMC 8462244. PMID 34621848.
  4. ^ a b Fisher C (September 2004). "Myofibrosarcoma". Virchows Archiv. 445 (3): 215–23. doi:10.1007/s00428-004-1038-9. PMID 15173943. S2CID 220565385.
  5. ^ Zhao R, Wang J, Zhang H, Chi Y, Bi N (October 2020). "High-grade myofibroblastic sarcoma of the pleura: A case report and literature review". Thoracic Cancer. 11 (10): 3011–3014. doi:10.1111/1759-7714.13613. PMC 7529570. PMID 32815307.
  6. ^ Sbaraglia M, Bellan E, Dei Tos AP (April 2021). "The 2020 WHO Classification of Soft Tissue Tumours: news and perspectives". Pathologica. 113 (2): 70–84. doi:10.32074/1591-951X-213. PMC 8167394. PMID 33179614.
  7. ^ Choi JH, Ro JY (January 2021). "The 2020 WHO Classification of Tumors of Soft Tissue: Selected Changes and New Entities". Advances in Anatomic Pathology. 28 (1): 44–58. doi:10.1097/PAP.0000000000000284. PMID 32960834. S2CID 221862064.
  8. ^ a b c Mulay K, Sen M, Honavar SG (November 2020). "Limbal, low-grade myofibroblastic sarcoma: Case report and literature review". Indian Journal of Ophthalmology. 68 (11): 2538–2540. doi:10.4103/ijo.IJO_2410_20. PMC 7774147. PMID 33120683.
  9. ^ a b Baranov E, Hornick JL (March 2020). "Soft Tissue Special Issue: Fibroblastic and Myofibroblastic Neoplasms of the Head and Neck". Head and Neck Pathology. 14 (1): 43–58. doi:10.1007/s12105-019-01104-3. PMC 7021862. PMID 31950474.
  10. ^ Wu X, Guo L, Li S, Zheng Y, Fan B, Zhou C (January 2020). "Low-grade myofibroblastic sarcoma with abdominal pain, a stuffy nose, hearing loss, and multiple cavity effusion: a case report and literature review". The Journal of International Medical Research. 48 (1): 300060519895661. doi:10.1177/0300060519895661. PMC 7114293. PMID 31975633.
  11. ^ Xu Y, Xu G, Wang X, Mao M, Wu H, Baklaushev VP, Chekhonin VP, Peltzer K, Wang G, Zhang C (February 2021). "Is there a role for chemotherapy and radiation in the treatment of patients with low-grade myofibroblastic sarcoma?". Clinical & Translational Oncology. 23 (2): 344–352. doi:10.1007/s12094-020-02425-4. PMID 32607812. S2CID 220286531.