Skip to main content

Advertisement

SpringerLink
Log in

Myxofibrosarcoma Arising in the Maxillary Sinus: A Case Report with a Review of the Ultrastructural Findings and Differential Diagnoses

  • Review Paper
  • Published:
Journal of Maxillofacial and Oral Surgery Aims and scope Submit manuscript

Abstract

This is a case report of a patient presenting with a destructive lesion with histologic features of a low grade malignancy in a predominantly myxoid matrix. Various low grade myxoid malignancies were considered in the differential diagnosis of which an overview is presented. A literature review of the ultrastructural findings and possible histogenesis is discussed along with the diagnostic criteria and recent change in the terminology regarding the malignancies previously diagnosed as myxoid malignant fibrous histiocytomas. A final diagnosis of a myxofibrosarcoma was only possible after assessing the immuno-histochemical profile, results of histochemical stains and ultrastructural features of this lesion.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Merck C, Angerval L, Kindblom L, Oden A (1983) Myxofibrosarcoma: a malignant soft tissue tumor of fibroblastic-histiocytic origin. Acta Path Microbiol Scand 91(282):1–40

    Google Scholar 

  2. Angervall I, Kindblom L, Merck C (1977) Myxofibrosarcoma. Acta Path Microbiol Scand 85:127–140

    Google Scholar 

  3. O’Brien JE, Stout AP (1964) Malignant fibrous xanthomas. Cancer 17:1445–1455

    Article  PubMed  Google Scholar 

  4. Anavi Y, Herman GE, Graybrill S, MacIntosh RB, Tiqva P (1987) Malignant fibrous histiocytoma of the mandible. Oral Surg Oral Med Oral Pathol 68:436–443

    Article  Google Scholar 

  5. Bras J, Batsakis JG, Luna MA (1987) Malignant fibrous histiocytoma of the oral soft tissues. Oral Surg Oral Med Oral Pathol 64:57–67

    Article  PubMed  CAS  Google Scholar 

  6. Weiss SW, Enzinger FM (1977) Myxoid variant of malignant fibrous histiocytoma. Cancer 39:1672–1685

    Article  PubMed  CAS  Google Scholar 

  7. Hollowood K, Fletcher CDM (1995) Malignant fibrous histiocytoma: morhologic pattern or pathologic entity. Semin Diagn Pathol 12(3):210–220

    PubMed  CAS  Google Scholar 

  8. Wada T, Hasegawa T, Nagoya S, Kwaguchi S, Kaya M, Ishii S (2000) Myxofibrosarcoma with infitrative growth pattern: a case report. Jap Jnl Clin Oncol 30:458–462

    Article  CAS  Google Scholar 

  9. Waters B, Panice KDM, Lefkowitz RA, Antonescu CR, Healy JH, Athanason EA, Brennan MF (2007) Low-grade myxofibrosarcoma: CT and MRI patterns in recurrent disease. Am J Roentgenol 188(2):W193–W198

    Article  Google Scholar 

  10. Pezzi CM, Rawlings MS, Esqro JJ, Pollock RE, Romsdhal MM (1992) Prognostic factors in 227 patients with malignant fibrous histiocytoma. Cancer 69(8):2013–2098

    Article  Google Scholar 

  11. Huang HY, Quin J, Brennan MF, Antonescu CR (2004) 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 Pathol 35(5):612–621

    Article  Google Scholar 

  12. Silverman JF, Coalson JJ (1984) Primary myxoid malignant fibrous histiocytoma of the lung. Arch Pathol Lab Med 108:49–54

    PubMed  CAS  Google Scholar 

  13. Rooser B, Willen H, Gustafson P, Alvegard TA, Rydbholm A (1991) Malignant fibrous histiocytoma of soft tissue. Cancer 67:499–505

    Article  PubMed  CAS  Google Scholar 

  14. Nascimento AF, Bertoni F, Fletcher CD (2007) Epithelioid variant of myxofibrosarcoma: expanding the clinicomorphologic spectrum of myxofibrosarcoma in a series of 17 cases. Am J Surg Pathol 115(7):1237–1240

    Google Scholar 

  15. Fletcher CDM, Mehrtens F (2002) World heath organization classification of tumors: pathology and genetics of tumors of soft tissue and bone. IARC Press, France

    Google Scholar 

  16. Mentzel T, Calonje E, Wadden C, Camplejohn RS, Beham A, Smith MA, Fletcher C (1996) Myxofibrosarcoma: clinicopathological analysis of 75 cases with emphasis on the low-grade variant. Am J Surg Pathol 20(4):391–405

    Article  PubMed  CAS  Google Scholar 

  17. Mansoor A, White CR (2003) Myxofibrosarcoma presenting in the skin: clinicopathological features and differential diagnosis with cutaneous myxoid neoplasms. Am J Dermatopathol 25(4):281–286

    Article  PubMed  Google Scholar 

  18. Ackerman M (1997) Malignant fibrous histiocytoma—the commonest soft tissue sarcoma or a nonexistent entity? Acta Orthop Scand Suppl 273:41–46

    Google Scholar 

  19. Lagare R, Aurias A (2002) Does malignant fibrous histiocytoma exist? Ann Pathol 22(1):29–34

    Google Scholar 

  20. Erlandsen RA, Antonescu CR (2004) The rise and fall of malignant fibrous histiocytoma. Ultrastruct Pathol 28:283–289

    Article  Google Scholar 

  21. Oda Y, Tamiya S, Oshiro Y, Hachitanda Y, Kinukawa N, Iwamoto Y, Tsuneyoshi M (2002) Reassessment and clinicopathological prognostic factors of malignant fibrous histiocytoma of soft parts. Pathol Int 52(9):595–606

    Article  PubMed  Google Scholar 

  22. Al-Agha OM, Igbokwe AA (2008) Malignant fibrous histiocytoma: between the past and the present. Arch Path Lab Med 132(6):1030–1035

    PubMed  Google Scholar 

  23. Blitzer A, Lawson W, Zak FG, Biller HF, Som ML (1981) Clinicopathological determinants in prognosis of fibrous histiocytomas of head and neck. Laryngoscope 87(9):2053–2070

    Google Scholar 

  24. Allen PW (1980) Myxoid tumors of soft tissues. Path Ann 15(1):133–192

    CAS  Google Scholar 

  25. Weiss SW, Enzinger FM (1978) Malignant fibrous histiocytoma: an analysis of 200 cases. Cancer 41(6):2250–2260

    Article  PubMed  CAS  Google Scholar 

  26. Kindblom L, Merck C, Angercvall L (1979) The ultrastructre of myxofibrosarcoma: a study of 11 cases. Virchows Arch Anat Pathol 381:121–139

    CAS  Google Scholar 

  27. Hollowood K, Fletcher CDM (1995) Soft tissue sarcomas that mimick benign lesions. Semin Diagn Pathol 12(1):87–97

    PubMed  CAS  Google Scholar 

  28. Nuamah IK, Browne RM (1995) Malignant fibrous histiocytoma presenting as a perioral abscess. Int J Oral Maxillofac Surg 24:158–159

    Article  PubMed  CAS  Google Scholar 

  29. Parka SW, Kimb H-J, Leed JH, Koc YH (2009) Malignant fibrous histiocytoma of the head and neck: CT and MRI findings. Am J Neuroradiol 30:71–76

    Article  Google Scholar 

  30. Ogura JH, Toomey JM, Setzen M, Sobol S (1980) Malignant fibrous histiocytoma of the head and neck. Laryngoscope 90(9):1429–1440

    PubMed  CAS  Google Scholar 

  31. Crissman JD, Henson SL (1987) Malignant fibrous histiocytoma of the maxillary sinus. Arch Otolaryngol 104:228–230

    Google Scholar 

  32. Schaefer SD, Denton RA, Blend BL, Carder HM (1983) Malignant fibrous histiocytoma of the frontal sinus. Laryngoscope 93(2):2021–2026

    Google Scholar 

  33. Al-Salihi KA, Al-Jashamy KA, Ab Rahman S, Samsudin AR (2006) Maxilla tuberosity malignant fibrous histiocytoma with giant fibroblastic cells: case report and review of the literature. Oral Oncol Extra 42(3):112–115

    Article  Google Scholar 

  34. Barnes L, Kanbour A (1988) Malignant fibrous hiostiocytoma of the head and neck. A report of 12 cases. Arch Otolaryngol Head Neck Surg 114:1149–1156

    Article  PubMed  CAS  Google Scholar 

  35. Van Hale HM, Handlers JP, Abrams AM, Strahs G (1981) Malignant fibrous histiocytoma, myxoid variant metastatic to the oral cavity. Oral Surg Oral Med Oral Pathol 51(2):156–163

    Article  PubMed  Google Scholar 

  36. Lam PK, Trendell-Smith N, Li JHC, Fan YW, Yuen PW (2002) Myxofibrosarcoma of the sphenoid sinus. J Laryngol Otol 116:464–466

    PubMed  Google Scholar 

  37. Enoz M, Suoglu Y (2007) Myxofibrosarcoma of the maxillary sinus. Int J Head and Neck Surg 1(1):1–5

    Google Scholar 

  38. Shinozaki T, Kato F, Watanabe H, Yanagawa T, Ahmed AR, Takagishi K (2001) Discriminant analysis of prognostic factors for malignant fibrous histiocytoma in soft tissue. J Orthop Sci 6(4):339–342

    Article  PubMed  CAS  Google Scholar 

  39. Blumber AK, Kay S, Adelaar RS (1989) Nerve sheath myxoma of digital nerve. Cancer 63:1215–1218

    Article  Google Scholar 

  40. Lagace R, Delage C, Seemayer TA (1979) Myxoid variant of malignant fibrous histiocytoma. Cancer 43:526–534

    Article  PubMed  CAS  Google Scholar 

  41. Kreicbergs A, Lonnquist P, Willems J (1985) Chondromyxoid fibroma. A review of the literature and a report on our own experience. Acta Pathol Microbiol Scand A 93(4):189–197

    CAS  Google Scholar 

  42. Vuzevski VD, Van der Heul RO (1988) Comparative ultrastructure of soft-tissue myxoid tumors. Ultrastr Pathol 12(1):87–105

    Article  CAS  Google Scholar 

  43. Fujimura T, Okuyama R, Terui T, Okuno K, Masu A, Masu T, Chiba S et al (2005) Myxofibrosarcoma (MFH) showing cutaneous presentation: report of two cases. J Cut Pathol 32(7):512–515

    Article  Google Scholar 

  44. Vasuder S, Harris M (1978) Sarcoma of myofibroblasts. Arch Pathol Lab Med 102:185–188

    Google Scholar 

  45. Mentzel T, Dry S, Katenkamp D, Fletcher CD (1998) Low-grade myofibroblastic sarcoma: analysis of 18 cases in the spectrum of myofibroblastic tumors. Am J Surg Pathol 22(10):1228–1238

    Article  PubMed  CAS  Google Scholar 

  46. Evans HL (1987) Low-grade fibromyxoid sarcoma: a report of the metastatizing neoplasm having a deceptively benign appearance. Am J Clin Pathol 88(5):615–619

    PubMed  CAS  Google Scholar 

  47. Foshini MP, Fulcheri, Boracchini C, Betts CM, Eusebi V (1990) Squamous cell carcinoma with prominent myxoid stroma. Human Pathol 21:859–865

    Article  Google Scholar 

  48. Fletcher CD, Gustafson P, Rydholm A, Willen H, Ackerman M (2001) Clinicopathologic re-evaluation of 100 malignant fibrous histiocytomas: prognostic relevance of subclassification. J Clin Oncol 19(2):3045–3050

    PubMed  CAS  Google Scholar 

  49. Suh CH, Ordonez NG, Mackay B (2000) Malignant fibrous histiocytoma: an ultrastructural perspective. Ultrastruct Pathol 24:243–250

    Article  PubMed  CAS  Google Scholar 

  50. Bloustein PA (1978) Hepatic leiomyosarcoma; ultrastructural study and review of the differential diagnoses. Human Pathol 9(6):713–715

    Article  CAS  Google Scholar 

  51. Evans HL (1993) Low-grade fibromyxoid sarcoma: a report of 12 cases. Am J Surg Pathol 17(6):595–600

    Article  PubMed  CAS  Google Scholar 

  52. Block MS, Cade JE, Rodriquez FH (1986) Malignant fibrous histiocytoma of the maxilla. J Oral Maxillofac Surg 44:404–412

    Article  PubMed  CAS  Google Scholar 

  53. Hirose T, Toshiaki S, Hizawa K (1988) Ultrastructural study of the myxoid area of malignant fibrous histiocytomas. Ultrastruct Pathol 12:621–630

    Article  PubMed  CAS  Google Scholar 

  54. Tsuneyoshi M, Hashimoto H, Enjoji M (1983) Myxoid malignant fibrous histiocytoma versus myxoid liposarcoma. Virchows Arch (Anat Pathol) 400:187–199

    Article  CAS  Google Scholar 

  55. Matushansky I, Charytonowicz E, Mills J, Siddiqqi S, Hricik T, Cordon-Cardo C (2009) MFH classification: differentiating undifferentiated pleomorphic sarcoma in the 21st century. Expert Rev Anticancer Ther 9(8):1113–1144

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Diagnostics, Oral and Dental Teaching Hospital, University of the Western Cape, Private Bag X1, Tygerberg, 7505, South Africa

    Ernst J. G. Norval

  2. Oral Pathology, Medunsa Campus, University of Limpopo, Limpopo, South Africa

    Erich J. Raubenheimer

Authors
  1. Ernst J. G. Norval
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Erich J. Raubenheimer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ernst J. G. Norval.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Norval, E.J.G., Raubenheimer, E.J. Myxofibrosarcoma Arising in the Maxillary Sinus: A Case Report with a Review of the Ultrastructural Findings and Differential Diagnoses. J. Maxillofac. Oral Surg. 10, 334–339 (2011). https://doi.org/10.1007/s12663-011-0259-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12663-011-0259-0

Keywords

Search

Navigation