Abstract

A 75-year-old male with a past medical history of multiple myeloma, myasthenia gravis, prostate cancer, type 2 diabetes, and hypertension presented to the clinic for follow-up. The patient had a history of an atypical fibrous histiocytoma on his left forearm that had been excised with negative margins six months prior. On physical exam, multiple 0.5 cm subcutaneous firm nondescript nodules were noted on the left forearm, near the scar from the excision of the atypical fibrous histiocytoma. A superficial and deep 7mm punch biopsy was performed on the most distal nodule. Histopathological analysis revealed a dermal proliferation of atypical spindled to stellate cells within a myxoid stroma with an infiltrative growth pattern extending down the subcutaneous septae. The biopsy features were most consistent with low grade / grade I myxofibrosarcoma. Surgery was consulted and the patient was scheduled for a wide local excision to achieve negative margins of the tumor. He tolerated all procedures well with no complications. Patient was instructed to monitor the area for any changes or growing nodules. Myxofibrosarcoma is a malignant neoplasm of fibroblastic origin found mostly in the elderly population between the ages of sixty and eighty. It presents as painless nodules or tumors that can extend to the dermis and skeletal muscle. Myxofibrosarcoma has a high potential of local recurrence and metastasis, especially when intermediate or high grade. Because of histological variations of myxofibrosarcoma, misdiagnosis of patients can occur. Herein, we present a case of myxofibrosarcoma in a 75-year-old male patient.

Financial Disclosure:
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