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Myxofibrosarcoma
Eric Walker, MD, MHA, FACR, FACHE; Catherine C. Roberts, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Synonyms

                • Fibrosarcoma, myxoid type
                • Not recommended: myxoid malignant fibrous histiocytoma
              • Definitions

                • Spectrum of malignant fibroblastic sarcomas with variably myxoid stroma occurring in older adult patients
                  • Reclassified as distinct entity by WHO in 2002
                  • Not same entity as low-grade fibromyxoid sarcoma (Evans tumor)

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • MR Findings

                      • Ultrasonographic Findings

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Scalas G et al: Magnetic resonance imaging of soft tissue sarcoma: features related to prognosis. Eur J Orthop Surg Traumatol. 31(8):1567-75, 2021
                                          2. Huang HY et al: Myxofibrosarcoma. In Fletcher CDM et al: WHO Classification of Tumours: Soft Tissue and Bone Tumours. 5th ed. IARC Press. 124-6, 2020
                                          3. Sambri A et al: The biology of myxofibrosarcoma: state of the art and future perspectives. Oncol Res Treat. 43(6):314-22, 2020
                                          4. Kikuta K et al: An analysis of factors related to the tail-like pattern of myxofibrosarcoma seen on MRI. Skeletal Radiol. 44(1):55-62, 2015
                                          5. Kransdorf MJ et al: Fibrous and fibrohistiocytic tumors. In Kransdorf MJ et al: Imaging of Soft Tissue Tumors. 3rd ed. Lippincott Williams & Wilkins. 327-45, 2014
                                          6. Petscavage-Thomas JM et al: Soft-tissue myxomatous lesions: review of salient imaging features with pathologic comparison. Radiographics. 34(4):964-80, 2014
                                          7. Lefkowitz RA et al: Myxofibrosarcoma: prevalence and diagnostic value of the "tail sign" on magnetic resonance imaging. Skeletal Radiol. 42(6):809-18, 2013
                                          8. Walker E et al: Dilemmas in distinguishing between tumor and the posttraumatic lesion with surgical or pathologic correlation. Clin Sports Med. 32(3):559-76, 2013
                                          9. Walker EA et al: Magnetic resonance imaging of malignant soft tissue neoplasms in the adult. Radiol Clin North Am. 49(6):1219-34, vi, 2011
                                          10. Kaya M et al: MRI and histological evaluation of the infiltrative growth pattern of myxofibrosarcoma. Skeletal Radiol. 37(12):1085-90, 2008
                                          11. Weiss SW et al: Fibrosarcoma. In Weiss SW et al: Enzinger and Weiss' Soft Tissue Tumors. 5th ed. Elsevier. 312-16, 2008
                                          12. Lin CN et al: Prognostic factors of myxofibrosarcomas: implications of margin status, tumor necrosis, and mitotic rate on survival. J Surg Oncol. 93(4):294-303, 2006
                                          13. Manoso MW et al: Infiltrative MRI pattern and incomplete initial surgery compromise local control of myxofibrosarcoma. Clin Orthop Relat Res. 450:89-94, 2006
                                          14. Huang HY et al: 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. Hum Pathol. 35(5):612-21, 2004
                                          15. Mentzel T et al: Myxofibrosarcoma. In Fletcher CDM et al: WHO Classification of Tumours. Pathology and Genetics of Tumours of Soft Tissue and Bone. IARC Press. 102-3, 2002
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Pathology

                                                  • Clinical Issues

                                                    • Diagnostic Checklist

                                                      TERMINOLOGY

                                                      • Synonyms

                                                        • Fibrosarcoma, myxoid type
                                                        • Not recommended: myxoid malignant fibrous histiocytoma
                                                      • Definitions

                                                        • Spectrum of malignant fibroblastic sarcomas with variably myxoid stroma occurring in older adult patients
                                                          • Reclassified as distinct entity by WHO in 2002
                                                          • Not same entity as low-grade fibromyxoid sarcoma (Evans tumor)

                                                      IMAGING

                                                      • General Features

                                                        • Radiographic Findings

                                                          • CT Findings

                                                            • MR Findings

                                                              • Ultrasonographic Findings

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    • Gross Pathologic & Surgical Features

                                                                      • Microscopic Features

                                                                        CLINICAL ISSUES

                                                                        • Presentation

                                                                          • Demographics

                                                                            • Natural History & Prognosis

                                                                              • Treatment

                                                                                DIAGNOSTIC CHECKLIST

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Scalas G et al: Magnetic resonance imaging of soft tissue sarcoma: features related to prognosis. Eur J Orthop Surg Traumatol. 31(8):1567-75, 2021
                                                                                  2. Huang HY et al: Myxofibrosarcoma. In Fletcher CDM et al: WHO Classification of Tumours: Soft Tissue and Bone Tumours. 5th ed. IARC Press. 124-6, 2020
                                                                                  3. Sambri A et al: The biology of myxofibrosarcoma: state of the art and future perspectives. Oncol Res Treat. 43(6):314-22, 2020
                                                                                  4. Kikuta K et al: An analysis of factors related to the tail-like pattern of myxofibrosarcoma seen on MRI. Skeletal Radiol. 44(1):55-62, 2015
                                                                                  5. Kransdorf MJ et al: Fibrous and fibrohistiocytic tumors. In Kransdorf MJ et al: Imaging of Soft Tissue Tumors. 3rd ed. Lippincott Williams & Wilkins. 327-45, 2014
                                                                                  6. Petscavage-Thomas JM et al: Soft-tissue myxomatous lesions: review of salient imaging features with pathologic comparison. Radiographics. 34(4):964-80, 2014
                                                                                  7. Lefkowitz RA et al: Myxofibrosarcoma: prevalence and diagnostic value of the "tail sign" on magnetic resonance imaging. Skeletal Radiol. 42(6):809-18, 2013
                                                                                  8. Walker E et al: Dilemmas in distinguishing between tumor and the posttraumatic lesion with surgical or pathologic correlation. Clin Sports Med. 32(3):559-76, 2013
                                                                                  9. Walker EA et al: Magnetic resonance imaging of malignant soft tissue neoplasms in the adult. Radiol Clin North Am. 49(6):1219-34, vi, 2011
                                                                                  10. Kaya M et al: MRI and histological evaluation of the infiltrative growth pattern of myxofibrosarcoma. Skeletal Radiol. 37(12):1085-90, 2008
                                                                                  11. Weiss SW et al: Fibrosarcoma. In Weiss SW et al: Enzinger and Weiss' Soft Tissue Tumors. 5th ed. Elsevier. 312-16, 2008
                                                                                  12. Lin CN et al: Prognostic factors of myxofibrosarcomas: implications of margin status, tumor necrosis, and mitotic rate on survival. J Surg Oncol. 93(4):294-303, 2006
                                                                                  13. Manoso MW et al: Infiltrative MRI pattern and incomplete initial surgery compromise local control of myxofibrosarcoma. Clin Orthop Relat Res. 450:89-94, 2006
                                                                                  14. Huang HY et al: 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. Hum Pathol. 35(5):612-21, 2004
                                                                                  15. Mentzel T et al: Myxofibrosarcoma. In Fletcher CDM et al: WHO Classification of Tumours. Pathology and Genetics of Tumours of Soft Tissue and Bone. IARC Press. 102-3, 2002