Myxofibrosarcoma - low-grade

Case contributed by Domenico Nicoletti

Presentation

Nodular swelling of the forearm hard and painful for several months.

Patient Data

Age: 55 years
Gender: Female
mri

Pre-contrast MR imaging demonstrates nodular neoformation with well-defined margins, flattened shape, localized in the subcutis, with ample contact with the fascia; there is the “tail sign”. The lesion has low signal in T1-weighted sequences, low and non-homogeneous in T2 with intense enhancement after administration of contrast.

Annotated image

Tail sign. 

pathology

Histological report after surgical removal.

Case Discussion

Superficial myxofibrosarcomas are highly associated with infiltrative growth (tail sign) and local recurrence.

The “tail sign” is a thick fascial enhancement that extends from the tumor margin, and the histology reveals infiltration of the tumor cells along the deep fascia from the main mass.

MR imaging features of nodular fasciitis are generally non-specific and can be mistaken for a soft tissue sarcoma.

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