Myxoinflammatory fibroblastic sarcoma of the thigh: A morphologic diversity
A 50-year-old woman presented with a mass in the left thigh of 15 days duration. The mass was painless and smooth with ill-defined borders. Fine needle aspiration yielded only adipose tissue fragments. Wide excision was done. Grossly, the mass was grey pink and measured 6×3.5×2 cm. The outer surface was nodular. Cut section showed grey-white to grey-yellow areas. Histological examination showed a well circumscribed, multinodular tumor having myxoid and hyalinized areas []. A heterogeneous population of round to oval cells with eccentric nuclei and clear cytoplasm, pleomorphic multinucleated giant cells with bizarre vesicular nuclei and inflammatory infiltrate consisting of lymphocytes and plasma cells were seen. Lipoblast-like cells, large cells with vesicular unilobed and bilobed nuclei, prominent macronucleoli and abundant cytoplasm resembling Reed Sternberg-like cells and virocyte-like cells were also noted []. On immunohistochemistry (IHC), tumor cells were positive for vimentin and negative for epithelial membrane antigen (EMA), cytokeratin (CK), CD30, CD68, CD34 and HMB45. On the basis of histopathology and IHC, a final diagnosis of MIFS was made. The margins of the tumor were free. Patient continues to remain disease free after two years of surgical excision with no evidence of recurrence or metastasis.