Is low-grade fibromyxoid sarcoma a benign or malignant tumor?
Patient's Query
Hello doctor,
I am a 60-year-old female who was diagnosed with a huge mass in the pelvic region a few years ago. It was described as a low-grade fibromyxoid tumor on biopsy. Is it a benign or a malignant lesion? Please help.
Hello,
Welcome to icliniq.com.
I understand your concern and will definitely help you regarding it. I went through your reports (the attachments removed to protect the patient's identity). Soft tissue tumors are classified according to their grade. The histomorphological features are suggestive of a low-grade soft tissue neoplasm. The low-grade soft tissue tumors usually show benign behavior. But, the standardized uptake value (SUV) in your case is on the higher side. The SUV increases with higher tumor grade. The median SUV is around 1.3 (range 0.37 to 1.9) for low-grade soft tissue sarcomas, 2.7 (range 1.2 to 6) for intermediate grade, and 4.5 (range 1.4 to 9.1) for high-grade. In my opinion, the soft tissue mass should be resected completely with appropriate margins. I wish you a healthy life ahead. I hope this has helped you. Thanks and regards.
Patient's Query
Hello doctor,
Thank you for the response. When this was discovered a few years ago and biopsied, I was advised not to remove it due to a very technically difficult surgery with likely complications due to the location of the mass. Is it a benign or malignant mass? Please help.
Hello,
Welcome back to icliniq.com.
As one of the differentials is low-grade myxoid sarcoma, it is important to discuss it. In spite of the low-grade and benign histological appearance, early studies of retrospectively diagnosed LGFMS (low-grade fibromyxoid sarcoma) have shown a distinct biological behavior, with a relatively high and atypical metastasizing potential, making the correct diagnosis of LGFMS important. And, as the SUV in your case is also high, it appears prudent to weigh the risk over the benefits of resection. Yes, it should be a discussion between your surgeon and your pathologist about the further course of action. Though recurrences are common, if feasible, a resection with wide margins may be helpful. I hope this has helped you. Thanks and regards.
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