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Kim, Song, Kang, Kang, Kim, Lee, Kim, and Kim: A Case of Low-grade Fibromyxoid Sarcoma of the Colon
Case Report

Korean J Gastroenterol 2014;64(6):375-379.

Published online: 4 October 2014

DOI: https://doi.org/10.4166/kjg.2014.64.6.375

A Case of Low-grade Fibromyxoid Sarcoma of the Colon

Min Kim, Tae Jun Song1, Seung Dae Kang, Jong Sik Kang, Jin Suk Kim, June Sung Lee, Chul Nam Kim2, Han Seong Kim3

Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea

2Department of General Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea

3Department of Pathology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea

1Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

Correspondence to: Tae Jun Song, Department of Internal Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Korea. Tel: +82-2-3010- 3180, Fax: +82-2-476-0824, E-mail: medi01@naver.com

Received 17 February 201415 May 2014       Accepted 27 May 2014

Copyright © 2014 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Low-grade fibromyxoid sarcoma is a slowly growing soft tissue neoplasm that shows benign histologic features but may have clinical course of malignant disease. It has been reported to occur in the thigh, inguinal area, axilla, shoulder, neck, perineum or buttock. However, there have been few cases of abdominal organ involvement. A 21-year-old woman presented with a large palpable abdominal mass. A 7×4 cm sized round soft tissue tumor at right upper quadrant area was identified by abdominopelvic CT scan. Percutaneous ultrasound-guided biopsy revealed features of spindle cell tumor. On exploration, the tumor originated from transvers colon and was attached to gastrocolic ligament, transverse mesocolon and stomach. The tumor could be dissected with transverse colectomy and partial gastrectomy. The excised tumor, measuring 7×5×5 cm, was well demarcated and appeared as an ovoid mass with firm and myxoid cut surface. She was diagnosed with low-grade fibromyxoid sarcoma arising from transverse colon, and is currently being followed-up without recurrence or metastasis.

Keywords: Low-grade fibromyxoid sarcoma, Colon, Stomach

References

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Fig. 1.
Abdominal computed tomography shows a 7×4 cm sized homogeneous enhancing mass (arrows) between stomach and transvers colon.
kjg-64-375f1.tif
Fig. 2.
Gross pathologic image shows ovoid well demarcated lesion and bisecting surface demonstrates a mixture of yellow colored, mucoid and fibrous tissue.
kjg-64-375f2.tif
Fig. 3.
(A) Transition from fibrous (arrow) to myxoid (asterisk) tumor areas are noted (H&E, ×100). (B) Portion of fibrous tumor reveals arcades of slender blood vessels (H&E, ×100).
kjg-64-375f3.tif
Table 1.
Characteristics and Clinical Outcomes of Reported Low-grade Fibromyxoid Sarcoma Cases
Variable Value (%)
District  
 Europe 48.7
 America 33.3
 Asia 17.2
 Others 0.8
Involved organ  
 Lower limbs 41.3
 Trunk wall 21.2
 Internal organs 14.7
 Upper limbs 15.4
 Head and neck 6.2
 Others 1.1
Treatment  
 Surgical resection only 91.6
 Surgical resection+RT 3.7
 Surgical resection+CTx 2.6
 Surgical resection+RT+CTx 1.1
 Not done 1.1
Prognosis  
 Local recurrences 29.3
 Distant metastases 18.5

RT, radiotherapy; CTx, chemotherapy.

Table 2.
Comparison on Low-grade Fibromyxoid Sarcoma Cases Occurring in Colon
  Kim et al.6 Park et al.7 Present case
Sex Male Male Female
Age (yr) 56 43 21
Size of tumor (cm) 7.5×6 8×6×5 7×5×5
Shape of tumor Ovoid Dumbbell Ovoid
Primary location SF of the colon HF of the colon Transvers colon
Invasion Diaphragm Right kidney Stomach
Immunohistochemical stain      
 Vimentin Not done + Not done
 S-100 protein Not done − +/−
 Desmin Not done − +/−
 SMA + − +/−
Treatment Wedge resection of left diaphragm and partial colectomy Hemicolectomy and nephrectomy Transvers colectomy and partial gastrectomy
Postoperative treatment Radiotherapy None None
Recurrence None None None

SF, splenic flexure; HF, hepatic flexure male.

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