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Abstract
Purpose
We report the diagnosis, treatment outcomes and prognosis of the patients with soft tissue malignant myoepithelioma in the extremities.
Materials and Methods
We retrospectively reviewed 6 patients with soft tissue malignant myoepithelioma in the extremities who were treated at our institution between 2008 and 2014. Two patients received unplanned excision at another hospital and remaining 4 patients underwent the biopsy procedures and received wide excision at our hospital.
Results
There were 3 men and 3 women with mean age of 41 (33−54) years. The average follow up was 28 (9−45) months. Among the 6 patients, only 4 patients underwent biopsy procedures under the impression of malignant soft tissue sarcoma. Surgical margins for these 4 patients were negative. Two patients who had unplanned excision received another re-excision and one of them showed no residual tumor in the resected specimen. Local recurrences were developed in all patients and distant metastasis in 4 patients. All 4 patients who developed distant metastasis died due to disease progression. Among the 2 patients who developed local recurrence only, one patient has another local recurrence after reoperation and remaining one patient is no evidence of disease for 2 years after resection of locally recurred mass.
References
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Figure 1.
40-year-old woman suffered from tingling sensation for two weeks (Case 5). (A) Initial T2-weighted axial MR image shows a large deep-seated soft tissue mass at right posterior thigh. (B) T2-weighted axial MR image which was taken 14 months after the index operation shows a local recurrence. (C) The tumor cells show variegated appearance from chondromyxoid to spindle cell morphology with hypercellularity and nuclear atypism (H&E stain, ×100). (D) High power field view reveals atypical tumor cells showing prominent nucleoli and frequent mitotic figures (H&E stain, ×400). (E) Immunostaining for keratin (PAN-K) is positive (×100).
Figure 2.
35-year-old man complained about his right arm mass which is developed 3 months ago (Case 2). (A) Initial T2-weighted axial MR image shows a soft tissue mass at right posterior upper arm. (B) After unplanned excision, T2-weighted axial MR image which was taken after referral shows a localized mass lesion. Re-excision was performed and the pathologic specimen revealed that there was no residual tumor cell. However, local recurrence developed at 29 months after re-excision. (C) High power field view reveals nuclear atypism and mitosis (H&E stain, ×400). (D) Immunostaining for keratin (PAN-K) is positive (×200). (E) Immunostaining for smooth muscle actin is also positive (×100).
Table 1.
Demographic and Clinico-pathologic Data
Table 2.
Treatments for Local Recurrence and/or Metastasis
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