title: Low-grade fibromyxoid sarcoma presenting clinically as a primary ovarian neoplasm: a case report.
abstract: Low-grade fibromyxoid sarcoma is an uncommon, deceptively bland mesenchymal neoplasm that typically occurs in the deep soft tissues of the proximal extremities of young to middle-aged patients. Intra-abdominal low-grade fibromyxoid sarcomas are distinctly rare. We describe the first reported example of this sarcoma involving the ovary. The 42-year-old patient presented with progressing abdominal pain and urinary frequency. Computed tomographic imaging of the abdomen and pelvis showed a 14-cm left-sided pelvic mass. The patient underwent surgical resection and, intraoperatively, a left ovarian mass was identified that extended to both the left hypogastric artery and the left ureter. The resected specimen consisted of a 17-cm tan, fleshy mass containing grossly recognizable nodules of gelatinous, myxoid tissue and a small rim of normal ovary. Microscopic examination of the neoplasm revealed a cytologically bland spindle cell proliferation set in a collagenized stroma that abruptly transitioned to nodules of a myxoid stroma with a well-formed capillary vasculature, features characteristic of low-grade fibromyxoid sarcoma. On the basis of the diagnosis, the patient was clinically staged as a retroperitoneal sarcoma with secondary ovarian involvement. The patient has stable residual disease 11 months postoperatively. This case adds to the literature of intra-abdominal low-grade fibromyxoid sarcoma and expands the list of malignant mesenchymal neoplasms that may involve the ovary.
authors.affiliation: Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205, USA.
authors.forename: Harry L
authors.initials: HL
authors.lastname: Winfield
authors.forename: Luis E
authors.initials: LE
authors.lastname: De Las Casas
authors.forename: William W
authors.initials: WW
authors.lastname: Greenfield
authors.forename: Alessandro D
authors.initials: AD
authors.lastname: Santin
authors.forename: Jesse K
authors.initials: JK
authors.lastname: McKenney
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D005350:Fibroma / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000473:pathology; D012186:Retroperitoneal Neoplasms / Q000175:diagnosis* / Q000473:pathology; D012509:Sarcoma / Q000175:diagnosis* / Q000473:pathology