Upper extremity myxofibrosarcoma mimicking an erosive inflammatory arthritis: a case report

Skeletal Radiol. 2019 Oct;48(10):1643-1649. doi: 10.1007/s00256-019-03217-w. Epub 2019 Apr 15.

Abstract

Myxofibrosarcoma is a malignant fibroblastic soft tissue neoplasm containing a variable amount of myxoid stroma that commonly presents as a slow-growing mass in elderly patients. The neoplasm may be superficial or deep to the muscle fascia and characteristically has an infiltrative growth pattern with a dominant or multinodular mass. We describe an unusual case of high-grade myxofibrosarcoma of the wrist and forearm that infiltrated the muscles, tendons, and wrist joint, causing bone erosions. The tumor was mistakenly diagnosed as synovitis and a chronic, erosive, inflammatory process. The diffuse nature, absence of a dominant mass, and radiographic appearance complicated the diagnosis. Although neoplasms of the synovial spaces are rare, this case demonstrates that tumors with a highly infiltrative growth pattern can mimic inflammatory synovitis and that neoplasms should be considered in the differential diagnosis when clinical and laboratory features are discordant with the imaging appearance.

Keywords: Infiltrative growth pattern; Myxofibrosarcoma; Synovitis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Amputation, Surgical
  • Arthritis*
  • Diagnosis, Differential
  • Female
  • Fibrosarcoma / diagnostic imaging*
  • Fibrosarcoma / surgery
  • Humans
  • Magnetic Resonance Imaging
  • Muscle Neoplasms / diagnostic imaging*
  • Muscle Neoplasms / surgery
  • Myxosarcoma / diagnostic imaging*
  • Myxosarcoma / surgery
  • Radiography
  • Upper Extremity / diagnostic imaging*
  • Upper Extremity / surgery