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©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Low-grade fibromyxoid sarcoma of the liver: A case report
Vladimir Dugalic, Igor I Ignjatovic, Jelena Djokic Kovac, Nikola Ilic, Jelena Sopta, Slavenko R Ostojic, Dragan Vasin, Marko D Bogdanovic, Igor Dumic, Tamara Milovanovic
Vladimir Dugalic, Igor I Ignjatovic, Slavenko R Ostojic, Marko D Bogdanovic, Department of Hepatobiliary & Pancreatic Surgery, Clinic for Digestive Surgery, Clinical Center of Serbia, Belgrade 11000, Serbia
Jelena Djokic Kovac, Dragan Vasin, Department of Radiology, Clinical Center of Serbia, Belgrade 11000, Serbia
Nikola Ilic, Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade 11000, Serbia
Jelena Sopta, Institute of Pathology, University of Belgrade, Belgrade 11000, Serbia
Igor Dumic, Mayo Clinic Health System, Mayo Clinic College of Medicine and Science, Rochester, NY 10029, United States
Tamara Milovanovic, Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade 11000, Serbia
Author contributions: Dugalic V and Ilic N performed surgery; Dugalic V and Igrnjatovic II wrote the paper, study conception and design; Bogdanovic MD and Ostojic SR analyzed and collected data; Dumic I performed language revision; Milovanovic T critical review of manuscript; Sopta J performed the histopatologic analysis; Kovac JD and Vasin D analyzed and interpreted the imaging findings; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Tamara Milovanovic, MD, PhD, Professor, Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, School of Medicine, University of Belgrade, 2, Dr Koste Todorovica Street, Belgrade 11000, Serbia. tamara.alempijevic@med.bg.ac.rs
Received: May 25, 2020
Peer-review started: May 25, 2020
First decision: June 12, 2020
Revised: September 15, 2020
Accepted: November 21, 2020
Article in press: November 21, 2020
Published online: January 6, 2021
BACKGROUND
Low grade fibromyxoid sarcoma (LGFMS) is a rare and benign mesenchymal tumor with indolent course, most commonly found in young or middle-aged men. The majority of the LGFMSs are located in the trunk and deep soft tissue of the lower extremities. They appear as well circumscribed, although not encapsulated, which often leads to incomplete surgical resection. Despite their seemingly benign appearance, these tumors have aggressive behavior with high metastatic and recurrence rates. Accurate histopathologic examination of the specimen and its immunohistochemical analysis are mandatory for a precise diagnosis.
CASE SUMMARY
We report a case of a 38 year-old-man who presented with jaundice and upper abdominal discomfort. Multi-detector computed tomography and magnetic resonance imaging showed a large left liver tumor mass, extending to the hepatoduodenal ligament. Left hepatectomy was performed with resection and reconstruction of hepatic artery and preservation of middle hepatic vein. Histopathologic examination confirmed the tumor being a low-grade fibromyxoid sarcoma. Three and a half years after surgery, the patient died after being diagnosed with spine metastasis.
CONCLUSION
Due to poor response to all modalities of adjuvant treatment, we consider that the focus of treatment should be on surgery as the only option for curing the disease.
Core Tip: Low grade fibromyxoid sarcoma (LGFMS) is very rare mesenchymal tumors with indolent course but aggressive biological behavior. There are no effective diagnostic procedures to achieve an accurate preoperative diagnosis. Symptoms are usually caused by compression on adjacent organs and structures. This report describes the case of a large left liver LGFMS in male patient, extending to the hepatoduodenal ligament, which was detected with abdominal ultrasound and confirmed by multi-detector computed tomography and magnetic resonance imaging. Left hepatectomy was performed and the tumor was completely removed at laparotomy.
