Publication:

A chest wall sarcoma, a recurrence 8 years after index excision: a case report

Soft tissue sarcomas (STS) occur in 2-5 patients per 100,000 people, as a rare heterogeneous group of tumors arising in connective tissues, embryologically derived from mesenchyme. These tumors comprise <1% of all neoplasms with a 4:1 male preponderance. Prognosis depends on size, grade, depth and metastasis. Even in STS classified as low-grade, the risk of local recurrence requiring further intervention remains high, therefore emphasizing the importance of long-term follow-up. While nodal metastasis is rare, the tumor immediately becomes stage III when this occurs, regardless of size or depth. More than 50 subtypes exist and originate from cartilage, muscle, blood vessels, nerves, fat, tendons and deep skin tissues. Low-grade fibromyxoid sarcoma (LGFMS), one rare subtype with a relatively benign histologic appearance, has a high recurrence rate, late metastatic spread, and chemotherapy and radiotherapy insensitivity. We present the case of a 57-year-old male with a right chest wall mass diagnosed as a recurrent low-grade fibromyxoid sarcoma (LGFMS) 8 years after index excision. We emphasize the importance of early detection and management given the value of early surgical intervention due to the limited response of adjuvant therapy in this low-grade yet aggressive tumor.