Cytological diagnosis of adult-type fibrosarcoma of the neck in an elderly patient. Report of one case and review of the literature

Immacolata Cozzolino,Alessia Caleo,Alfredo Garzi,Mario Vitale,Mariapia Cinelli,Chiara Carlomagno,Vincenzo Di Crescenzo

doi:10.1186/1471-2482-13-s2-s42

Immacolata Cozzolino, Alessia Caleo + Show 5 more

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https://doi.org/10.1186/1471-2482-13-s2-s42

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Abstract

BackgroundFibrosarcoma (FS) accounts for about 3% of all soft tissue sarcomas. It may arise in any area of the body, but it is relative rare in the head and neck district. Fine-needle cytology (FNC) is widely used in the diagnosis of neoplastic and non-neoplastic lesions of soft tissue. This article describes a case of FS of the neck diagnosed by FNC.MethodsFNC was performed in a sub-fascial supraclavicular mass of an elderly patient under ultrasound (US) control. FNC was used to prepare cytological smears that were conventionally and immunocytochemically (ICC) stained.ResultsSmears showed a monomorphous spindle cell population and were positive at ICC for Vimentin and negative for CKAE1AE3, Actin, S-100, CD68, CT and PAX-8. The cytological diagnosis was confirmed by histological diagnosis. The patient underwent surgical resection and subsequent radiotherapy.ConclusionsFNC diagnosis of FS is reliable and accurate and may be conveniently used in the scheduling of surgical procedures, when needed, avoiding the treatment of benign nodules.

Highlights

Old age is characterized by increased incidence of degenerative and neoplastic diseases
The aim of this study is to present one case of conventional FS in an elderly patient in which Fine-needle cytology (FNC) pre-surgical diagnosis contributed to a correct and differentiated treatment
The differential diagnosis included mesenchymal neoplasms and pseudotumors such as nodular fasciitis [15,23,39,40], possible primary thyroid tumors such as the anaplastic carcinoma or medullary carcinoma [15,41], as well as other lesions located in the neck with a spindle cellular component, such as the ectopic thymoma [42,43]

Summary

Introduction

Old age is characterized by increased incidence of degenerative and neoplastic diseases. Conventional FS accounts for only 1 to 3% of sarcomas arising from soft tissues [5,6] and falls into two main groups, the adult and infantile types, both very uncommon. Since the head and neck region is characterized by a significant heterogeneity and a variety of organs and pathologies, FNC can provide specific information to define the organ or tissue involved, the specific pathologies and being useful to the differential diagnosis [32,35,36]. Fibrosarcoma (FS) accounts for about 3% of all soft tissue sarcomas. It may arise in any area of the body, but it is relative rare in the head and neck district. This article describes a case of FS of the neck diagnosed by FNC

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