Infiltrative low-grade fibromyxoid sarcoma of the thoracic spine

Abstract

A 25-year-old man presented with a 1-year history of recurrent thoracic back pain. Physical examination revealed a mild hypoesthesia of both lower extremities. Computed tomography scan showed an expansile lytic lesion involving the vertebral bodies as well as the posterior elements at the T1– T3 levels (Fig. 1, Left), which was confirmed to be extending into the right ribs on axial computed tomography image (Fig. 1, Right). Magnetic resonance imaging revealed a large multiloculated lesion measuring 13×10.8×4.7 cm, with high vascularization within the paraspinal soft tissues at the level of T1–T3 accompanied with associated intraspinal extension (Fig. 2). Complete resection of the mass lesion was performed by a posterior approach with instrumentation. Postoperative period was uneventful. Pathologic examination and immunohistochemical staining confirmed the diagnosis of lowgrade fibromyxoid sarcoma. Low-grade fibromyxoid sarcoma is a rare mesenchymal malignancy with a deceptively bland histologic appearance but showing potential for late recurrence and metastasis [1,2]. Low-grade fibromyxoid sarcoma occurs most commonly in the deep soft tissues of proximal extremities, and also in the inguinal area, neck, or chest wall [2,3]. Spinal involvement with low-grade fibromyxoid sarcoma has rarely been reported [3,4].