Myxofibrosarcoma in the skin. J Cutan Pathol. 2008 May 20.

Myxofibrosarcoma, also known as myxoid malignant fibrous histiocytoma, is increasingly recognized as a distinct malignant neoplasm of fibroblastic origin with variable clinical and histopathologic features. Myxofibrosarcomas are among the most common malignant mesenchymal neoplasms of older adults, and approximately two thirds develop within the dermis or subcutis. Herein, we describe the clinicopathologic features of four cases of myxofibrosarcoma involving the skin. Three of these cases were initially misdiagnosed as benign cutaneous neoplasms, two as myxoid neurofibroma. These cases illustrate the clinicopathologic spectrum encompassed by myxofibrosarcoma in the skin and highlight the diagnostic difficulties it may present.

Flow Cytometric Analysis of DNA Ploidy and S-Phase Fraction in Primary Localized Myxofibrosarcoma: Correlations with Clinicopathological Factors, Skp2 Expression, and Patient Survival.Ann Surg Oncol. 2008 May 31.

BACKGROUND: Histological assessment for prognostication of myxofibrosarcomas remains challenging. We previously reported independent prognostic value of Skp2, an oncoprotein promoting S-phase progression (Clin Cancer Res 2006;12:487-98). METHODS: We evaluated S-phase fraction (SPF) and ploidy of myxofibrosarcomas and the association between SPF and Skp2. Flow cytometric findings were analyzed for 75 cases and correlated with clinicopathological factors, Skp2 labeling index (LI), metastasis-free survival (MeFS), and overall survival (OS). RESULTS: Forty-seven and 28 cases were classified as diploid and nondiploid, respectively. High SPF (>/=20%) was detected in 32 of 61 interpretable cases. Skp2 overexpression (LI >/= 10%) was seen in 36 of 72 cases with scoring. Nondiploidy correlated with higher French Federation of Cancer Centers (FNCLCC) grades (P = .006), remarkable necrosis (P = .010), and Skp2 overexpression (P = .018). Noticeably, SPF was significantly related to Skp2 LI (P < .001, r = .458), FNCLCC grade, American Joint Committee on Cancer stage, and mitotic rate. Nondiploidy predicted shorter OS (P = .0045) and MeFS (P = .0489), whereas SPF >/= 20% was only associated with inferior MeFS (P = .0252). In multivariate analyses, nondiploidy independently correlated with both OS (P = .020, RR = 3.337) and MeFS (P = .013, RR = 5.780), together with Skp2 overexpression (P = .014 for OS; P = .017 for MeFS) and disease-positive margins (P = .004 for OS; P = .002 for MeFS). CONCLUSION: Skp2 promotes S-phase progression in myxofibrosarcomas. SPF provides no independent prognostic usefulness; it is probably overshadowed by Skp2. Nondiploidy adds another predictive value to Skp2 overexpression and disease-positive margins in prognostication.

Primary Myxofibrosarcoma of the Left Atrium: Case Report and Review of the Literature. Angiology. 2008 Apr 2.

A 63-year-old woman with progressive dyspnea underwent transthoracic echocardiography and was found to have a large multilobed mass in the left atrium that was attached to lateral wall. On inspection during surgery, the tumor was found to infiltrate the posterior mitral annulus and leaflet. The patient underwent surgical resection of the tumor and mitral valve replacement. Histologic and cytochemical evaluation confirmed that the tumor was a myxofibrosarcoma. Despite chemotherapy, the tumor recurred and the patient died 3 months after surgery.