The Uncertainty of the Surgical Margin in the Treatment of Low Grade Fibromyxoid Sarcoma: a Case Report and Literature Review

Low grade fibromyxoid sarcoma (LGFMS) is a rare soft tissue tumor appearing mainly in young adults. Despite its bland histological features, the tumor has a tendency toward late local recurrence and distant metastases even up to 45 years after the diagnosis. The treatment of choice in this type of neoplasm is a radical surgical excision with clear resection margins. We decided to present a case report of a 17-year-old patient with LGFMS of the right hip. Surgical resection of the tumor was performed, but in the histopathological examination was described the minimal resection margin (0.3 mm). The multi-specialist team composed of oncologist, radiologist, and pediatric surgeon based on the literature decided to widen the resection margin despite its obtainment during the primary operation. The scar after the first surgery and surrounding soft tissues with the bigger margin were resected. No evidence of cancerous infiltration was found in the second histopathological material. Patient has stayed under the routine control of pediatric surgeon, pediatric oncologist, and has not presented recurrence for 3 years. In conclusion, when the resection margin is uncertain after the primary surgery, the increase of the range of operation allows the prevention of the late recurrence of the disease.