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Clinical Problem Solving: Pathology
May 2013

Pathology Quiz Case 1: Diagnosis

Author Affiliations


JAMA Otolaryngol Head Neck Surg. 2013;139(5):526-527. doi:10.1001/jamaoto.2013.2857b

Diagnosis: Hyalinzed spindle cell tumor with giant rosettes (HSCTGR)

Low-grade fibromyxoid sarcoma (LGFMS) is a rare metastatic sarcoma that was first described by Evans1 in 1987 in a report of 2 cases in which the masses were located in the soft tissues of the scapula and the axillary region. In 1993, Evans2 added an additional 10 cases in which LGFMS was diagnosed histologically. The tumors consisted of bland, benign-appearing fibroblastic spindle cells surrounded by myxoid areas with a whorling growth pattern. Cellularity was low to moderate, few mitotic figures were seen, and little nuclear polymorphism was visible. Despite its relatively benign pathologic characteristics, LGFMS does have the potential to metastasize, and this most commonly happens to the lungs.1,2

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