Myxofibrosarcoma is the most common soft tissue sarcoma that occurs in late adult life, peaking in the seventh decade, and it is mainly encountered in the lower extremities. Cases within the head and neck region are extremely rare and to date only 19 cases have been described so far. The case report described here is of 35-year-old caucasian man who presented with a complaint of facial asymmetry for a mass in his right midcheek area, which had increased in size over four months. An intraoral examination revealed an expansion of his upper right gums and the vestibular portion and his teeth were movable with the presence of a widespread periodontitis. Computed tomography revealed a hyperdense mass 83mm x55mm in the pterygopalantine fossa. An open biopsy sample was obtained and this was consistent with a myxofibrosarcoma. A total right maxillectomy was performed using a Weber-Ferguson approach preserving the orbital floor. The tumour was detached and the excised portion was reconstructed with a free rectus abdominis myocutaneous flap. Postoperative radiotherapy was given to the area. The authors having reviewed the literature recommend a complete tumour resection with adequate resection margins, followed by adjuvant radiotherapy with possible re-excision of recurrent lesions. Aggressive follow-up is required to monitor any possibility of metastases.
Head and neck myxofibrosarcoma: a case report and review of the literature
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