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7 slides generated from the cancer page, with a quiz from the open benchmark and speaker notes that cite the sources. Arrow keys move between slides; Print gives one slide per page.
Myxofibrosarcoma is a sarcoma of older people that grows just beneath the skin of the limbs and sends invisible tails along the tissue planes, so it comes back after surgery more often than any other sarcoma. Wide surgery guided by MRI, usually with radiotherapy, is the treatment; chemotherapy is reserved for spread disease.
Myxofibrosarcoma is a fibroblastic sarcoma of late adult life, usually presenting as a painless superficial or subcutaneous mass in the limbs, and is now the commonest sarcoma diagnosis in the elderly. Its defining behaviour is infiltrative growth along fascial planes and septa well beyond the palpable mass, seen on MRI as curvilinear tail-like enhancement, and this explains a local recurrence rate that exceeds every other soft tissue sarcoma. Grade rises with each recurrence, and metastasis, mainly to the lungs, follows grade: rare in low-grade tumours, common in high-grade ones.
Treatment is wide surgical resection planned on contrast-enhanced MRI to encompass the tail sign, with radiotherapy for most intermediate- and high-grade tumours and for recurrent disease, given preoperatively or postoperatively as for other extremity sarcomas. Positive margins are common even in expert hands and re-excision is frequently needed. Systemic therapy for high-grade or metastatic disease follows the general soft tissue sarcoma approach with doxorubicin-based chemotherapy, and the tumour has no recurrent driver alteration to target.
| Setting | Approach | Guideline |
|---|---|---|
| Localised | Wide resection planned on contrast-enhanced MRI to include tail-like extensions; preoperative or postoperative radiotherapy for intermediate- and high-grade and recurrent tumours. | not mapped |
| Recurrent local disease | Re-resection with radiotherapy if not previously given; amputation only for uncontrollable multiply recurrent disease. | not mapped |
| Metastatic | Doxorubicin-based chemotherapy as for other high-grade soft tissue sarcomas; metastasectomy for limited lung disease. | not mapped |