Innovating the surgical approach to a low grade fibromyxoid sarcoma of the subscapularis muscle

Authors

  • Gonçalo Vieira da Silva Department of Orthopaedics, Centro Hospitalar e Universitario de Santo António, Portugal
  • Manuel Carrapatoso Department of Orthopaedics, Centro Hospitalar e Universitario de Santo António, Portugal
  • Pedro Neto Department of Orthopaedics, Centro Hospitalar e Universitario de Santo António, Portugal
  • Filipe Vargas Department of Orthopaedics, Centro Hospitalar e Universitario de Santo António, Portugal
  • Gonçalo Sá Department of Orthopaedics, Centro Hospitalar e Universitario de Santo António, Portugal
  • José Manuel Lourenço Department of Orthopaedics, Hospital Santa Maria do Porto, Portugal
  • Vânia Oliveira ICBAS-School of Medical and Biomedical Sciences, Universidade do Porto, Portugal

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20262927

Keywords:

Fibromyxoid sarcoma, Surgical approach, Soft tissue tumor

Abstract

We report a 47-year-old female with pulmonary emphysema and an incidental subscapularis intramuscular lesion (76×35×17 mm). Biopsy confirmed low-grade fibromyxoid sarcoma (LGFMS). Surgical excision was performed through a novel modified Judet approach with scapular osteotomy, ensuring complete resection while preserving function. The patient remains asymptomatic at 12 months, with full mobility and no recurrence. This case highlights the importance of including LGFMS in the differential diagnosis of shoulder tumors and demonstrates the utility of a modified Judet approach as a safe, effective option for rare intramuscular sarcomas.

 

References

Mohamed M, Fisher C, Thway K. Low-grade fibromyxoid sarcoma: clinical, morphologic and genetic features. J Bone Joint Surg Am. 2023;81:20-8.

Fu H, Liu Y, Xu L, Chang Y, Zhou L, Zhang W, et al. MUC4 expression distinguishes SWI/SNF-mutant renal medullary carcinomas from other renal carcinomas. Mod Pathol. 2021;34(3):646-53.

Andritsos D, Rizkalla J, Mital M. Low-grade fibromyxoid sarcoma: clinical presentation, treatment, and prognosis. Am J Case Rep. 2018;19:736-41.

Zhang X, Qiu Y, Zhang J, Chen Z, Yang Q, Huang W, et al. An elderly low-grade fibromyxoid sarcoma patient with early postoperative recurrences and metastases: a case report and literature review. Front Med. 2024;11:1172746.

Tsuchiya T, Seki Y, Yamamoto K. Local recurrence of low-grade fibromyxoid sarcoma with MUC4 expression after marginal excision: a case report and literature review. BMC Musculoskelet Disord. 2021;22(1):98.

Houdek MT, Wilke BK, Barlow JD. Management of scapular tumors. Orthop Clin North Am. 2023;54(1):101-8.

Evans HL. Low-grade fibromyxoid sarcoma: a report of two metastasizing neoplasms having a deceptively benign appearance. Am J Clin Pathol. 1987;88:615-22.

Evans HL. Low-grade fibromyxoid sarcoma: a report of 12 cases. Am J Surg Pathol. 1993;17:595-600.

Folpe AL, Lane KL, Paull G, Weiss SW. Low-grade fibromyxoid sarcoma and hyalinizing spindle cell tumor with giant rosettes: a clinicopathologic study of 73 cases supporting their identity and assessing the impact of high-grade areas. Am J Surg Pathol. 2000;24:1353-60.

Evans HL. Low-grade fibromyxoid sarcoma: a clinicopathologic study of 33 cases with long-term follow-up. Am J Surg Pathol. 2011;35:1450-62.

Ugai K, Kizaki T, Morimoto K, Sashikata T. A case of low-grade fibromyxoid sarcoma of the thigh. Pathol Int. 1994;44:793-9.

Griffin AM, Shaheen M, Bell RS, Wunder JS, Ferguson PC. Oncologic and functional outcome of scapular chondrosarcoma. Ann Surg Oncol. 2008;15:2250-6.

Mayil Vahanan N, Mohanlal P, Bose JC, Gangadharan R, Karthisundar V. The functional and oncological results after scapulectomy for scapular tumours: 2-16 year results. Int Orthop. 2007;31:831-6.

Bartoníček J, Říha M, Tuček M. Osteochondroma of scapular body-trans-scapular technique of resection: a case report. J Shoulder Elbow Surg. 2018;27(11):1.

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Published

2026-08-25

How to Cite

Silva, G. V. da, Carrapatoso, M., Neto, P., Vargas, F., Sá, G., Lourenço, J. M., & Oliveira, V. (2026). Innovating the surgical approach to a low grade fibromyxoid sarcoma of the subscapularis muscle. International Journal of Research in Orthopaedics, 12(5), 1509–1512. https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20262927