A case of an 82-year-old man with a spinal extradural malignant ossifying fibromyxoid tumor

BACKGROUND: Ossifying fibromyxoid tumor (OFMT) is a rare mesenchymal tumor predominantly involving the subcutaneous tissues or skeletal muscles in the proximal extremities, typically in middle-aged men. OFMT in the spine is extremely rare, with only 3 previously reported cases in the literature. CAS...

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Main Authors: Lu, Qiqi, Ho, Chi Long
Other Authors: Lee Kong Chian School of Medicine (LKCMedicine)
Format: Article
Language:English
Published: 2023
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Online Access:https://hdl.handle.net/10356/171867
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Institution: Nanyang Technological University
Language: English
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spelling sg-ntu-dr.10356-1718672023-11-19T15:37:36Z A case of an 82-year-old man with a spinal extradural malignant ossifying fibromyxoid tumor Lu, Qiqi Ho, Chi Long Lee Kong Chian School of Medicine (LKCMedicine) Sengkang General Hospital Duke-NUS Medical School Yong Loo Lin School of Medicine, NUS Science::Medicine Diagnostic Imaging Soft Tissue Neoplasms BACKGROUND: Ossifying fibromyxoid tumor (OFMT) is a rare mesenchymal tumor predominantly involving the subcutaneous tissues or skeletal muscles in the proximal extremities, typically in middle-aged men. OFMT in the spine is extremely rare, with only 3 previously reported cases in the literature. CASE REPORT: Here, we present a rare case of an 82-year-old man presenting with paresthesia of both arms and weakness of both legs, who underwent magnetic resonance imaging (MRI) of the spine, which showed an aggressive extradural tumor. Following surgical debulking, histology examination revealed a tumor of stromal origin with myxoid and ossifying components and pleomorphic features. Overall findings were suggestive of a malignant OFMT. The patient underwent postoperative adjuvant radiotherapy. However, the first follow-up MRI study at 8 months showed residual tumor, which also demonstrated avid tracer uptake on technetium-99m scintigraphy and PET-CT scans. The second MRI follow-up about 9 months later showed several metastatic foci along the craniospinal axis. Despite subsequent resection of the spinal metastasis, the patient eventually died of sepsis about 21 months after the initial tumor diagnosis. CONCLUSIONS: We presented a case of extradural spinal malignant OFMT and highlighted the difficulty distinguishing this rare primary tumor from spinal metastases. In this case, MRI signal intensities and identifying intratumoral bone formation, combined with histopathology following surgical resection, confirmed the diagnosis. This case has also shown the importance of follow-up by a multidisciplinary team to monitor for the recurrence of primary OFMT. Published version 2023-11-14T00:46:22Z 2023-11-14T00:46:22Z 2023 Journal Article Lu, Q. & Ho, C. L. (2023). A case of an 82-year-old man with a spinal extradural malignant ossifying fibromyxoid tumor. American Journal of Case Reports, 24, e939408-. https://dx.doi.org/10.12659/AJCR.939408 1941-5923 https://hdl.handle.net/10356/171867 10.12659/AJCR.939408 37218126 2-s2.0-85159805655 24 e939408 en American Journal of Case Reports © 2023 Am J Case Rep. This work is licensed under Creative Common Attribution NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0). application/pdf
institution Nanyang Technological University
building NTU Library
continent Asia
country Singapore
Singapore
content_provider NTU Library
collection DR-NTU
language English
topic Science::Medicine
Diagnostic Imaging
Soft Tissue Neoplasms
spellingShingle Science::Medicine
Diagnostic Imaging
Soft Tissue Neoplasms
Lu, Qiqi
Ho, Chi Long
A case of an 82-year-old man with a spinal extradural malignant ossifying fibromyxoid tumor
description BACKGROUND: Ossifying fibromyxoid tumor (OFMT) is a rare mesenchymal tumor predominantly involving the subcutaneous tissues or skeletal muscles in the proximal extremities, typically in middle-aged men. OFMT in the spine is extremely rare, with only 3 previously reported cases in the literature. CASE REPORT: Here, we present a rare case of an 82-year-old man presenting with paresthesia of both arms and weakness of both legs, who underwent magnetic resonance imaging (MRI) of the spine, which showed an aggressive extradural tumor. Following surgical debulking, histology examination revealed a tumor of stromal origin with myxoid and ossifying components and pleomorphic features. Overall findings were suggestive of a malignant OFMT. The patient underwent postoperative adjuvant radiotherapy. However, the first follow-up MRI study at 8 months showed residual tumor, which also demonstrated avid tracer uptake on technetium-99m scintigraphy and PET-CT scans. The second MRI follow-up about 9 months later showed several metastatic foci along the craniospinal axis. Despite subsequent resection of the spinal metastasis, the patient eventually died of sepsis about 21 months after the initial tumor diagnosis. CONCLUSIONS: We presented a case of extradural spinal malignant OFMT and highlighted the difficulty distinguishing this rare primary tumor from spinal metastases. In this case, MRI signal intensities and identifying intratumoral bone formation, combined with histopathology following surgical resection, confirmed the diagnosis. This case has also shown the importance of follow-up by a multidisciplinary team to monitor for the recurrence of primary OFMT.
author2 Lee Kong Chian School of Medicine (LKCMedicine)
author_facet Lee Kong Chian School of Medicine (LKCMedicine)
Lu, Qiqi
Ho, Chi Long
format Article
author Lu, Qiqi
Ho, Chi Long
author_sort Lu, Qiqi
title A case of an 82-year-old man with a spinal extradural malignant ossifying fibromyxoid tumor
title_short A case of an 82-year-old man with a spinal extradural malignant ossifying fibromyxoid tumor
title_full A case of an 82-year-old man with a spinal extradural malignant ossifying fibromyxoid tumor
title_fullStr A case of an 82-year-old man with a spinal extradural malignant ossifying fibromyxoid tumor
title_full_unstemmed A case of an 82-year-old man with a spinal extradural malignant ossifying fibromyxoid tumor
title_sort case of an 82-year-old man with a spinal extradural malignant ossifying fibromyxoid tumor
publishDate 2023
url https://hdl.handle.net/10356/171867
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