Histopathological spectrum of myxoid soft-tissue neoplasms in a tertiary care center with a special focus on vascular patterns: A 13-year compilation

Abstract

Introduction: Myxoid soft-tissue tumors are a diverse group of tumors which have similar histomorphology but have varied genetic sequence and clinical outcome, hence differentiating and diagnosing them is a challenge for any pathologist. This study describes the various histomorphological spectrum and vascular pattern of various myxoid soft-tissue tumors. Materials and Methods: This was a retrospective and prospective observational study of myxoid soft-tissue tumors over a period of 13 years. A total of 224 cases with myxoid morphology were included and were examined morphologically with a special focus on the vascular pattern. SPSS v 24 was used for statistical analysis. Results: The predominant lesions were benign in 164 (73.21%) cases, followed by malignant lesions in 43 (19.19%) cases and intermediate lesions 17 (7.58%) cases. Both benign and malignant lesions showed a male preponderance and were seen to arise predominantly from the extremities. The most common benign myxoid lesions in this study were of neural origin with myxoid neurofibroma constituting 65 (29. 01%) cases, followed by schwannoma 38 (16.9%) cases. Myxoid dermatofibrosarcoma protuberans was the most common intermediate lesion. Tumors with adipocytic differentiation were the predominant lesions among the malignant group, i.e myxoid liposarcoma seen in 17 (7.5%) cases. Conclusions: Vascular pattern in the myxoid lesions are subtle yet crucial in arriving at a histo-morphological diagnosis. Further studies correlating the vascular pattern with the genetic profile of these tumours can help arriving at a histo-morphological diagnosis of myxoid lesions.

Keywords

• crow's feet vessels
• histomorphology
• liposarcoma
• myxoid
• neurofibroma
• soft tissue
• vascular pattern