FIBROSARCOMA - MYXOFIBROSARCOMA

Fibrosarcoma and myxofibrosarcoma are rare high-grade malignant soft tissue tumors with similar characteristics.

There are two different types of fibrosarcoma that occur in childhood (infantile) and adults.

Fibrosarcoma most commonly occurs in the thigh in adults between the ages of 30 and 60.

Patients with fibrosarcoma often present to the doctor with a complaint of swelling. They are often localized in the thigh, but can also occur in the arm. They are usually deep and large in size. Pain is very rare.

Fibrosarcoma can develop spontaneously, but they can also be caused by burns or radiation.

Fibrosarcoma is usually detected on physical examination as a soft, mobile, painless swelling.

In patients with fibrosarcoma, we most commonly use MRI with medication as the imaging modality. MRI gives us detailed information about the location, size, boundaries, and contents of the tumor. MRI is also used to plan surgery, evaluate response to chemotherapy and radiotherapy, and monitor for recurrence.

The definitive diagnosis of fibrosarcoma is made by biopsy after clinical and radiologic evaluation. The biopsy is often performed using a closed procedure with special needles. It is important that the physician who performs the biopsy is an orthopedic oncologist who specializes in bone and soft tissue tumors, and that the pathologist who evaluates the biopsy sample is experienced in this field.

Patients diagnosed with fibrosarcoma will undergo a CT scan, whole-body MRI or PET-CT to detect metastases (most commonly to the lungs).

The main treatment for fibrosarcoma is clean removal of the tumor through surgery. The tumor that is not removed cleanly with wide margins has a recurrence rate of almost one hundred percent and is prone to metastasis. For this reason, it is important that the surgeon who performs the surgery is an orthopedic oncologist with experience in this field.

Radiotherapy is used before or after surgery to facilitate surgery and reduce the possibility of recurrence. Although there are advantages and disadvantages to using radiation before or after surgery, there is no absolute superiority of one over the other.

Chemotherapy is not routinely used in patients with fibrosarcoma. Chemotherapy is used for large and deep-seated tumors, especially in the presence of metastases.

Patients diagnosed with fibrosarcoma should be followed up for many years at regular intervals for recurrence and metastasis, which means spread to other parts of the body.