Anterior Thigh Myxofibrosarcoma with Management of Wide Excision and Modified Anterior Thigh Compartment Resection : A Case Report

Joko Wibowo Sentoso *

Faculty of Medicine, Sebelas Maret University, Dr. Moewardi Hospital, Surakarta, Indonesia.

Kristanto Yuli Yarsa

Department of Surgery, Sub Oncology Surgery, Faculty of Medicine, Sebelas Maret University, Dr. Moewardi Hospital, Surakarta, Indonesia.

*Author to whom correspondence should be addressed.


Introduction: Myxofibrosarcoma (MFS) is a type of malignancy from the group of malignant fibrous histiocytoma. Myfxofibrosarcoma is a type of soft tissue neoplasm that is aggressive. The clinical symptoms are not pathognomonic and the histological picture is very heterogeneous, often receiving delayed treatment and causing misdiagnosis. Complementary histochemical and immunohistochemical staining is mandatory to confirm the diagnosis of MFS. Extensive surgical treatment and followed by radiotherapy is the first choice of myxofibrosarcoma treatment.

Case Presentation: A 54-years old woman complained of a lump on her left thigh that had been getting bigger for the past 2 years. The lump initially looked the size of a marble, then grew to the size of a tennis ball in the last 7 months. On physical examination, a mass was found in the left thigh area, a hard, fixed mass, the size of a tennis ball. Fine needle aspiration examination showed suspicious results for myxofibrosarcoma. The patient underwent a Magnetic Resonance Imaging examination in the left lower extremity area and underwent wide excision and anterior thigh compartment resection surgery.

Discussion: Wide resection is the standard treatment for MFS [4]. The choice of procedure for each patient is different and should be based on tumor size, location, stage, surrounding neurovascular and bony elements, as well as functional and cosmetic considerations [4]. The minimum resection margin in MFS is at least 1 cm which aims to minimize the risk of local recurrence [4]. The recommended resection margin is at least 2 cm for MFS resection [4]. We had plan a 2 cm margin of the entire preoperative MRI enhancement area. It should be noted that the local recurrence rate for MFS in margin-negative resections is relatively high compared with other STS subtypes.

Conclusion: We recommend Wide Excison and Modified Anterior Thigh compartment Resection is recommended procedure for anterior thigh myxofibrosarcoma. This procedure involves preserving uncontaminated thigh neurovascular, and only resecting one of the sarcoma-infiltrated muscle heads and preserving the other quadriceps muscle head of the thigh to maintain knee extension function. This paper is the first report on the successful treatment of anterior thigh myxofibrosarcoma without weakness of knee extension complication.

Keywords: Thigh myxofibrosarcoma, wide excision, modified anterior thigh compartment resection

How to Cite

Sentoso , Joko Wibowo, and Kristanto Yuli Yarsa. 2023. “Anterior Thigh Myxofibrosarcoma With Management of Wide Excision and Modified Anterior Thigh Compartment Resection : A Case Report”. Journal of Cancer and Tumor International 13 (3):42-46.


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Charlotte Castronovo et al. Myxofibrosarcoma: A Diagnostic Pitfall. Rare Tumors. 2013;5(2): 60–61.

Juan Enrique Berner, Timothy P. Crowley et al. The importance of clear margins in myxofibrosarcoma: Improving local control by means of staged resection and reconstruction. European Journal of Surgical Oncology. 2021;47(10):2627-2632.

Mahmoud N Kulaylat , Constantine P, Karakousis. Modified anterior compartment resection of the thigh. Int Surg. 2007; 92(5):266-71.

Jun Nishio, Shizuhide Nakayama. Biology and Management of High-Grade Myxofibrosarcoma: State of the Art and Future Perspectives. Diagnostics. 2023; 13(19):3022.

Baheti AD, Sree Harsha Tirumani, Rosenthal MH, et al. Myxoid Soft-Tissue Neoplasms: Comprehensive Update of the Taxonomy and MRI Features. American Journal of Roentgenology. 2015;204(2): 374-385. DOI:

Rachdi, Daoud F, Fatma Khanchel, et al. Myxofibrosarcoma of the leg: A diagnostic challenge. Clinical Case Reports. 2020; 8(12):3332-3335. DOI:

Rhee I, Benedetta Spazzoli, Stevens J, et al. Oncologic outcomes in myxofibrosarcomas: The role of a multidisciplinary approach and surgical resection margins. ANZ Journal of Surgery. 2023;93(3):577-584. DOI:

Radtke C, Panzica M, Khaled Dastagir, Krettek C, Vogt PM. Soft Tissue Coverage of the Lower Limb following Oncological Surgery. Frontiers in Oncology. 2016;5. DOI:

Endo M, Lin PP. Surgical margins in the management of extremity soft tissue sarcoma. Chinese clinical oncology. 2018; 7(4):37-37. DOI:

Alexandre Rochwerger, Jean Camille Mattei. Management of soft tissue tumors of the musculoskeletal system. Orthopaedics & Traumatology: Surgery & Research. 2018;104(1):S9-S17. DOI:

Daniels C, Wei Lien Wang, Madewell JE, Wei W, Amini B. Pattern of Recurrence of Myxofibrosarcoma is not Associated with Pattern at Presentation or Rate of Delayed Diagnosis. Iranian Journal of Radiology. 2016;14(1). DOI: