High-grade sarcoma of the hyoid bone: An unusual case illustrating the challenges faced by the pathologist to arrive at a diagnosis

Our case was a suprahyoid mass in the neck with the probable epicenter in the hyoid bone. Cytopathology of suprahyoid neck masses, without imaging guidance, may lead to misdiagnoses. Imaging was suggestive of the hyoid bone as the probable epicenter. Based on the morphology and IHC findings of the core biopsy, a diagnosis of high-grade sarcoma most likely of myofibroblastic origin was made, which was also confirmed in the main surgical specimen. En bloc surgical excision of the mass was performed preserving the rest of the laryngeal framework and the thyroid gland followed by adjuvant radiotherapy. However, the patient developed distant metastasis within a few months of treatment completion highlighting the high-grade nature of the sarcoma.