Myxofibrosarcoma metastasis to the colon: Case report and review of the literature

Myxofibrosarcoma is a connective tissue malignancy that classically presents as a subcutaneous mass and metastasizes in 20–35% of cases, most typically to the lymph nodes, lungs, and bone. Here we document the first reported case of high grade myxofibrosarcoma metastasizing to the colon. An 81-year old man presented with a 5 cm tumor in the right forearm; the tumor was excised and found to be high grade myxofibrosarcoma. Over the next 4 years, the disease metastasized to multiple distant sites, and the metastases were treated with surgery and radiation. At 4.5 years after the initial presentation, the patient complained of melena. Colonoscopy revealed a firm, ball-like polypoid lesion in the proximal transverse colon, measuring 3.5×3×1.3 cm³, found on pathologic analysis to be metastatic high grade myxofibrosarcoma. This report underscores the metastatic and aggressive potential of myxofibrosarcoma. Therefore, when myxofibrosarcoma is diagnosed, aggressive treatment and follow-up should be implemented to prevent its spread. New onset gastrointestinal symptoms in patients with myxofibrosarcoma may indicate metastasis, and a gastrointestinal workup should be implemented in such cases.