case_images: PMC9893065_01
case_images: Left chest wall mass extending to axilla (orange arrow).
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case_images: Chest X-ray showed large left chest wall soft tissue mass with axillary extension involving the inferior angle of the scapula (Figure 1).
case_images: CT-chest shows left axillary soft tissue mass measuring 9.6 x 8.5 x 10.9 cm3 in size infiltrating the pectoralis muscle (orange arrow).. Left axillary lymph nodes enlargement, the largest measuring 1.1 x 1.05 cm2 in size.
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case_images: Left axillary lymph nodes enlargement, the largest measuring 1.1 x 1.05 cm2 in size (Figure 2).
case_images: (a) Diffuse proliferation of mononuclear spindle cells admixed with occasional multinucleated giant cells; with variably myxoid to chondroid stroma, representing various stages of cartilaginous development (H&E stained 40x original magnification). (b) Photomicrograph of the tumor displaying myofibroblastic-like spindle cell proliferation with loosely arranged myxoid stroma, minimal cellular atypia, and rare mitoses together with storiform or fascicular pattern (H&E stained 200x original magnification).
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case_images: The excised tumor was taken for histopathology which concluded it to be CMF (Figure 3) with differential diagnosis of inflammatory myofibroblastic tumor.
case_images: Photograph showing recurrent left axillary mass with previous surgery scars.
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case_images: The child presented again after 7 months with recurrence for the second time at the same site (Figure 4).
case_images: Post-operative clinical photograph showing no recurrence and healed hypertrophic scar.
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case_images: He was reviewed after 1 month, whereby the wound has healed with a hypertrophic scar, has no upper limb edema, and has a full range of motion of his shoulder joint (Figure 5).
case_images: (a) CMF demonstrating diffuse population of mononuclear spindle cells and admixed multinucleated giant cells (H&E 40x original magnification). (b) CMF highlighting the presence of lobules of stellate cells with variably myxoid to chondroid stroma, representing various stages of cartilaginous development (H&E 100x original magnification). (c) Photomicrograph of CMF showing cells having variable pink cytoplasm, bipolar to multipolar cytoplasmic extensions and oval to spindled nuclei with myxoid stroma (H&E 200x original magnification). (d) Infiltration of skeletal muscle by the tumor cells with moderate nuclear pleomorphism (H&E 200x original magnification).
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case_images: The presence of infiltrative pattern and necrosis gave the differential diagnosis of low-grade myxofibrosarcoma, myxoid dermatofibrosarcoma, proliferative fasciitis, and solitary fibrous tumor (Figure 6).