Acute Trauma Precipitating the Onset of Chest Wall Myxofibrosarcoma

Abstract

A previously healthy, 47-year-old male presented to his primary care physician with the complaint of a nontender, palpable breast mass discovered coincidentally 1 month after being scratched in the same location by his pet cat. Family history revealed his father was diagnosed with a soft tissue sarcoma of the thigh, 6 months following a traumatic injury in the same location. Cat scratch disease was considered; however, Bartonella Henselae antibody testing was negative. Imaging studies revealed a subpectoral mass without rib involvement. Subsequent core biopsy revealed malignant fibrous histiocytoma, myxoid type, also known as myxofibrosarcoma. The patient underwent complete surgical resection with no complications. Medical advice recommended adjuvant radiation therapy due to the high risk of recurrence; however, the patient refused this option. Twenty-five months later, the patient remains in remission and in overall good health. This case describes the development of a chest wall tumor, diagnosed as myxofibrosarcoma, following acute trauma to the area. The association between acute traumatic injury and the development of a soft tissue sarcoma, as described in this case, continues to be widely reported, suggesting the possibility for an underlying causal mechanism. Future studies are required to unravel the pathogenesis in order to advance the management of this disease.