Myofibroblastic sarcoma of the nasal cavity and paranasal sinus: a clinicopathologic study of 6 cases and review of the literature.

Objective: We describe the clinicopathologic features of 6 cases of myofibroblastic sarcoma (MS) occurring in the nasal cavity and paranasal sinus.

Study Design: The paraffin-embedded tissues of 6 cases of MS were stained immunohistochemically and examined by electron microscopy.

Results: Clinically, a painless enlarging mass was the most common symptom, followed by the nasal obstruction, epistaxis, copious rhinorrhea, and proptosis. Histologically, the tumors showed a diffusely infiltrative growth pattern and consisted mainly of spindle cells with abundant eosinophilic cytoplasm. The hypocellular myxoid areas and the hypercellular fibrous areas were identified. Immunohistochemically, all 6 tumors were positive for vimentin, alpha-smooth muscle actin, calponin, and fibronectin. Ultrastructural examination in 3 cases showed characteristic features of myofibroblast. Follow-up in 6 patients revealed high local recurrence rate (6 out of 6).

Conclusion: Myofibroblastic sarcoma of the nasal cavity and paranasal sinus exhibit diverse histologic appearances and a strong aggressive behavior.