Hyalinizing Spindle Cell Tumor With Giant Rosettes

Salsabil Attafi, Soumaya Rammeh1, Khaled Hadhri, Adnène Boubaker, Fethia Mamouri, Sami G'ritli, Nadia Znaidi, Faten Fareh, Rachida Zermani

Abstract


Hyalinizing spindle cell tumor with giant rosettes (HSCTGR )is recently considered as a variant of low-grade fibromyxoid sarcoma. It is a slow growing tumor, with a potential of local recurrence and metastasis. We propose to study the clinicopathological features of this tumor with focus on differential diagnosis.
We report a case developed in the cervical region with extension to spine in a 37 year-old woman.
The patient consulted for recent post-traumatic neck pain. Computed tomography scanning revealed a lytic process of the lateral mass of C1 and C2. The magnetic resonance imaging revealed a right para-spinal soft tissue mass with spinal lysis and extension of to the upper cervical spine. The patient had a surgery to reduce the tumor volume with occipito-cervical arthrodesis. Histological examination showed a well-circumscribed tumor composed of spindle-shaped, bland-looking cells with no architectural pattern. Some areas showed spindle cells arranged in irregular crisscrossing fascicles separated by a moderate amount of collagen. In other areas there was extensive stromal hyalinization. Complete surgical resection was impossible and the patient was put under endoxan 50. At 5 years follow up the patient was free of metastasis.
Cervical location of HSCTGR is rare. The risk of recurrence and metastasis, although exceptional should motivate the long term follow-up.

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