Research Article

Diagnostic Differences in Expert Second-Opinion Consultation Cases at a Tertiary Sarcoma Center

Table 2

Fibroblastic/myofibroblastic tumors with discrepancy in opinion.

Original diagnosisSecond-opinion diagnosisComments

Malignant to malignant, 2 cases
Pleomorphic sarcomaMyxoinflammatory fibroblastic sarcoma
Low-grade spindle cell neoplasmLow-grade fibromyxoid sarcoma/sclerosing epithelioid fibrosarcomaMUC4 negative but FUS-CREB gene fusion present

Malignant to Intermediate, 6 cases
Low-grade fibromyxoid sarcomaFibromatosisMUC4 negative and β-catenin positive
FibrosarcomaFibromatosisMUC4 negative and β-catenin positive
Gastrointestinal stromal tumorFibromatosisKIT and PDGFRA mutational analysis negative and β-catenin positive
Synovial sarcomaInflammatory myofibroblastic tumorALK gene rearrangements absent
SarcomaMyxoinflammatory fibroblastic sarcoma
High-grade sarcoma, possibly gastrointestinal stromal tumorSolitary fibrous tumorKIT and PDGFRA mutational analysis negative and focal TLE1 positive

Malignant to benign, 2 cases
Low-grade spindle cell tumorNodular fasciitis
LeiomyosarcomaMammary-type myofibroblastoma

Benign to benign, 13 cases
Fibrous hamartoma of infancyNodular fasciitis
Spindle cell tumorFibroblastic tumor without malignant featuresETV6 negative, t(8; 15) present
Genital stromal fibroepithelial polypSuperficial myofibroblastoma
Benign fibrous histiocytomaSuperficial myofibroblastoma
Inflammatory myofibroblastic tumor-type lesionFibroblastic proliferation of unknown significanceALK and MUC4 immunostains negative
LipomaIntravascular fasciitisCDK4 immunostain negative
AngiomyxomaFibroma
Benign lesionMyofibroblastoma
Specialised genital stromal tumorMyofibroblastoma
NeurothekeomaFibromyxomaMUC4 negative
Benign lesionPleomorphic fibroma
Nodular fasciitisMyofibroma
Benign lesionFibroma

Benign to malignant, 1 case
Proliferative myositisPossibility of low-grade fibromyxoid sarcoma

Benign to intermediate, 2 cases
AngiofibromaSolitary fibrous tumor
Benign spindle cell lesionSolitary fibrous tumor
Intermediate to intermediate, 1 case
Spindle cell neoplasm of uncertain malignant potentialFibromatosis

Intermediate to benign, 5 cases
FibromatosisScar tissueFocal β-catenin positive
Palmar fibromatosisOssifying fasciitisUSP6 positive
Atypical nodular spindle cell lesionNodular fasciitis
Fibrous pseudotumor/solitary fibrous tumorFibroma of testis
FibromatosisProliferative myositis

Intermediate to malignant, 2 cases
Solitary fibrous tumorLow-grade fibromyxoid sarcomaMUC4 positive and FUS-CREB gene fusion present
Dermatofibrosarcoma protuberans/solitary fibrous tumorMyxofibrosarcoma