Myxofibrosarcoma
Grading / Staging / Report
Myxofibrosarcoma grading system (Mentzel 1996)
- Low grade
- Hypocellular, myxoid throughout
- No solid areas
- Atypical cells are scattered
- No mitotic figures or necrosis
- Intermediate grade
- Myxoid throughout
- May contain small solid areas
- Increased cellularity, mitotic figures and pleomorphism
- No necrosis or marked pleomorphism
- High grade
- Solid areas of pleomorphic sarcoma
French Federation of Cancer Centers System grading scheme for adult sarcomas
- Tumor differentiation score = 2 for myxofibrosarcoma
- Mitotic index
- Score 1 0-9 mitoses per 10 hpf (0.1744 sq mm)
- Score 2 10-19 mitoses per 10 hpf
- Score 3 >19 mitoses per 10 hpf
- Tumor cell necrosis
- Score 0 No necrosis on any slide (one slide per 2 cm tumor diameter)
- Score 1 <50% of tumor is necrotic on slides examined
- Score 2 >50% of tumor is necrotic on slides examined
- Final Grade (add the three scores above)
- Grade 1 Sum of scores = 2 or 3
- Grade 2 Sum of scores = 4 or 5
- Grade 3 Sum of scores = 6 or more
Use TNM Staging
The surgical pathology report should contain or address the following:
- Location
- Type of resection or biopsy
- Histologic diagnosis
- Extent of tumor cell necrosis
- Grade
- Stage
- Size
- Depth (dermis, subcutis, below fascia, body cavity)
- Margins
- Involved
- Not involved
- If under 2 cm give all such distances and sites
- If over 2 cm give minimum distance and site
- Results of supplementary studies if performed
- Relationship to other specimens from the same patient
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