Primary malignant myopericytoma with cancer cachexia: Report of the first case and review of literature

RATIONALE: Malignant myopericytoma is extremely rare, with a few cases described in the English literature. PATIENT CONCERNS: This novel study aimed to report a case of malignant myopericytoma with cancer cachexia arising in the left armpit. Also, it presented a review of the English literature regarding primary malignant myopericytoma, aiming to clarify the clinical features and potentially curative treatment. A 56-year-old male presented with an ulcerated and smelly mass involving her left armpit. The patient had obvious symptoms of cancer cachexia, including emaciation, anemia, and lower extremity edema. DIAGNOSES: Computer tomography (CT) scan demonstrated a mass in the left armpit, with no evidence of metastasis according to the chest CT, abdominal ultrasound, and emission CT. The patient underwent a core biopsy of the mass, and a diagnosis of malignant myopericytoma was rendered. INTERVENTIONS: He received 2 standard courses of theprubicin combined with ifosfamide chemotherapy regimen with no tumor response. Then, he subsequently underwent complete excision of the tumor. OUTCOMES: The symptoms of cancer cachexia disappeared gradually after operation. Recurrence and metastasis were not shown during follow-up for 5 years. LESSONS: Myopericytoma are generally considered benign with an indolent clinical course, and a few reports have described malignant myopericytoma in the literature. No standard treatment is available, and complete surgical excision of the lesion may be the only potentially curative treatment. The efficacy of chemotherapy and radiation is uncertain.