Low-grade fibromyxoid sarcoma in the middle ear as a rare location: a case report.

Background: Low-grade fibromyxoid sarcoma (LGFMS) is a rare soft tissue tumor with a misleadingly bland histological appearance and fully malignant behavior, typically occurring in the deep soft tissues of the proximal extremities or trunk of young adults. However, no cases of primary middle ear LGFMS have been reported previously. LGFMS is characterized by high rates of local recurrence and metastatic spread, which should be attached of great importance to clinical diagnosis and treatment. Case Description: Herein, we report an unusual case of LGFMS occurring primarily in the middle ear of a 12-year-old boy, who presented with aural fullness and gradually progressive hearing loss in the left ear for 6 months, without other related symptoms and family history. Preoperative imaging examination suggested that the lesions were located in the tympanic cavity, tympanic antrum, and mastoid portion, with equisignal or hypointense on T1 weighted image ( Conclusions: The primary LGFMS in the middle ear is very rare, and the clinical manifestations and related examinations lack specificity, so a clinical diagnosis of LGFMS is very difficult, and the final diagnosis is mainly determined by pathological diagnosis. Due to its malignant behavior, clinical diagnosis and treatment should be vigilant against it. Treatment of LGFMS mainly requires extensive resection combined with radiotherapy and chemotherapy if necessary, and long-term follow-up is essential. Reporting and identification of this rare case are imperative to improving our understanding of LGFMS and reducing misdiagnosis.