Low-Grade Fibromyxoid Sarcoma of the Malar Area.

to mammary duct carcinoma. Arch Klin Exp Ohren Nasen Kehlkopfheilkd 1968;192:100-5. 2. Jayaprakash V, Merzianu M, Warren GW, et al. Survival rates and prognostic factors for infiltrating salivary duct carcinoma: Analysis of 228 cases from the Surveillance, Epidemiology, and End Results database. Head Neck 2014;36:694-701. 3. Wee DT, Thomas AA, Bradley PJ. Salivary duct carcinoma: what is already known, and can we improve survival? J Laryngol Otol 2012;126 Suppl 2:S2-7. 4. Salovaara E, Hakala O, Back L, et al. Management and outcome of salivary duct carcinoma in major salivary glands. Eur Arch Otorhinolaryngol 2013;270:281-5. 5. Carr RJ, Bowerman JE. A review of tumours of the deep lobe of the parotid salivary gland. Br J Oral Maxillofac Surg 1986;24:155-68. normal-appearing skin. There was no discoloration, erythema, and inflammation. On computed tomography (CT), a slightly diffuse enhancing lowdensity mass was seen on the subcutaneous layer adjacent to the zygomaticus muscle (Fig. 1). Removal of the mass was performed under general anesthesia by using an intraoral approach and a pull-through technique with a gingivobuccal incision. The mass was not easily separated from the surrounding tissues and zygomaticus muscles. The margin of the mass was intermingled with the surrounding fibrous tissue (Fig. 2). The lesion was completely excised with no remarkable occurrences (Fig. 3). Grossly, the mass was round, with a diameter of 1.3 cm. The gross findings of the mass included a well-circumscribed, oval-to-round mass with a thin, fibrous pseudocapsule. The cut surface showed a whorled, whitegray, firm, and fibrous consistency with a homogenous appearance. A histological examination revealed a well-circumscribed mass with no capsulation (Fig. 4). The tumor primarily had a myxoid appearance and was hyper-cellular with bland spindle cells; it had minimal cytologic atypia, generally low mitotic activity and no necrosis, but there were abrupt transitions to collagen rosettes, which was a heavily collagenized area with sparse cellularity. The vasculature in the tumor showed an arcade appearance with hyalinization (Fig. 5). An immunohistochemical study showed that the tumor cells were focally positive for smooth muscle actin but negative for S-100, desmin, and CD34. The