Published online Jun 6, 2020. doi: 10.12998/wjcc.v8.i11.2350
Peer-review started: January 21, 2020
First decision: April 14, 2020
Revised: April 17, 2020
Accepted: April 29, 2020
Article in press: April 29, 2020
Published online: June 6, 2020
Core tip: Myxofibrosarcoma (MFS) is a malignant fibroblastic tumor that has a predilection for lower and upper extremities. Rare occurrences have been reported in the scalp. We describe a 46-year-old male diagnosed with a MFS of the scalp (highly malignant with massive necrotic lesions) by histologic examination and immunohistochemistry testing. The magnetic resonance imaging findings did not conform to the reported typical “tail sign”, which may be confused with other tumors and lead to the correct diagnosis being missed. The definitive diagnosis of MFS is based on immunohistologic features. Considering the location and non-specific imaging manifestations of this case, the treatment is also worthy of discussion. Surgical excision combined with postoperative adjuvant radiotherapy was effective in our case.