In sclerosing epithelioid fibrosarcoma (SEF), a rare variant of low-grade fibrosarcoma, treatment results and therapeutic
options are poorly characterized. We systematically analyzed the data of all 89 patients (43 female, 46 male; mean age, 47 years
[range, 14–87 years]) reported in the literature concerning clinical presentation, histopathology, differential diagnosis,
treatment, survival rates, and prognosis, and we present an additional case. Information detailing treatment, disease control,
and followup was available in 60 (67%), 75 (84%), and 68 patients (76%), respectively. Case history was variable with one-third
of patients reporting a painful, enlarging mass. Ten patients (13%) presented with metastases, 23 (31%) had metastases develop
after diagnosis, and 28 (37%) had local recurrence. Low cellularity, mild pleomorphy, and sclerotic hyaline matrix of SEF
suggest a benign clinical behavior, and cell morphology allows for the wide differential diagnosis of benign, pseudosarcomatous,
and malignant proliferations. In addition to surgery, 11 patients (15%) had chemotherapy, 22 (29%) had postoperative radiation
therapy, and three (4%) had a combination of both. Twenty-three patients (34%) died from their disease after a mean of 46 months,
24 (35%) were alive with disease, and 20 (31%) were alive without evidence of disease. Patients with SEF of the head and neck
had the worst prognosis.
Level of Evidence: Level III, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.
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Each author certifies that his or her institution has approved or waived approval for the reporting of this case and that
all investigations were conducted in conformity with ethical principles of research.