{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:48:41Z","timestamp":1790790521987,"version":"4.1.0"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T00:00:00Z","timestamp":1784937600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T00:00:00Z","timestamp":1784937600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100018935","name":"Universit\u00e4tsklinikum Erlangen","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100018935","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Virchows Arch"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Low-grade fibromyxoid sarcoma (LGFMS) is a rare, slow-growing deceptively bland-looking fibroblastic sarcoma that usually develops in the deep soft tissues of the extremities. Development of the tumor in the abdomen, pelvis, and retroperitoneum is extremely rare. We analyzed 26 cases of LGFMS originating at these sites. The patients age ranged from 5 to 75 years (median, 39) with a slight female predominance (54%). Most tumors were located in the abdominal wall\/abdomen or peritoneal tissues (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200911; 42%), followed by the intestinal wall\/mesentery (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20097; 27%), pelvis (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20094; 15%), retroperitoneum (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20093; 11%) and the perirectal perineum (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20091; 4%). Median tumor size was 10\u00a0cm (range, 1.9\u201368). Histologically, tumors were characterized by spindle cells with mild-to-moderate nuclear atypia arranged into short fascicles and whorling pattern within alternating variably myxoid to collagenous stroma rich in arcuate vessels with perivascular hyalinization. Eight tumors (31%) showed areas of sclerosing epithelioid fibrosarcoma (SEF), hence qualifying as hybrid LGFMS\/SEF. Large collagen rosettes were observed in 8 tumors (31%). All 26 tumors (100%) were immunohistochemically diffusely positive for MUC4.\n                    <jats:italic>FUS or EWSR1<\/jats:italic>\n                    gene rearrangements were identified in 9 of 9 (100%) tumors tested. One of 17 tumors showed variable nuclear Betacatenin reactivity (this case harbored\n                    <jats:italic>EWSR1::CREB3L1<\/jats:italic>\n                    fusion). Of 15 patients with follow-up data (range, 6\u201384 months; median, 28.5), 2 (13%) died of disease, 3 (20%) developed metastases, and 2 (13%) had local tumor recurrence. In total, 7 (47%) patients experienced disease progression. Eight (53%) patients were disease-free at 5\u201384 months follow-up (median, 45). LGFMSs at these rare sites are similar to their extremity counterparts but likely peruse a more aggressive clinical course with adverse events being noted in half of patients at a median follow-up of 45 months, suggesting a possibly more unfavorable outcome at long-term.\n                  <\/jats:p>","DOI":"10.1007\/s00428-026-04644-6","type":"journal-article","created":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T05:28:38Z","timestamp":1784957318000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Low-grade fibromyxoid sarcoma in abdominopelvic and retroperitoneal locations: a clinicopathologic analysis of 26 cases and a review of the literature"],"prefix":"10.1007","author":[{"given":"Beena U","family":"Ahsan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasir Ud","family":"Din","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerem","family":"Ozcan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatima","family":"Safdar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A.","family":"Montgomery","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew E.","family":"Rosenberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abbas","family":"Agaimy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,25]]},"reference":[{"key":"4644_CR1","doi-asserted-by":"publisher","first-page":"615","DOI":"10.1093\/ajcp\/88.5.615","volume":"88","author":"HL Evans","year":"1987","unstructured":"Evans HL (1987) Low-grade fibromyxoid sarcoma: a report of two metastasizing neoplasms having a deceptively benign appearance. Am J Clin Pathol 88:615\u2013619","journal-title":"Am J Clin Pathol"},{"key":"4644_CR2","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1097\/00000478-199306000-00007","volume":"17","author":"HL Evans","year":"1993","unstructured":"Evans HL (1993) Low-grade fibromyxoid sarcoma: a report of 12 cases. Am J Surg Pathol 17:595\u2013600","journal-title":"Am J Surg Pathol"},{"key":"4644_CR3","doi-asserted-by":"publisher","first-page":"1353","DOI":"10.1097\/00000478-200010000-00004","volume":"24","author":"AL Folpe","year":"2000","unstructured":"Folpe AL, Lane KL, Paull G, Weiss SW (2000) Low-grade fibromyxoid sarcoma and hyalinizing spindle cell tumor with giant rosettes: a clinicopathologic study of 73 cases supporting their identity and assessing the impact of high-grade areas. Am J Surg Pathol 24:1353\u20131360","journal-title":"Am J Surg Pathol"},{"key":"4644_CR4","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1111\/j.1365-2559.2004.01886.x","volume":"45","author":"Y Oda","year":"2004","unstructured":"Oda Y, Takahira T, Kawaguchi K, Yamamoto H, Tamiya S, Matsuda S, Tanaka K, Iwamoto Y, Tsuneyoshi M (2004) Low-grade fibromyxoid sarcoma versus low\u2010grade myxofibrosarcoma in the extremities and trunk. A comparison of clinicopathological and immunohistochemical features. Histopathology 45:29\u201338","journal-title":"Histopathology"},{"key":"4644_CR5","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1186\/1471-2482-3-7","volume":"3","author":"K Harish","year":"2003","unstructured":"Harish K, Ashok AC, Alva NK (2003) Low grade fibromyxoid sarcoma of the falciform ligament: a case report. BMC Surg 3:7","journal-title":"BMC Surg"},{"key":"4644_CR6","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1111\/j.1341-8076.2003.00133.x","volume":"29","author":"A Koishi","year":"2003","unstructured":"Koishi A, Gomibuchi H, Inoue J et al (2003) Hyalinizing spindle cell tumor with giant rosettes of the omentum. J Obstet Gynaecol Res 29:388\u2013391","journal-title":"J Obstet Gynaecol Res"},{"key":"4644_CR7","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1016\/j.dld.2006.01.015","volume":"39","author":"IJ Park","year":"2007","unstructured":"Park IJ, Kim HC, Yu CS et al (2007) Low-grade fibromyxoid sarcoma of the colon. Dig Liver Dis 39:274\u2013277","journal-title":"Dig Liver Dis"},{"key":"4644_CR8","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1007\/s11604-007-0214-7","volume":"26","author":"S Fujii","year":"2008","unstructured":"Fujii S, Kawawa Y, Horiguchi S et al (2008) Low-grade fibromyxoid sarcoma of the small bowel mesentery: computed tomography and magnetic resonance imaging findings. Radiat Med 26:244\u2013247","journal-title":"Radiat Med"},{"key":"4644_CR9","doi-asserted-by":"publisher","first-page":"1069","DOI":"10.1097\/PAS.0b013e31821bc17a","volume":"35","author":"JA Laurini","year":"2011","unstructured":"Laurini JA, Zhang L, Goldblum JR et al (2011) Low-grade fibromyxoid sarcoma of the small intestine: report of 4 cases with molecular cytogenetic confirmation. Am J Surg Pathol 35:1069\u20131073","journal-title":"Am J Surg Pathol"},{"key":"4644_CR10","doi-asserted-by":"publisher","first-page":"1804","DOI":"10.1016\/j.humpath.2011.01.023","volume":"42","author":"AF Lee","year":"2011","unstructured":"Lee AF, Yip S, Smith AC et al (2011) Low-grade fibromyxoid sarcoma of the perineum with heterotopic ossification: case report and review of the literature. Hum Pathol 42:1804\u20131809","journal-title":"Hum Pathol"},{"key":"4644_CR11","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1159\/000341191","volume":"2","author":"A Alevizopoulos","year":"2012","unstructured":"Alevizopoulos A, Mygdalis V, Tyritzis S et al (2012) Low-grade fibromyxoid sarcoma of the renal pelvis: first report. Case Rep Nephrol Urol 2:87\u201391","journal-title":"Case Rep Nephrol Urol"},{"key":"4644_CR12","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1007\/s12262-012-0415-x","volume":"74","author":"K Singh","year":"2012","unstructured":"Singh K, Singh S, Pal N et al (2012) Low-grade fibromyxoid sarcoma of anterior abdominal wall. Indian J Surg 74:351\u2013353","journal-title":"Indian J Surg"},{"key":"4644_CR13","first-page":"736","volume":"13","author":"OI Alatise","year":"2013","unstructured":"Alatise OI, Oke OA, Olaofe OO et al (2013) A huge low-grade fibro- myxoid sarcoma of small bowel mesentery simulating hyper immune splenomegaly syndrome: a case report and review of literature. Afr Health Sci 13:736\u2013740","journal-title":"Afr Health Sci"},{"key":"4644_CR14","doi-asserted-by":"publisher","first-page":"228","DOI":"10.5455\/jihp.20140612073245","volume":"2","author":"G Vasudevan","year":"2014","unstructured":"Vasudevan G, Shivamurthy A (2014) Low grade fibromyxoid sarcoma of the mesentery, an under recognized entity: a case report. J Interdiscipl Histopathol 2:228\u2013231","journal-title":"J Interdiscipl Histopathol"},{"key":"4644_CR15","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1007\/s11604-014-0305-1","volume":"32","author":"KJ Kim","year":"2014","unstructured":"Kim KJ, Seo JW (2014) Intra-abdominal low-grade fibromyxoid sarcoma of the transverse mesocolon mimicking lymphoma. Jpn J Radiol 32:360\u2013364","journal-title":"Jpn J Radiol"},{"key":"4644_CR16","doi-asserted-by":"publisher","first-page":"321","DOI":"10.2350\/14-05-1487-CR.1","volume":"17","author":"JC Rubinstein","year":"2014","unstructured":"Rubinstein JC, Visa A, Zhang L et al (2014) Primary low-grade fibromyxoid sarcoma of the kidney in a child with the alternative EWSR1- CREB3L1 gene fusion. Pediatr Dev Pathol 17:321\u2013326","journal-title":"Pediatr Dev Pathol"},{"key":"4644_CR17","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1016\/j.yexmp.2015.02.007","volume":"98","author":"AS Mendoza","year":"2015","unstructured":"Mendoza AS, O\u2019Leary MP, Peng SK et al (2015) Low-grade fibromyxoid sarcoma of the sigmoid colon. Exp Mol Pathol 98:300\u2013303","journal-title":"Exp Mol Pathol"},{"key":"4644_CR18","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1016\/j.ijscr.2015.06.022","volume":"14","author":"J Konecna","year":"2015","unstructured":"Konecna J, Liberale G, Haddad J et al (2015) Diffuse intra-abdominal low grade fibromyxoid sarcoma with hepatic metastases: case report and review of the literature. Int J Surg Case Rep 14:40\u201343","journal-title":"Int J Surg Case Rep"},{"key":"4644_CR19","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1002\/iju5.12718","volume":"7","author":"T Noguchi","year":"2024","unstructured":"Noguchi T, Suzuki T, Shibata Y, Koizumi M, Osaka K, Kishida T (2024) Retroperitoneal low-grade fibromyxoid sarcoma. IJU Case Rep 7:255\u2013258","journal-title":"IJU Case Rep"},{"key":"4644_CR20","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1093\/ajcp\/aqx137","volume":"149","author":"N Ud Din","year":"2018","unstructured":"Ud Din N, Ahmad Z, Zreik R, Horvai A, Folpe AL, Fritchie K (2018) Abdominopelvic and retroperitoneal low-grade fibromyxoid sarcoma: a clinicopathologic study of 13 cases. Am J Clin Pathol 149:128\u2013134","journal-title":"Am J Clin Pathol"},{"key":"4644_CR21","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1097\/PAS.0b013e318210c268","volume":"35","author":"LA Doyle","year":"2011","unstructured":"Doyle LA, M\u00f6ller E, Dal Cin P, Fletcher CD, Mertens F, Hornick JL (2011) MUC4 is a highly sensitive and specific marker for low-grade fibromyxoid sarcoma. Am J Surg Pathol 35:733\u2013741","journal-title":"Am J Surg Pathol"},{"key":"4644_CR22","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1016\/j.anndiagpath.2017.04.001","volume":"28","author":"M Mohamed","year":"2017","unstructured":"Mohamed M, Fisher C, Thway K (2017) Low-grade fibromyxoid sarcoma: Clinical, morphologic and genetic features. Ann Diagn Pathol 28:60\u201367","journal-title":"Ann Diagn Pathol"},{"key":"4644_CR23","doi-asserted-by":"publisher","first-page":"1450","DOI":"10.1097\/PAS.0b013e31822b3687","volume":"35","author":"HL Evans","year":"2011","unstructured":"Evans HL (2011) Low-grade fibromyxoid sarcoma: a clinicopathologic study of 33 cases with long-term follow-up. Am J Surg Pathol 35:1450\u20131462","journal-title":"Am J Surg Pathol"},{"issue":"1","key":"4644_CR24","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1186\/s40792-023-01662-3","volume":"9","author":"EJ Weiler","year":"2023","unstructured":"Weiler EJ, Murickan T, Drayer CN, Samat SH, Kia MA (2023) A rare case report of pancreatic low-grade fibromyxoid sarcoma (LGFMS). Surg Case Rep 9(1):123","journal-title":"Surg Case Rep"},{"key":"4644_CR25","doi-asserted-by":"publisher","first-page":"1189","DOI":"10.1016\/j.asjsur.2020.09.004","volume":"43","author":"M Yuan","year":"2020","unstructured":"Yuan M, Wang R, Zhang F, Wang L (2020) Low-grade fibromyxoid sarcoma in inguinal region: A case report. Asian J Surg 43:1189\u20131190","journal-title":"Asian J Surg"},{"key":"4644_CR26","first-page":"20","volume":"15","author":"AJ McCarthy","year":"2019","unstructured":"McCarthy AJ, Pal P, Szentgyorgyi E, De Perrot M, Howarth DJ, Dickson BC, Chetty R (2019) Primary low-grade fibromyxoid sarcoma of the large intestine with lung metastases: a case report and review of the literature. Hum Pathol: Case Rep 15:20\u201328","journal-title":"Hum Pathol: Case Rep"},{"key":"4644_CR27","doi-asserted-by":"publisher","first-page":"1025","DOI":"10.1007\/s12029-020-00369-0","volume":"51","author":"SP Kramer","year":"2020","unstructured":"Kramer SP, Bowman CJ, Wang ZJ, Sheahon KM, Nakakura EK, Cho SJ, Umetsu SE, Behr SC (2020) Hybrid low-grade fibromyxoid sarcoma and sclerosing epithelioid fibrosarcoma of the pancreas. J Gastrointest Cancer 51:1025\u20131029","journal-title":"J Gastrointest Cancer"},{"key":"4644_CR28","doi-asserted-by":"publisher","first-page":"e188","DOI":"10.1055\/a-2332-6187","volume":"14","author":"A Barger","year":"2024","unstructured":"Barger A, Vishnia M, Hanna M, Horgan R, Martins J (2024) Abdominal Fibromyxoid Sarcoma in Pregnancy: An Unusual Cause of Preterm Labor and Sepsis. Am J Perinatol Rep 14:e188\u2013e192","journal-title":"Am J Perinatol Rep"},{"key":"4644_CR29","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13000-019-0905-2","volume":"15","author":"J Huang","year":"2020","unstructured":"Huang J, Cohen S, Jour G (2020) Primary small intestine mesenteric low-grade fibromyxoid sarcoma with foci of atypical epithelioid whorls and diffuse DOG1 expression: a case report. Diagn Pathol 15:1\u20137","journal-title":"Diagn Pathol"},{"key":"4644_CR30","doi-asserted-by":"publisher","first-page":"607","DOI":"10.1016\/j.pathol.2020.04.010","volume":"52","author":"KA Murshed","year":"2020","unstructured":"Murshed KA, Ammar A (2020) Hybrid sclerosing epithelioid fibrosarcoma\/low grade fibromyxoid sarcoma arising in the small intestine with distinct HEY1-NCOA2 gene fusion. Pathology 52:607\u2013610","journal-title":"Pathology"},{"key":"4644_CR31","doi-asserted-by":"crossref","unstructured":"Mu\u00f1oz-Leija MA, Alem\u00e1n-Jim\u00e9nez MC, Plata-\u00c1lvarez H, Menes-Ram\u00edrez G (2023) Low-Grade Fibromyxoid Sarcoma of the Abdominal Wall: A Clinical Case Report. Cureus. ;15(3)","DOI":"10.7759\/cureus.35699"},{"key":"4644_CR32","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12957-017-1174-8","volume":"15","author":"LK Ban","year":"2017","unstructured":"Ban LK, Tseng AH, Huang SH, Lee HH (2017) Low-grade fibromyxoid sarcoma of the external anal sphincter: a case report. World J Surg Oncol 15:1\u20134","journal-title":"World J Surg Oncol"},{"key":"4644_CR33","doi-asserted-by":"publisher","first-page":"175","DOI":"10.12998\/wjcc.v9.i1.175","volume":"9","author":"V Dugalic","year":"2021","unstructured":"Dugalic V, Ignjatovic II, Kovac JD, Ilic N, Sopta J, Ostojic SR, Vasin D, Bogdanovic MD, Dumic I, Milovanovic T (2021) Low-grade fibromyxoid sarcoma of the liver: A case report. World J Clin Cases 9:175","journal-title":"World J Clin Cases"},{"key":"4644_CR34","doi-asserted-by":"publisher","first-page":"203636131877703","DOI":"10.1177\/2036361318777031","volume":"10","author":"B Geramizadeh","year":"2018","unstructured":"Geramizadeh B, Zare Z, Dehghanian AR, Bolandparvaz S, Marzban M (2018) Huge mesenteric low-grade fibromyxoid sarcoma: A case report and review of the literature. Rare Tumors 10:2036361318777031","journal-title":"Rare Tumors"},{"key":"4644_CR35","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1007\/s12262-017-1698-8","volume":"80","author":"R Bhattar","year":"2018","unstructured":"Bhattar R, Aggarwal SP, Yadav SS, Tomar V (2018) Primary Low-Grade Fibromyxoid Sarcoma of Kidney-an Extremely Rare Entity. Indian J Surg 80:281\u2013283","journal-title":"Indian J Surg"},{"key":"4644_CR36","doi-asserted-by":"publisher","first-page":"1125","DOI":"10.1097\/PAS.0000000000002441","volume":"49","author":"F Repetto","year":"2025","unstructured":"Repetto F, Odintsov I, Sholl LM, Hornick JL, Anderson WJ (2025) MUC4-positive Fibroblastoma: A Distinctive Hyalinized Spindle Cell Neoplasm with Aberrant Nuclear Beta-catenin Expression and Frequent Biallelic Inactivation of APC. Am J Surg Pathol 49:1125\u20131132","journal-title":"Am J Surg Pathol"},{"key":"4644_CR37","doi-asserted-by":"publisher","first-page":"1586","DOI":"10.1016\/j.humpath.2009.04.003","volume":"40","author":"K Thway","year":"2009","unstructured":"Thway K, Fisher C, Debiec-Rychter M, Calonje E (2009) Claudin-1 is expressed in perineurioma-like low-grade fibromyxoid sarcoma. Hum Pathol 40:1586\u20131590","journal-title":"Hum Pathol"},{"key":"4644_CR38","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1007\/s00428-024-03995-2","volume":"486","author":"LM Warmke","year":"2025","unstructured":"Warmke LM, Ameline B, Fritchie KJ, Dehner CA, Agaimy A, Din NU, Miettinen MM, Dermawan JK, Gross JM, Thangaiah JJ, Chrisinger JSA, Suster DI, Perret R, Le Loarer F, Charville GW, Buehler D, Yeung MCF, Smith BF, Baumhoer D, Davis JL (2025) YAP1::KMT2A-rearranged sarcomas harbor a unique methylation profile and are distinct from sclerosing epithelioid fibrosarcoma and low-grade fibromyxoid sarcoma. Virchows Arch 486:457\u2013477","journal-title":"Virchows Arch"},{"key":"4644_CR39","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1097\/PAS.0000000000002520","volume":"50","author":"F Malik","year":"2026","unstructured":"Malik F, Vong M, Dehner CA, Shi Z, Karanian M, Pissaloux D, Pinto SN, Blackburn PR, Tran QT, Orr BA, Koo SC (2026) Novel EPS15:: KLF17 and EPS15L1 :: KLF17 Fusions Define a Distinctive Group of MUC4-Positive Spindled to Epithelioid Sarcomas. Am J Surg Pathol 50:501\u2013512","journal-title":"Am J Surg Pathol"}],"container-title":["Virchows Archiv"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00428-026-04644-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00428-026-04644-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00428-026-04644-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T05:28:40Z","timestamp":1784957320000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00428-026-04644-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,25]]},"references-count":39,"alternative-id":["4644"],"URL":"https:\/\/doi.org\/10.1007\/s00428-026-04644-6","relation":{},"ISSN":["0945-6317","1432-2307"],"issn-type":[{"value":"0945-6317","type":"print"},{"value":"1432-2307","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,25]]},"assertion":[{"value":"21 April 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 June 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 July 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 July 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Samples were used in accordance with ethical guidelines for the use of retrospective tissue samples provided by the local ethics committee of the Friedrich-Alexander University Erlangen-Nuremberg (ethics committee statements 24.01.2005 and 18.01.2012). Informed consent was obtained for publishing this case.","order":1,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"AA is the Editor-in-Chief of Virchows Archiv. The authors have no financial or non-financial conflicts of interest to disclose.","order":2,"name":"Ethics","label":"Conflicts of interest","group":{"name":"EthicsHeading","label":"Declarations"}}]}}