Abstract
INTRODUCTION AND IMPORTANCE: Myopericytoma (MPC) is a rare soft tissue tumor that typically occurs in the extremities or distal limbs. These tumors are usually slow-growing, painless, and measure <2 cm on average. While generally benign, they can lead to complications if misdiagnosed. Surgical excision is the definitive treatment. PRESENTATION OF CASE: A 15-year-old female from southern China presented with a painless mass in her right thigh, which had persisted for three years. Imaging revealed a mass measuring approximately 8.5 cm, initially suspected to be a synovial sarcoma. Magnetic resonance imaging (MRI) showed a large, irregular soft tissue mass adjacent to the lower femur with heterogeneous signal intensity. Surgical excision was performed, and histopathological analysis confirmed the diagnosis of MPC. CLINICAL DISCUSSION: MPC is rare and often misdiagnosed owing to its nonspecific clinical and radiological features. This case is notable for the size of the mass, which exceeds the typical size of MPCs, making it the largest reported case of lower extremity MPC in Asia. A definitive diagnosis is made through histopathological examination, and surgical excision remains the gold standard treatment. Given its rarity, early recognition and accurate diagnosis are essential to avoid mismanagement. CONCLUSION: This case highlights the rarity of MPC and underscores the necessity of comprehensive diagnostic evaluation. Surgical excision is essential for symptom resolution and complication prevention.