Epithelioid sarcoma pulmonary metastases

Case contributed by Dr Maxim Stalkov

Presentation

Chest pain, cough and haemoptysis. Previous resection of finger lesion few years ago then histologically identified as "inflammatory pseudotumor".

Patient Data

Age: 30
Gender: Female
Modality: CT

Multiple cystic lesions accompanied by ill-defined nodules and a dominant solid mass in the right upper lobe. Peri-lesional ground-glass changes are demonstrated. Small left-sided pneumothorax.

Findings consistent with cystic and solid haemorrhagic pulmonary metastases, complicated by pneumothorax.

Biopsy revealed epithelioid sarcoma metastases.

Case Discussion

Epithelioid sarcoma is a rare soft tissue tumor with unclear histogenesis that represents the most common soft tissue sarcoma of a hand. This tumor is often mistaken for a chronic inflammatory process or necrotizing granuloma due to its innocuous presentation as well as unusual both epithelial and mesenchymal diffirentiation (vimentin and cytokeratin 8 IHC stains were positive). Epithelioid sarcoma has known propensity for pulmonary metastases, which can present as cystic lesions and be complicated by development of pneumothorax and haemorrhage. 

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Case Information

rID: 36550
Case created: 29th Apr 2015
Last edited: 27th Sep 2015
System: Chest
Inclusion in quiz mode: Included

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